Super-reliable loss networks

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Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Барьерная функция кожи и роль жирорастворимых витаминов в коррекции ее нарушений

The main function of the skin is to protect the body from negative environmental influences. The physical barrier permeability is mainly represented by the stratum corneum; however, other layers of the epidermis and the dermis are its important components. The mechanical strength of the skin is provided by intercellular contacts in the epidermis and structural proteins of the dermis. The chemical-biological barrier includes lipids, acids, natural moisturizing factor and antimicrobial peptides. Mucosal immunity system creates a barrier against infection. The microflora of healthy skin counteracts its colonization by pathogens and is vital for its immune functions. Physiological processes in the skin are closely related. A violation in one of them often leads to the formation of a whole cascade of pathological reactions affecting all the links of its protection. Vitamins A, D and E are used to correct impaired barrier function of the skin. The most pronounced effect of vitamin A (retinol palmitate) is the proliferation of epidermal cells and synthesis of extracellular matrix structures of the dermis; vitamin D (cholecalciferol) regulation of differentiation and suppression of excessive proliferation of keratinocytes; vitamin E (tocopherol acetate) antioxidant effect. The combined use of these vitamins in the composition of RadevitActive ointment affects all the main elements of the protection of the epidermis and dermis: strengthens the mechanical strength of the stratum corneum and dermis, stabilizes chemical and physical protection, including prevents the penetration of foreign substances and microorganisms, reduces transepidermal loss of water and electrolytes, reduces the damaging effect of UV, increases antimicrobial and antioxidant protection.Основная функция кожи защищать организм от негативных воздействий окружающей среды. Физический барьер проницаемости представлен в основном роговым слоем, однако и другие слои эпидермиса, и дерма являются его важными компонентами. Механическую прочность кожи обеспечивают межклеточные контакты в эпидермисе и структурные белки дермы. Химико-биологический барьер включает липиды, кислоты, натуральный увлажняющий фактор и антимикробные пептиды. Система местного иммунитета создает барьер против инфекции. Микрофлора здорового кожного покрова противодействует его колонизации патогенами и имеет важное значение для поддержания ее иммунных функций. Физиологические процессы в коже тесно связаны между собой. Нарушение в одном из них вызывает каскад патологических реакций, затрагивающих все звенья ее защиты. Для коррекции нарушений барьерной функции кожи используют витамины А, D и Е. Наиболее выраженный эффект витамина А (ретинола пальмитата) стимуляция пролиферации кератиноцитов и синтеза структур внеклеточного матрикса дермы; витамина D (колекальциферола) регуляция дифференцировки и подавление избыточной пролиферации кератиноцитов; витамина Е (токоферола ацетата) антиоксидантный эффект. Совместное применение витаминов в составе мази РадевитАктив оказывает влияние на все основные звенья защиты эпидермиса и дермы: укрепляет механическую прочность рогового слоя и дермы, стабилизирует химическую и физическую защиту, в том числе препятствует проникновению чужеродных веществ и микроорганизмов, снижает трансэпидермальную потерю воды и электролитов, уменьшает повреждающее действие УФ, увеличивает антимикробную и антиоксидантную защиту

Применение мочевины для коррекции нарушений кожного барьера

The review summarizes information about the main causes and pathogenesis of xerosis cutis as one of the conditions indicating a violation of the epidermal barrier. Xerosis cutis is a clinical sign of a decrease in the amount and/or quality of lipids and/or hydrophilic substances in the stratum corneum of the epidermis. The modern approach to the treatment of dermatoses accompanied by violations of the epidermal barrier includes basic moisturizers. Urea not only moisturizes the skin. It is involved in the regulation of barrier function and antimicrobial protection. It is a low-molecular regulator of protein synthesis in keratinocytes, such as filaggrin, loricrin, involucrin and transglutaminase 1, cathelicidin, beta-defensin-2, water and urea carrier proteins into the cell, as well as proteins that promote the synthesis of intercellular matrix lipids. The main dermatotropic pharmacological effects of urea (hydration of the epidermis, strengthening of the barrier function of the skin, keratolytic effect, increased penetration of drugs into the skin) have been used in dermatological practice for many years. External agents with urea are used to treat skin diseases accompanied by dryness and excessive keratinization, to correct the deformation of nail plates of various genesis, to facilitate the local penetration of medicines. The use of topical UrocrEM5, UrocrEM10, Uroderm ointments containing 5%, 10% and 30% urea, respectively, is effective and safe.В обзоре обобщена информация о причинах и патогенезе сухости кожи как одного из состояний, свидетельствующего о нарушении эпидермального барьера. Сухость кожи является клиническим признаком снижения в роговом слое эпидермиса количества и/или качества липидов и/или гидрофильных веществ. Современный подход к лечению дерматозов, сопровождающихся нарушениями эпидермального барьера, включает базовые увлажняющие средства. Мочевина не только увлажняет кожу, она участвует в регулировании барьерной функции и противомикробной защите. Она является низкомолекулярным регулятором синтеза белков в кератиноцитах, таких как филаггрин, лорикрин, инволюкрин и трансглутаминаза 1, кателицидин, бета-дефензин-2, белков переносчиков воды и мочевины в клетку, а также белков, способствующих синтезу липидов межклеточного матрикса. Основные дерматотропные фармакологические эффекты мочевины (увлажнение эпидермиса, усиление барьерной функции кожи, кератолитическое действие, усиление проникновения лекарственных средств в кожу) используют в дерматологической практике для лечения кожных болезней, сопровождающихся сухостью и избыточным ороговением, коррекции деформации ногтевых пластин различного генеза, облегчения местного проникновения лекарственных препаратов. Использование топических средств УрокрЭМ5, УрокрЭМ10, мази Уродерм, содержащих 5, 10 и 30% мочевины соответственно, эффективно и безопасно

Investigation of properties of titanium alloys with mechanically stable beta-structure for body armor application

The paper presents the results of investigation of mechanical properties of titanium alloys with meta-stable beta-structure under static and dynamic loading after different thermal treatment modes. The thermal treatment modes were selected which ensure optimal combination of the toughness and strength characteristics of the material. The technological characteristics of sheet alloy semis and their armor resistance were estimated. The obtained results show that the investigated alloys can be considered as the promising materials for application in those body armor components which are produced by cold sheet stamping

Основные эффекты воздействия ретинола пальмитата на структуры кожи и принципы его применения в дерматологической практике

Vitamin A and its synthetic analogues are used in the treatment of numerous skin diseases. The main genomic effects of the natural form of vitamin A (retinol palmitate) are associated with its active metabolite all-trans-retinoic acid and are compensated by several restrictive mechanisms. Numerous studies have proved that retinol stimulates the proliferation of keratinocytes of the basal layer of the epidermis and endothelial cells, and also activates dermal fibroblasts to synthesize proteins of the extracellular matrix of the dermis. As a result, the thickening the epidermis, increases the mechanical strength of the skin and the hydrating ability of the dermis, angiogenesis increase. The ability of retinol to enhance the adhesion of endothelial cells and leukocytes, regulate the processes of keratinization and sebum secretion was found. Vitamin A is also a powerful antioxidant. Retinol palmitate is used as the main or auxiliary drug for the treatment of a wide range of dermatoses. The principle of application is based on clinical studies and confirmed by existing experimental data. In the treatment, the following algorithm is followed. If retinol palmitate is necessary to improve epithelialization and strengthen the epidermal barrier, medium therapeutic doses should be used. For the treatment of disorders of keratinization processes, depending on the severity of the pathological condition, medium and high therapeutic doses of the drug are used. Violation of the processes of sebum secretion and severe hyperkeratosis respond better to treatment at high therapeutic doses. It should be noted that many skins clinical manifestations mostly regress under the action of vitamin A in doses that do not lead to the appearance of signs of toxicity of the drug.Витамин А и его синтетические аналоги используют при лечении многочисленных кожных заболеваний. Основные геномные эффекты натуральной формы витамина А ретинола пальмитата связаны с его активным метаболитом полностью транс-ретиноевой кислотой и компенсированы несколькими ограничительными механизмами. Многочисленными исследованиями доказано, что ретинол стимулирует пролиферацию кератиноцитов базального слоя эпидермиса и эндотелиальных клеток, а также активирует дермальные фибробласты к синтезу белков внеклеточного матрикса дермы. В результате происходит утолщение эпидермиса, усиливаются механическая прочность кожи и гидратирующая способность дермы, оказывается положительное влияние на ангиогенез. Обнаружена способность ретинола усиливать способность к адгезии эндотелиальных клеток и лейкоцитов, регулировать процессы ороговения и салоотделения. Витамин А также является мощным антиоксидантом. Ретинола пальмитат используется как основной или вспомогательный препарат для лечения большого спектра дерматозов. Принцип применения основан на клинических исследованиях и подтвержден существующими экспериментальными данными. В лечении придерживаются следующего алгоритма. Если ретинола пальмитат необходим для улучшения эпителизации и укрепления эпидермального барьера, необходимо использовать средние терапевтические дозы. Для лечения нарушений процессов ороговения в зависимости от тяжести патологического состояния применяют средние и высокие терапевтические дозы препарата. Нарушение процессов салоотделения и выраженный гиперкератоз лучше поддаются лечению высокими терапевтическими дозами. Следует отметить, что клинические проявления преимущественно регрессируют под действием витамина А в дозах, не приводящих к появлению признаков токсичности препарата

Pure, lithium- or magnesium-doped ferroelectric single crystals of Ca9Y(VO4)7: Cation arrangements and phase transitions

Single crystals of Ca9Y(VO4)7 (1), Ca9Y(VO4)7:Li+ (2) and Ca9Y(VO4)7:Mg2+ (3) were grown by the Czochralski method. Their chemical composition was analyzed by ICP spectroscopy and their crystal structure was examined by single crystal X-ray analysis. The crystals are characterized by trigonal symmetry, space group R3c. Hexagonal unit-cell parameters are as follows: a=10.8552(1) Å, c=38.0373(2) Å, V=3881.65(1) Å3 for 1; a=10.8570(1) Å, c=38.0161(3) Å, V=3880.77(4) Å3 for 2; a=10.8465(1) Å, c=38.0366(2) Å, V=3875.36(3) Å3 for 3. All crystals are characterized by β-Ca3(PO4)2-type structure with statistical distribution of Ca2+ and Y3+ over M1, M2 and M5 sites in different ratios and with completely empty M4-cationsite. The impurity of Mg2+cations in structure 2 has been detected in octahedral M5 site. Ferroelectric phase transitions are evidenced by DSC and SHG. At about 1220 and 1300 K, they demonstrate phase transitions. Upon heating the symmetry of the crystal structure changes according to the scheme R3cm and is restored during consequent cooling. The first of them is of ferroelectric and the second of non-ferroelectric nature. Even a small amount of impurities in Ca9Y(VO4)7 structure is accompanied by a noticeable decrease in the temperature of the ferroelectric-paraelectric phase transition. © 2018 Walter de Gruyter GmbH, Berlin/Boston 2018

Enhanced nonlinear optical activity and Ca2+-conductivity in Са10.5-xPbx(VO4)7 ferroelectrics

Са3(VO4)2-based compositions are considered as promising multifunctional materials combining ferroelectric, optical nonlinear, and Ca2+-ion conductive properties. Their ferroelectric Curie points stretch from minimal for β-Ca3(PO4)2-type compounds temperatures of about 800 K to very high. Investigated in this paper lead substitution for calcium is as a factor controlling ferroelectricity, ionic-conductivity and non-linear optical activity in Ca3(VO4)2-based materials. Polar phase containing powders and ceramics in Ca10.5-xPbx(VO4)7 system are synthesized for 0 ≤ x ≤ 9.5 by the solid state method, and structurally characterized with X-ray powder diffraction and transmission electron microscopy. Dielectric properties, differential thermal analysis and second harmonic generation (SHG) evidence that Ca10.5-xPbx(VO4)7 solid solution (0 ≤ x ≤ 4.5) belongs to whitlockite-type ferroelectrics. SHG activity strongly increases with x up to its maximum at x = 4.5, where it has a record value among all studied before Ca3(XO4)2-related compounds (X = P,V). Ferroelectric Curie temperatures of Ca3(VO4)2 drops from its known value Tc = 1368 K (x = 0) to 770 K (x = 4.5). Crystal symmetry at Tc changes from R3c to R3¯c. After this, one more phase transition to the symmetry R3¯m takes place, its temperature bringing down from 1387 K (x = 0) to 804 K (x = 4.5). Ferroelectric and non-ferroelectric phase transitions in the Са10.5-xPbx(VO4)7 are separated by a broad interval ΔT = 20–50 K and both classified as first-order transformations going in the sequence: R3c↔R3¯c↔R3¯m. Structures of Са10.5-xPbx(VO4)7 compositions with x = 0.5–4 were refined by the Rietveld method and peculiarities of the Pb2+cations distribution in the M1 - M3 and M4 sites of β-Ca3(PO4)2-type structure are discussed regarding the optical nonlinear, ferroelectric and ion-conductive properties. Manifold increased Ca2+- ion conductivity of Са10.5-xPbx(VO4)7 in vicinity of 1000 K at x = 4–4.5 in combination with their ferroelectric and optical nonlinear properties extends applicability of ion-exchange technologies to new promising materials. © 2017 Elsevier B.V