22 research outputs found
Effective index approximations of photonic crystal slabs: a 2-to-1-D assessment
The optical properties of slab-like photonic crystals are often discussed on the basis of effective index (EI) approximations, where a 2-D effective refractive index profile replaces the actual 3-D structure. Our aim is to assess this approximation by analogous steps that reduce finite 2-D waveguide Bragg-gratings (to be seen as sections through 3-D PC slabs and membranes) to 1-D problems, which are tractable by common transfer matrix methods. Application of the EI method is disputable in particular in cases where locally no guided modes are supported, as in the holes of a PC membrane. A variational procedure permits to derive suitable effective permittivities even in these cases. Depending on the structural properties, these values can well turn out to be lower than one, or even be negative. Both the âstandardâ and the variational procedures are compared with reference data, generated by a rigorous 2-D Helmholtz solver, for a series of example structures.\u
FORMATION OF THE PROJECT COMPETENCE OF FUTURE SPECIALISTS IN INFORMATION, LIBRARY AND ARCHIVE SERVICES IN A DIGITAL SOCIETY
The article substantiates the importance of forming the project competence of future specialists in information, library and archive services with the help of the project management information systems. The essence of project development in the library sphere is specified. The key features of the project activity of specialists in information, library and archive services under the conditions of digitalization, as well as the specifics of its informatization, are analyzed. The special features of project management as a component of library management are described. Some project management information systems are characterized. The structure of library workersâ project competence (value-motivational (axiological), knowledge-content (cognitive), technological (activity-practical) components) is specified. The value-motivational component is determined by a set of stable motives (personal, cognitive, professional ones) and suggests a conscious positive attitude to the project activity automation, readiness for its implementation. The knowledge-content component assumes having knowledge of the project activity automation. The technological component includes the ability to perform the project activity automation, to feel free in the information environment, etc. The results of the experimental verification of the efficiency of pedagogical conditions in order to form the project competence of future specialists in information, library and archive services (illustrated by the implementation of the authorâs special course "Information Systems for Project Management in the Professional Activities of Information, Library and Archive Specialists") are presented. The implementation of the author's special course has visualized certain positive changes in the levels of the project competence development of students in experimental groups compared with those in control ones. The results of the obtained data analysis made it possible to ascertain the positive dynamics of changes in the quantitative indicators of the levels of the project competence development of future specialists in librarianship
Therapeutic strategy in patients with long-lasting essential hypertension with comorbid type 2 diabetes mellitus and obesity
Background: Presently the level of blood pressure (BP) control is extremely unsatisfactory in hypertensive patients throughout the world. The aim of our study was to find the optimal drug therapy for patients with hard-to-treat essential hypertension (EH) associated with type 2 diabetes mellitus (T2DM) and obesity, namely the comparison of strategies of fixed and non-fixed combination.
Material and methods: Eighty-seven patients with EH, T2DM and obesity were enrolled into the study. Two groups were formed: the 1st group â 41 patients received antihypertensive therapy in the form of unfixed combination of drugs (âmulti-pillâ) perindopril, indapamide and amlodipine; the 2nd â 46 patients, who received the same drugs, but in a fixed-dose combination (âsingle pillâ).
Results: A favorable treatment result was found for fixed-dose combination of antihypertensive drugs, with significant reduction in the frequency of visits to the doctor: relative risk (RR) â 1.27 (95% CI: 1.01â1.61), p = 0.045, and odds ratio (OR) â 3.10 (95% CI: 1.05â9.13), p = 0.04. That indicates that patients on fixed-dose combination were less likely to visit a doctor with complaints. Patients on single-pill therapy were less likely to get to progression (worsening) group in contrast to multi-pill non-fixed combination: RR â 1.37 (95% CI: 1.02â1.84), p = 0.03; OR â 2.91 (95% CI: 1.12â7.59), p = 0.03.
Conclusion: The single-pill triple combination has significant advantage compared to multi-pill regimen in hard-totreat hypertensive patients with comorbid T2DM and obesity. Fixed-dose triple combination leads to significantly faster achievement of blood pressure control
ĐĐŸĐœŃДпŃŃĐ°Đ»ŃĐœŃĐ” ĐŸŃĐœĐŸĐČŃ ŃĐ”ĐłĐžĐŸĐœĐ°Đ»ŃĐœĐŸĐč ĐŸĐ±ŃĐ°Đ·ĐŸĐČĐ°ŃДлŃĐœĐŸĐč ĐżĐŸĐ»ĐžŃĐžĐșĐž
ĐŁ ĐŒĐŸĐœĐŸĐłŃĐ°ŃŃŃ ĐČĐžŃĐČŃŃĐ»Đ”ĐœĐŸ ĐșĐŸĐœŃДпŃŃĐ°Đ»ŃĐœŃ Đ·Đ°ŃĐ°ĐŽĐž ŃДгŃĐŸĐœĐ°Đ»ŃĐœĐŸŃ ĐŸŃĐČŃŃĐœŃĐŸŃ ĐżĐŸĐ»ŃŃĐžĐșĐž, ĐŸĐ±âŃĐșŃĐžĐČĐŸĐČĐ°ĐœŃ ĐČ ŃĐ”ĐŸŃĐ”ŃĐžŃĐœĐŸĐŒŃ ĐŸĐżĐžŃŃ ĐŸŃĐœĐŸĐČĐœĐžŃ
ĐżŃĐŽŃ
ĐŸĐŽŃĐČ, ĐżŃĐžĐœŃОпŃĐČ, ŃĐŒĐŸĐČ ŃДалŃĐ·Đ°ŃŃŃ ĐșĐŸĐœŃДпŃŃŃ ĐœĐ°ĐČŃĐ°ĐœĐœŃ ĐČĐżŃĐŸĐŽĐŸĐČж жОŃŃŃ ŃĐș ŃĐžĐœĐœĐžĐșĐ° ŃДгŃĐŸĐœĐ°Đ»ŃĐœĐŸŃ ŃĐŸĐ·ĐČĐžŃĐșŃ. ĐŃĐŸĐ°ĐœĐ°Đ»ŃĐ·ĐŸĐČĐ°ĐœĐŸ ĐŸŃĐœĐŸĐČĐœŃ ĐżĐ”ŃДЎŃĐŒĐŸĐČĐž ŃĐŸĐ·ŃĐŸĐ±Đ»Đ”ĐœĐœŃ ĐșĐŸĐœŃДпŃŃŃ ĐŸŃĐČŃŃĐž ĐČĐżŃĐŸĐŽĐŸĐČж жОŃŃŃ Ń ŃĐČŃŃŃ ŃĐ° ŃĐŸŃŃĐ°Đ»ŃĐœĐŸ-Đ”ĐșĐŸĐœĐŸĐŒŃŃĐœŃ ŃДзŃĐ»ŃŃĐ°ŃĐž ŃŃ ŃĐżŃĐŸĐČĐ°ĐŽĐ¶Đ”ĐœĐœŃ. ĐĐžĐșĐ»Đ°ĐŽĐ”ĐœĐŸ ĐŸŃĐŸĐ±Đ»ĐžĐČĐŸŃŃŃ ŃĐ° ŃпДŃĐžŃŃĐșŃ ĐŸŃĐČŃŃĐž ĐČĐżŃĐŸĐŽĐŸĐČж жОŃŃŃ, ĐŸŃĐČŃŃĐž ĐŽĐŸŃĐŸŃлОŃ
ŃĐș ŃŃ ŃĐșĐ»Đ°ĐŽĐŸĐČĐŸŃ ĐČ ŃĐŒĐŸĐČĐ°Ń
ŃДгŃĐŸĐœĐ°Đ»ŃĐœĐŸĐłĐŸ ŃĐŸĐ·ĐČĐžŃĐșŃ (ĐœĐ°ŃŃĐŸĐœĐ°Đ»ŃĐœĐžĐč Ń Đ·Đ°ŃŃбŃĐ¶ĐœĐžĐč ĐŽĐŸŃĐČŃĐŽ). ĐŃ
Đ°ŃĐ°ĐșŃĐ”ŃĐžĐ·ĐŸĐČĐ°ĐœĐŸ ĐżŃĐžŃ
ĐŸĐ»ĐŸĐłŃŃĐœŃ ĐŸŃĐŸĐ±Đ»ĐžĐČĐŸŃŃŃ ŃĐŸĐ·ĐČĐžŃĐșŃ ĐŸŃĐŸĐ±ĐžŃŃĐŸŃŃŃ ĐČ ĐŽĐŸŃĐŸŃĐ»ĐŸĐŒŃ ĐČŃŃŃ, Đ° ŃĐ°ĐșĐŸĐ¶ ĐżŃĐŸŃĐ”ŃŃĐčĐœĐŸĐłĐŸ ŃŃĐ°ĐœĐŸĐČĐ»Đ”ĐœĐœŃ ĐŸŃĐŸĐ±ĐžŃŃĐŸŃŃŃ ĐœĐ° ŃŃĐ·ĐœĐžŃ
Đ”ŃапаŃ
ĐŽĐŸŃĐŸŃĐ»ĐŸŃŃŃ. ĐĐžŃĐČŃŃĐ»Đ”ĐœĐŸ ŃĐŸĐ»Ń ĐœĐ”ŃĐŸŃĐŒĐ°Đ»ŃĐœĐŸŃ ĐŸŃĐČŃŃĐž ĐŽĐŸŃĐŸŃлОŃ
ŃĐș ŃĐžĐœĐœĐžĐșĐ° ŃĐŸĐ·ĐČĐžŃĐșŃ ŃДгŃĐŸĐœŃĐČ, ŃĐŸ ĐœĐ°ĐČŃĐ°ŃŃŃŃŃ, Đ° ŃĐ°ĐșĐŸĐ¶ ĐŒĐ”Ń
Đ°ĐœŃĐ·ĐŒĐž ŃĐŸĐ·ŃĐŸĐ±Đ»Đ”ĐœĐœŃ ŃĐ° ŃДалŃĐ·Đ°ŃŃŃ ĐșĐŸĐœŃДпŃŃŃ ĐŒŃŃŃĐ°, ŃДгŃĐŸĐœŃ, ŃĐŸ ĐœĐ°ĐČŃĐ°ŃŃŃŃŃ. ĐĐœŃĐ”ŃĐżŃĐ”ŃĐŸĐČĐ°ĐœĐŸ ŃДзŃĐ»ŃŃĐ°ŃĐž ŃĐŸŃŃĐŸĐ»ĐŸĐłŃŃĐœĐŸĐłĐŸ ĐŽĐŸŃĐ»ŃĐŽĐ¶Đ”ĐœĐœŃ ĐșŃĐ»ŃŃŃŃĐœĐŸ-ĐŸŃĐČŃŃĐœŃŃ
ĐżĐŸŃŃДб жОŃДлŃĐČ ĐĐ°ĐżĐŸŃŃĐ·ŃĐșĐŸŃ ĐŸĐ±Đ». ŃĐ° ŃŃĐČĐœŃ ŃŃ
Đ·Đ°ĐŽĐŸĐČĐŸĐ»Đ”ĐœĐŸŃŃŃ.The monograph describes the conceptual foundations of regional educational policy, objectified in the theoretical description of the main approaches, principles, conditions to implement the lifelong learning concept as a factor of regional development. The basic prerequisites for the development of lifelong learning concept in the world and the socio-economic results of its implementation are analyzed. The peculiarities and specifics of lifelong learning, education of adults as a part of it in the conditions of regional development (national and foreign experience) are described. The psychological peculiarities of personality development in adulthood as well as professional development of personality at different stages of adolescence are characterized. The role of non-formal adults education as a factor of learning regions development as well as mechanisms of the city development and implementation of the concept is highlighted. The results of sociological research of cultural and educationalneeds of Zaporizhzhya region's residents and their level of satisfaction are interpreted.Đ ĐŒĐŸĐœĐŸĐłŃĐ°ŃОО ĐŸŃĐČĐ”ŃĐ”ĐœŃ ĐșĐŸĐœŃДпŃŃĐ°Đ»ŃĐœŃĐ” ĐŸŃĐœĐŸĐČŃ ŃĐ”ĐłĐžĐŸĐœĐ°Đ»ŃĐœĐŸĐč ĐŸĐ±ŃĐ°Đ·ĐŸĐČĐ°ŃДлŃĐœĐŸĐč ĐżĐŸĐ»ĐžŃĐžĐșĐž, ĐŸĐ±ŃĐ”ĐșŃĐžĐČĐžŃĐŸĐČĐ°ĐœĐœŃĐ” ĐČ ŃĐ”ĐŸŃĐ”ŃĐžŃĐ”ŃĐșĐŸĐŒ ĐŸĐżĐžŃĐ°ĐœĐžĐž ĐŸŃĐœĐŸĐČĐœŃŃ
ĐżĐŸĐŽŃ
ĐŸĐŽĐŸĐČ, ĐżŃĐžĐœŃĐžĐżĐŸĐČ, ŃŃĐ»ĐŸĐČĐžĐč ŃДалОзаŃОО ĐșĐŸĐœŃДпŃОО ĐœĐ”ĐżŃĐ”ŃŃĐČĐœĐŸĐłĐŸ ĐŸĐ±ŃŃĐ”ĐœĐžŃ ĐșĐ°Đș ŃĐ°ĐșŃĐŸŃĐ° ŃĐ”ĐłĐžĐŸĐœĐ°Đ»ŃĐœĐŸĐłĐŸ ŃĐ°Đ·ĐČĐžŃĐžŃ. ĐŃĐŸĐ°ĐœĐ°Đ»ĐžĐ·ĐžŃĐŸĐČĐ°ĐœŃ ĐŸŃĐœĐŸĐČĐœŃĐ” ĐżŃĐ”ĐŽĐżĐŸŃŃĐ»ĐșĐž ĐŽĐ»Ń ŃĐ°Đ·ŃĐ°Đ±ĐŸŃĐșĐž ĐșĐŸĐœŃДпŃОО ĐŸĐ±ŃŃĐ”ĐœĐžŃ ĐœĐ° ĐżŃĐŸŃŃĐ¶Đ”ĐœĐžĐž ĐČŃĐ”Đč Đ¶ĐžĐ·ĐœĐž ĐČ ĐŒĐžŃĐ” Đž ŃĐŸŃОалŃĐœĐŸ-ŃĐșĐŸĐœĐŸĐŒĐžŃĐ”ŃĐșĐžŃ
ŃДзŃĐ»ŃŃĐ°ŃĐŸĐČ Đ”Đ” ŃДалОзаŃОО. ĐпОŃĐ°ĐœŃ ĐŸŃĐŸĐ±Đ”ĐœĐœĐŸŃŃĐž Đž ŃпДŃĐžŃĐžĐșĐ° ĐŸĐ±ŃŃĐ”ĐœĐžŃ ĐœĐ° ĐżŃĐŸŃŃĐ¶Đ”ĐœĐžĐž ĐČŃĐ”Đč Đ¶ĐžĐ·ĐœĐž, ĐŸĐ±ŃĐ°Đ·ĐŸĐČĐ°ĐœĐžŃ ĐČĐ·ŃĐŸŃĐ»ŃŃ
ĐșĐ°Đș Đ”ĐłĐŸ ŃĐŸŃŃĐ°ĐČĐ»ŃŃŃĐ”Đč ĐČ ŃŃĐ»ĐŸĐČĐžŃŃ
ŃĐ”ĐłĐžĐŸĐœĐ°Đ»ŃĐœĐŸĐłĐŸ ŃĐ°Đ·ĐČĐžŃĐžŃ (ĐœĐ°ŃĐžĐŸĐœĐ°Đ»ŃĐœŃĐč Đž Đ·Đ°ŃŃĐ±Đ”Đ¶ĐœŃĐč ĐŸĐżŃŃ). ĐŃ
Đ°ŃĐ°ĐșŃĐ”ŃĐžĐ·ĐŸĐČĐ°ĐœŃ ĐżŃĐžŃ
ĐŸĐ»ĐŸĐłĐžŃĐ”ŃĐșОД ĐŸŃĐŸĐ±Đ”ĐœĐœĐŸŃŃĐž ŃĐ°Đ·ĐČĐžŃĐžŃ Đ»ĐžŃĐœĐŸŃŃĐž ĐČĐŸ ĐČĐ·ŃĐŸŃĐ»ĐŸĐŒ ĐČĐŸĐ·ŃĐ°ŃŃĐ”, Đ° ŃĐ°ĐșжД ĐżŃĐŸŃĐ”ŃŃĐžĐŸĐœĐ°Đ»ŃĐœĐŸĐ” ŃĐ°Đ·ĐČĐžŃОД лОŃĐœĐŸŃŃĐž ĐœĐ° ŃĐ°Đ·ĐœŃŃ
ŃŃапаŃ
ĐżĐŸĐŽŃĐŸŃŃĐșĐŸĐČĐŸĐłĐŸ ĐČĐŸĐ·ŃĐ°ŃŃĐ°. ĐŃĐČĐ”ŃĐ”ĐœĐ° ŃĐŸĐ»Ń ĐœĐ”ŃĐŸŃĐŒĐ°Đ»ŃĐœĐŸĐłĐŸ ĐŸĐ±ŃĐ°Đ·ĐŸĐČĐ°ĐœĐžŃ ĐČĐ·ŃĐŸŃĐ»ŃŃ
ĐșĐ°Đș ŃĐ°ĐșŃĐŸŃĐ° ŃĐ°Đ·ĐČĐžŃĐžŃ ĐŸĐ±ŃŃĐ°ŃŃĐžŃ
ŃŃ ŃĐ”ĐłĐžĐŸĐœĐŸĐČ, Đ° ŃĐ°ĐșжД ĐŒĐ”Ń
Đ°ĐœĐžĐ·ĐŒŃ ŃĐ°Đ·ŃĐ°Đ±ĐŸŃĐșĐž Đž ŃДалОзаŃОО ĐșĐŸĐœŃДпŃОО ĐŸĐ±ŃŃĐ°ŃŃĐžŃ
ŃŃ ĐłĐŸŃĐŸĐŽĐŸĐČ
Reorienting adolescent sexual and reproductive health research: reflections from an international conference
On December 4th 2014, the International Centre for Reproductive Health (ICRH) at Ghent University organized an
international conference on adolescent sexual and reproductive health (ASRH) and well-being. This viewpoint
highlights two key messages of the conference - 1) ASRH promotion is broadening on different levels and 2) this
broadening has important implications for research and interventions â that can guide this research field into
the next decade. Adolescent sexuality has long been equated with risk and danger. However, throughout the
presentations, it became clear that ASRH and related promotion efforts are broadening on different levels: from
risk to well-being, from targeted and individual to comprehensive and structural, from knowledge transfer to
innovative tools. However, indicators to measure adolescent sexuality that should accompany this broadening
trend, are lacking. While public health related indicators (HIV/STIs, pregnancies) and their behavioral proxies (e.g.
condom use, number of partners) are well developed and documented, there is a lack of consensus on indicators
for the broader construct of adolescent sexuality, including sexual well-being and aspects of positive sexuality.
Furthermore, the debate during the conference clearly indicated that experimental designs may not be the only
appropriate study design to measure effectiveness of comprehensive, context-specific and long-term ASRH
programmes, and that alternatives need to be identified and applied. Presenters at the conference clearly
expressed the need to develop validated tools to measure different sub-constructs of adolescent sexuality and
environmental factors. There was a plea to combine (quasi-)experimental effectiveness studies with evaluations
of the development and implementation of ASRH promotion initiatives.IS
Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia
BACKGROUND
Patients with elevated triglyceride levels are at increased risk for ischemic events. Icosapent
ethyl, a highly purified eicosapentaenoic acid ethyl ester, lowers triglyceride levels, but data
are needed to determine its effects on ischemic events.
METHODS
We performed a multicenter, randomized, double-blind, placebo-controlled trial involving
patients with established cardiovascular disease or with diabetes and other risk factors, who
had been receiving statin therapy and who had a fasting triglyceride level of 135 to 499 mg
per deciliter (1.52 to 5.63 mmol per liter) and a low-density lipoprotein cholesterol level of
41 to 100 mg per deciliter (1.06 to 2.59 mmol per liter). The patients were randomly assigned
to receive 2 g of icosapent ethyl twice daily (total daily dose, 4 g) or placebo. The primary
end point was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal
stroke, coronary revascularization, or unstable angina. The key secondary end point was a
composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke.
RESULTS
A total of 8179 patients were enrolled (70.7% for secondary prevention of cardiovascular
events) and were followed for a median of 4.9 years. A primary end-point event occurred in
17.2% of the patients in the icosapent ethyl group, as compared with 22.0% of the patients
in the placebo group (hazard ratio, 0.75; 95% confidence interval [CI], 0.68 to 0.83; P<0.001);
the corresponding rates of the key secondary end point were 11.2% and 14.8% (hazard ratio,
0.74; 95% CI, 0.65 to 0.83; P<0.001). The rates of additional ischemic end points, as assessed
according to a prespecified hierarchical schema, were significantly lower in the icosapent
ethyl group than in the placebo group, including the rate of cardiovascular death (4.3% vs.
5.2%; hazard ratio, 0.80; 95% CI, 0.66 to 0.98; P=0.03). A larger percentage of patients in
the icosapent ethyl group than in the placebo group were hospitalized for atrial fibrillation
or flutter (3.1% vs. 2.1%, P=0.004). Serious bleeding events occurred in 2.7% of the patients
in the icosapent ethyl group and in 2.1% in the placebo group (P=0.06).
CONCLUSIONS
Among patients with elevated triglyceride levels despite the use of statins, the risk of ischemic events, including cardiovascular death, was significantly lower among those who received 2 g of icosapent ethyl twice daily than among those who received placebo. (Funded
by Amarin Pharma; REDUCE-IT ClinicalTrials.gov number, NCT01492361
ĐĐ°ŃŃĐŸĐœĐ°Đ»ŃĐœĐ° ĐŽĐŸĐżĐŸĐČŃĐŽŃ ĐżŃĐŸ ŃŃĐ°Đœ Ń ĐżĐ”ŃŃпДĐșŃĐžĐČĐž ŃĐŸĐ·ĐČĐžŃĐșŃ ĐŸŃĐČŃŃĐž ĐČ ĐŁĐșŃĐ°ŃĐœŃ: ĐŒĐŸĐœĐŸĐłŃĐ°ŃŃŃ (ĐĐŸ 30-ŃŃŃŃŃ ĐœĐ”Đ·Đ°Đ»Đ”Đ¶ĐœĐŸŃŃŃ ĐŁĐșŃĐ°ŃĐœĐž)
The publication provides a comprehensive analysis of the state and development of national education over the 30 years of Ukraineâs independence, identifies current problems in education, ascertains the causes of their emergence, offers scientifically reasoned ways to modernise domestic education in the context of globalisation, European integration, innovative development, and national self-identification.
Designed for legislators, state officials, education institutions leaders, teaching and academic staff, the general public, all those who seek to increase the competitiveness of Ukrainian education in the context of civilisation changes.ĐŁ ĐČĐžĐŽĐ°ĐœĐœŃ Đ·ĐŽŃĐčŃĐœĐ”ĐœĐŸ ĐČŃДбŃŃĐœĐžĐč Đ°ĐœĐ°Đ»ŃĐ· ŃŃĐ°ĐœŃ Ń ŃĐŸĐ·ĐČĐžŃĐșŃ ĐœĐ°ŃŃĐŸĐœĐ°Đ»ŃĐœĐŸŃ ĐŸŃĐČŃŃĐž Đ·Đ° 30-ŃŃŃĐœĐžĐč пДŃŃĐŸĐŽ ĐœĐ”Đ·Đ°Đ»Đ”Đ¶ĐœĐŸŃŃŃ ĐŁĐșŃĐ°ŃĐœĐž, ĐČĐžĐ·ĐœĐ°ŃĐ”ĐœĐŸ Đ°ĐșŃŃĐ°Đ»ŃĐœŃ ĐżŃĐŸĐ±Đ»Đ”ĐŒĐž ĐŸŃĐČŃŃĐœŃĐŸŃ ŃŃĐ”ŃĐž, ĐČĐžŃĐČĐ»Đ”ĐœĐŸ ĐżŃĐžŃĐžĐœĐž ŃŃ
ĐČĐžĐœĐžĐșĐœĐ”ĐœĐœŃ, Đ·Đ°ĐżŃĐŸĐżĐŸĐœĐŸĐČĐ°ĐœĐŸ ĐœĐ°ŃĐșĐŸĐČĐŸ ĐŸĐ±ÒŃŃĐœŃĐŸĐČĐ°ĐœŃ ŃĐ»ŃŃ
Đž ĐŒĐŸĐŽĐ”ŃĐœŃĐ·Đ°ŃŃŃ ĐČŃŃŃĐžĐ·ĐœŃĐœĐŸŃ ĐŸŃĐČŃŃĐž ĐČ ŃĐŒĐŸĐČĐ°Ń
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Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial
Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18â85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25â75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300â5000 mg/g who had received maximum labelled or tolerated reninâangiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for â„30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for â„90 days, chronic dialysis for â„90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4â2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49â0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85â2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75â1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie
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EPMA-World Congress 2015: Bonn, Germany. 3-5 September 2015
Table of contents A1 Predictive and prognostic biomarker panel for targeted application of radioembolisation improving individual outcomes in hepatocellular carcinoma Jella-Andrea Abraham, Olga Golubnitschaja A2 Integrated market access approach amplifying value of âRx-CDxâ Ildar Akhmetov A3 Disaster response: an opportunity to improve global healthcare Russell J. Andrews, Leonidas Quintana A4 USA PPPM: proscriptive, profligate, profiteering medicine-good for 1 % wealthy, not for 99 % unhealthy Russell J. Andrews A5 The role of IDO in a murine model of gingivitis: predictive and therapeutic potentials Babak Baban, Jun Yao Liu, Xu Qin, Tailing Wang, Mahmood S. Mozaffari A6 Specific diets for personalised treatment of diabetes type 2 Viktoriia V. Bati, Tamara V. Meleshko, Olga B. Levchuk, Nadiya V. Boyko A7 Towards personalized physiotherapeutic approach Joanna Bauer, Ewa Boerner, Halina Podbielska A8 Cells, animal, SHIME and in silico models for detection and verification of specific biomarkers of non-communicable chronic diseases Alojz Bomba, Viktor O. Petrov, Volodymyr G. Drobnych, Rostyslav V. Bubnov, Oksana M. Bykova, Nadiya V. Boyko A9 INTERACT-chronic care model: Self-treatment by patients with decision support e-Health solution Hans-Peter Brunner-La Rocca, Lutz Fleischhacker, Olga Golubnitschaja, Frank Heemskerk, Thomas Helms, Tiny Jaarsma, Judita Kinkorova, Jan Ramaekers, Peter Ruff, Ivana Schnur, Emilio Vanoli, Jose Verdu A10 PPPM in cardiovascular medicine in 2015 Hans-Peter Brunner-La Rocca A11 Magnetic resonance imaging of nanoparticles in mice, potential for theranostic and contrast media development â pilot results Rostyslav V. Bubnov, Sergiy A. Grabovetskyi, Olena M. Mykhalchenko, Natalia O. Tymoshok, Oleksandr B. Shcherbakov, Igor P. Semeniv, Mykola Y. Spivak A12 Ultrasound diagnosis for diabetic neuropathy - comparative study Rostyslav V. Bubnov, Tetyana V. Ostapenko A13 Ultrasound for stratification patients with diabetic foot ulcers for prevention and personalized treatment - pilot results Rostyslav V. Bubnov, Nazarii M. Kobyliak, Nadiya M. Zholobak, Mykola Ya. Spivak A14 Project ImaGenX â designing and executing a questionnaire on environment and lifestyle risk of breast cancer John Paul Cauchi A15 Genomics â a new structural brand of predictive, preventive and personalized medicine or the new driver as well? Dmitrii Cherepakhin, Marina Bakay, Artem Borovikov, Sergey Suchkov A16 Survey of questionnaires for evaluation of the quality of life in various medical fields Barbara CieĆlik, Agnieszka Migasiewicz, Maria-Luiza Podbielska, Markus Pelleter, Agnieszka Giemza, Halina Podbielska A17 Personalized molecular treatment for muscular dystrophies Sebahattin Cirak A18 Secondary mutations in circulating tumour DNA for acquired drug resistance in patients with advanced ALK + NSCLC Marzia Del Re, Paola Bordi, Valentina Citi, Marta Palombi, Carmine Pinto, Marcello Tiseo, Romano Danesi A19 Recombinant species-specific FcΔRI alpha proteins for diagnosis of IgE-mediated allergies in dogs, cats and horses Lukas Einhorn, Judit Fazekas, Martina Muhr, Alexandra Schoos, Lucia Panakova, Ina Herrmann, Krisztina Manzano-Szalai, Kumiko Oida, Edda Fiebiger, Josef Singer, Erika Jensen-Jarolim A20 Global methodology for developmental neurotoxicity testing in humans and animals early and chronically exposed to chemical contaminants ArpinĂ© A. Elnar, Nadia Ouamara, Nadiya Boyko, Xavier Coumoul, Jean-Philippe Antignac, Bruno Le Bizec, Gauthier Eppe, Jenny Renaut, Torsten Bonn, CĂ©dric Guignard, Margherita Ferrante, Maria Liusa Chiusano, Salvatore Cuzzocrea, Gerard O'Keeffe, John Cryan, Michelle Bisson, Amina Barakat, Ihsane Hmamouchi, Nasser Zawia, Anumantha Kanthasamy, Glen E. Kisby, Rui Alves, Oscar Villacañas PĂ©rez, Kim Burgard, Peter Spencer, Norbert Bomba, Martin Haranta, Nina Zaitseva, Irina May, StĂ©phanie Grojean, Mathilde Body-Malapel, Florencia Harari, Raul Harari, Kristina Yeghiazaryan, Olga Golubnitschaja, Vittorio Calabrese, Christophe Nemos, Rachid Soulimani A21 Mental indicators at young people with attributes hypertension and pre-hypertension Maria E. Evsevyeva, Elena A. Mishenko, Zurida V. Kumukova, Evgeniy V. Chudnovsky, Tatyana A. Smirnova A22 On the approaches to the early diagnosis of stress-induced hypertension in young employees of State law enforcement agencies Maria E. Evsevyeva, Ludmila V. Ivanova, Michail V. Eremin, Maria V. Rostovtseva A23 ĐĄentral aortic pressure and indexes of augmentation in young persons in view of risk factors Maria E. Evsevyeva, Michail V. Eremin, Vladimir I. Koshel, Oksana V. Sergeeva, Nadesgda M. Konovalova A24 Breast cancer prediction and prevention: Are reliable biomarkers in horizon? Shantanu Girotra, Olga Golubnitschaja A25 Flammer Syndrome and potential formation of pre-metastatic niches: A multi-centred study on phenotyping, patient stratification, prediction and potential prevention of aggressive breast cancer and metastatic disease Olga Golubnitschaja, Manuel Debald, Walther Kuhn, Kristina Yeghiazaryan, Rostyslav V. Bubnov, Vadym M. Goncharenko, Ulyana Lushchyk, Godfrey Grech, Katarzyna Konieczka A26 Innovative tools for prenatal diagnostics and monitoring: improving individual pregnancy outcomes and health-economy in EU Olga Golubnitschaja, Jan Jaap Erwich, Vincenzo Costigliola, Kristina Yeghiazaryan, Ulrich Gembruch A27 Immunohistochemical assessment of APUD cells in endometriosis Vadym M. Goncharenko, Vasyl O. Beniuk, Olga V. Kalenska, Rostyslav V. Bubnov A28 Updating personalized management algorithm of endometrial hyperplasia in pre-menopause women Vadym M. Goncharenko, Vasyl O. Beniuk, Rostyslav V. Bubnov, Olga Melnychuk A29 The personified treatment approach of polimorbid patients with periodontal inflammatory diseases Irina A. Gorbacheva, Lyudmila Y. Orekhova, Vadim V. Tachalov A30 Ukrainian experience in hybrid war â the challenge to update algorithms for personalized care and early prevention of different military injuries Olena I. Grechanyk, Rizvan Ya. Abdullaiev, Rostyslav V. Bubnov A31 Tear fluid biomarkers: a comparison of tear fluid sampling and storage protocols Suzanne Hagan, Eilidh Martin, Ian Pearce, Katherine Oliver A32 The correlation of dietary habits with gingival problems during menstruation Cenk Haytac, Fariz Salimov, Servin Yoksul, Anatoly A. Kunin, Natalia S. Moiseeva A33 Genomic medicine in a contemporary Spanish population of prostate cancer: our experience Bernardo Herrera-Imbroda, Sergio del RĂo-GonzĂĄlez, Maria Fernanda Lara, Antonia Angulo, Francisco Javier Machuca Santa-Cruz A34 Challenges, opportunities and collaborations for personalized medicine applicability in uro-oncological disease Bernardo Herrera-Imbroda, Sergio del RĂo-GonzĂĄlez, Maria Fernanda Lara A35 Metabolic hallmarks of cancer as targets for a personalized therapy John Ionescu A36 Influence of genetic polymorphism as a predictor of the development of periodontal disease in patients with gastric ulcer and 12 duodenal ulcer Alfiya Z. Isamulaeva, Anatoly A. Kunin, Shamil Sh. Magomedov, Aida I. Isamulaeva A37 Challenges in diabetic macular edema Tatjana Josifova A38 Overview of the EPMA strategies in laboratory medicine relevant for PPPM Marko Kapalla, Juraj KubĂĄĆ, Olga Golubnitschaja, Vincenzo Costigliola A39 EPMA initiative for effective organization of medical travel: European concepts and criteria Vincenzo Costigliola, Marko Kapalla, Juraj KubĂĄĆ, Olga Golubnitschaja A40 Design and innovation in e-textiles: implications for PPPM Anthony Kent, Tom Fisher, Tilak Dias A41 Biobank in Pilsen as a member of national node BBMRI_CZ Judita KinkorovĂĄ, OndĆej TopolÄan A42 Big data in personalized medicine: hype and hope Matthias Kohl A43 The 3P approach as the platform of the European Dentistry Department (DPPPD) Anatoly A. Kunin, Natalia S. Moiseeva A44 The endometrium cytokine patterns for predictive diagnosis of proliferation severity and cancer prevention Andrii I. Kurchenko, Vasyl A. Beniuk, Vadym M. Goncharenko, Rostyslav V. Bubnov, Nadiya V. Boyko, Andriy M. Strokan A45 A monocyte-based in-vitro system for testing individual responses to the implanted material: future for personalized implant construction Julia Kzhyshkowska, Alexandru Gudima, Ksenia S. Stankevich, Victor D. Filimonov4, Harald KlĂŒter, Evgeniya M. Mamontova, Sergei I. Tverdokhlebov A46 Prediction and prevention of adverse health effects by meteorological factors: Biomarker patterns and creation of a device for self-monitoring and integrated care Ulyana B. Lushchyk, Viktor V. Novytskyy, Igor P. Babii, Nadiya G. Lushchyk, Lyudmyla S. Riabets, Ivanna I. Legka A47 Targeting "disease signatures" towards personalized healthcare Mira Marcus-Kalish, Alexis Mitelpunkt, Tal Galili, Neta Shachar, Yoav Benjamini A48 Influence of the skin imperfection on the personal quality of life and possible tools for objective diagnosis Agnieszka Migasiewicz, Markus Pelleter, Joanna Bauer, Ewelina DereĆ, Halina Podbielska A49 The new direction in caries prevention based on the ultrastructure of dental hard tissues and filling materials Natalia S. Moiseeva, Anatoly A. Kunin, Dmitry A. Kunin A50 The use of LED radiation in prevention of dental diseases Natalia S. Moiseeva, Yury A. Ippolitov, Dmitry A. Kunin, Alexei N. Morozov, Natalia V. Chirkova, Nakhid T. Aliev A51 Status of endothelial progenitor cells in diabetic nephropathy: predictive and preventive potentials Mahmood S. Mozaffari, Jun Yao Liu, Babak Baban A52 The status of glucocorticoid-induced leucine zipper protein in salivary gland in Sjögrenâs syndrome: predictive and personalized treatment potentials Mahmood S. Mozaffari, Jun Yao Liu, Rafik Abdelsayed, Xing-Ming Shi, Babak Baban A53 Maximal aerobic capacity - important quality marker of health Jaroslav NovĂĄk, Milan Ć tork, VĂĄclav Zeman A54 The EMPOWER project: laboratory medicine and Horizon 2020 Wytze P. Oosterhuis, Elvar Theodorsson A55 Personality profile manifestations in patientâs attitude to oral care and adherence to doctorâs prescriptions Lyudmila Y. Orekhova, Tatyana V. Kudryavtseva, Elena R. Isaeva, Vadim V. Tachalov, Ekaterina S. Loboda A56 Results of an European survey on personalized medicine addressed to directions of laboratory medicine Mario Pazzagli, Francesca Malentacchi, Irene Mancini, Ivan Brandslund, Pieter Vermeersch, Matthias Schwab, Janja Marc, Ron H.N. van Schaik, Gerard Siest, Elvar Theodorsson, Chiara Di Resta A57 MCI or early dementia predictive speech based diagnosis techniques Matus Pleva, Jozef Juhar A58 Personalized speech based mobile application for eHealth Matus Pleva, Jozef Juhar A59 Circulating tumor cell-free DNA as the biomarker in the management of cancer patients JiĆĂ PolĂvka jr., Filip JankĆŻ, Martin PeĆĄta, Jan DoleĆŸal, Milena KrĂĄlĂÄkovĂĄ, JiĆĂ PolĂvka A60 Complex stroke care â educational programme in Stroke Centre University Hospital Plzen JiĆĂ PolĂvka, Alena LukeĆĄovĂĄ, Nina MĂŒllerovĂĄ, Petr Ć evÄĂk, VladimĂr Rohan A61 Sleep apnea and sleep fragmentation contribute to brain aging Kneginja Richter, Lence Miloseva, GĂŒnter Niklewski A62 Personalised approach for sleep disturbances in shift workers Kneginja Richter, Jens Acker, Guenter Niklewski A63 Medical travel and innovative PPPM clusters: new concept of integration Olga Safonicheva, Vincenzo Costigliola A64 Medical travel and women health Olga Safonicheva A65 Continuity of generations in the training of specialists in the field of reconstructive microsurgery Maxim Sautin, Janna Sinelnikova, Sergey Suchkov A66 Telemonitoring of stroke patients â empirical evidence of individual risk management results from an observational study in Germany SongĂŒl Secer, Stephan von Bandemer A67 Womenâs increasing breast cancer risk with n-6 fatty acid intake explained by estrogen-fatty acid interactive effect on DNA damage: implications for gender-specific nutrition within personalized medicine Niva Shapira A68 Cytobacterioscopy of the gingival crevicular fluid as a method for preventive diagnosis of periodontal diseases Aleksandr Shcherbakov, Anatoly A. Kunin, Natalia S. Moiseeva A69 Use of specially treated composites in dentistry to avoid violations of aesthetics Bogdan R. Shumilovich, Zhanna Lipkind, Yulia Vorobieva, Dmitry A. Kunin, Anastasiia V. Sudareva A70 National eHealth system â platform for preventive, predictive and personalized diabetes care Ivica Smokovski, Tatjana Milenkovic A72 The common energy levels of Prof. Szent-Györgyi, the intrinsic chemistry of melanin, and the muscle physiopathology. Implications in the context of Preventive, Predictive, and Personalized Medicine Arturo SolĂs-Herrera, MarĂa del Carmen Arias-Esparza, Sergey Suchkov A73 Plurality and individuality of hepatocellular carcinoma: PPPM perspectives Krishna Chander Sridhar, Olga Golubnitschaja A74 Strategic aspects of higher medical education reforms to secure newer educational platforms for getting biopharma professionals matures Maria Studneva, Sihong Song, James Creeden, Đark Đandrik, Sergey Suchkov A75 Overview of the strategies and activities of the European Federation of Clinical Chemistry and Laboratory Medicine, (EFLM) Elvar Theodorsson, EFLM A76 New spectroscopic techniques for point of care label free diagnostics Syed A. M. Tofail A77 Tumor markers for personalized medicine and oncology - the role of Laboratory Medicine OndĆej TopolÄan, Judita KinkorovĂĄ, OndĆej Fiala, Marie KarlĂkovĂĄ, Ć ĂĄrka SvobodovĂĄ, Radek KuÄera, Radka FuchsovĂĄ, Vladislav TĆeĆĄka, VĂĄclav Ć imĂĄnek, Ladislav Pecen, Jan Ć oupal, Ć tÄpĂĄn SvaÄina2 A78 Modern medical terminology (MMT) as a driver of the global educational reforms Evgeniya Tretyak, Maria Studneva, Sergey Suchkov A79 Juvenile hypertension; the relevance of novel predictive, preventive and personalized assessment of its determinants Francesca M. Trovato, G. Fabio Martines, Daniela Brischetto, Daniela Catalano, Giuseppe Musumeci, Guglielmo M. Trovato A80 Proteomarkers Biotech George Th. Tsangaris, Athanasios K. Anagnostopoulos A81 Proteomics and mass spectrometry based non-invasive prenatal testing of fetal health and pregnancy complications George Th. Tsangaris, Athanasios K. Anagnostopoulos A82 Integrated Ecosystem for an Integrated Care model for Heart Failure (HF) patients including related comorbidities (ZENITH) JosĂ© VerdĂș, German GutiĂ©rrez, Jordi Rovira, Marta Martinez, Lutz Fleischhacker, Donna Green, Arthur Garson, Elena Tamburini, Stefano Cuomo, Juan Martinez-Leon, Teresa Abrisqueta, Hans-Peter Brunner-La Rocca, Tiny Jaarsma, Teresa Arredondo, Cecilia Vera, Giuseppe Fico, Olga Golubnitschaja, Fernando Arribas, Martina Onderco, Isabel Vara, on behalf of ZENITH consortium A83 Predictive, preventive and personalized medicine in diabetes onset and complication (MOSAIC project) JosĂ© VerdĂș, Francesco Sambo, Barbara Di Camillo, Claudio Cobelli, Andrea Facchinetti, Giuseppe Fico, Riccardo Bellazzi, Lucia Sacchi, Arianna Dagliati, Daniele Segnani, Valentina Tibollo, Manuel Ottaviano, Rafael Gabriel, Leif Groop, Jacqueline Postma, Antonio Martinez, Liisa Hakaste, Tiinamaija Tuomi, Konstantia Zarkogianni, on behalf of MOSAIC consortium A84 Possibilities for personalized therapy of diabetes using in vitro screening of insulin and oral hypoglycemic agents Igor Volchek, Nina Pototskaya, Andrey Petrov A85 The innovative technology for personalized therapy of human diseases based on in vitro drug screening Igor Volchek, Nadezhda Pototskaya, Andrey Petrov A86 Bone destruction and temporomandibular joint: predictive markers, pathogenetic aspects and quality of life Ălle Voog-Oras, Oksana Jagur, Edvitar Leibur, Priit Niibo, Triin JagomĂ€gi, Minh Son Nguyen, Chris Pruunsild, Dagmar Piikov, Mare Saag A87 Sub-optimal health management â global vision for concepts in medical travel Wei Wang A88 Sub-optimal health management: synergic PPPM-TCAM approach Wei Wang A89 Innovative technologies for minimal invasive diagnostics Andreas WeinhĂ€usel, Walter Pulverer, Matthias Wielscher, Manuela Hofner, Christa Noehammer, Regina Soldo, Peter Hettegger, Istvan Gyurjan, Ronald Kulovics, Silvia Schönthaler, Gabriel Beikircher, Albert Kriegner, Stephan Pabinger, Klemens Vierlinger A90 Rare disease diobanks for personalized medicine AyĆe YĂŒzbaĆıoÄlu, Meral ĂzgĂŒĂ§, Member of EuroBioBank - European Network of DNA, Cell and Tissue Banks for Rare Disease