Создание монумента «Возрождение крымскотатарского народа» как культурное явление в жизни крымского общества

В статье автором охарактеризован градостроительный объект Монумент «Возрождение крымскотатарского народа» как культурное явление в жизни крымского общества, призванное внести вклад в процесс воспитания духовности и культуры в молодых людях.У статті автором охарактеризовано містобудівельний об’єкт Монумент «Відродження кримськотатарського народу» як культурне явище у житті кримського суспільства, що призвание донести внесок у процес виховання духовності та культури молоді.The author describes a monument „Rebirth of the Crimean Tatars” as a cultural phenomenon in the life of the Crimean society, which can contribute in the process of spiritual and cultural upbringing of young people

Етнологія релігії – актуальна сфера українського релігієзнавства

Background: Inhaled long-acting beta-2-adrenoceptor agonists (LABA) are frequently used in patients suffering from asthma and chronic obstructive pulmonary disease (COPD). For evaluation of real-life data, drug consumption studies are needed but results might be widely influenced due to methodological differences in particular regarding inter-country comparisons. Objectives: This study aims to compare the LABA prescribing in the general population and specifically in patients suffering from asthma and/or COPD in five European countries. Methods: Crude and age- and sex-standardized (European 2008 reference population) annual period prevalence rates per 10,000 persons were calculated for the period 2002-2009 based on seven European electronic health record databases (Denmark, Germany, Spain, the Netherlands (2), and the United Kingdom (2)). Stratification by sex, age, and indication were performed for the annual period prevalence rates. Results: In all databases, we observed an increase in LABA prescriptions during the study period for the general population and for patients suffering from asthma and/or COPD. In 2008, the highest standardized period prevalence was observed in the Dutch Mondriaan-AHC and the Spanish BIFAP database (443.3 and 395.5 per 10,000 persons), and the lowest in the German Bavarian Claims and Dutch Mondriaan- NPRCD database (278.7 and 290.6 per 10,000 persons). Prevalence rates for LABA increased with age and were highest in patients over 70 years. Patients with a combined diagnosis of asthma and COPD had higher prevalence rates of LABA compared to patients with a single diagnosis of asthma or COPD. The proportion of patients with one inhaled LABA prescription only ranged from 14% (UK databases) to 35% (Spanish BIFAP database) in 2008 in the general population. Conclusions: By using a standardized protocol, we demonstrated inter- and intra-country differences in LABA prescriptions. A general increase of LABA prescriptions during the study period was observed in all databases

Care after pancreatic resection according to an algorithm for early detection and minimally invasive management of pancreatic fistula versus current practice (PORSCH-trial): design and rationale of a nationwide stepped-wedge cluster-randomized trial

BACKGROUND: Pancreatic resection is a major abdominal operation with 50% risk of postoperative complications. A common complication is pancreatic fistula, which may have severe clinical consequences such as postoperative bleeding, organ failure and death. The objective of this study is to investigate whether implementation of an algorithm for early detection and minimally invasive management of pancreatic fistula may improve outcomes after pancreatic resection. METHODS: This is a nationwide stepped-wedge, cluster-randomized, superiority trial, designed in adherence to the Consolidated Standards of Reporting Trials (CONSORT) guidelines. During a period of 22 months, all Dutch centers performing pancreatic surgery will cross over in a randomized order from current practice to best practice according to the algorithm. This evidence-based and consensus-based algorithm will provide da

Adult height, coronary heart disease and stroke: a multi-locus Mendelian randomization meta-analysis

BACKGROUND: We investigated causal effect of completed growth, measured by adult height, on coronary heart disease (CHD), stroke and cardiovascular traits, using instrumental variable (IV) Mendelian randomization meta-analysis. METHODS: We developed an allele score based on 69 single nucleotide polymorphisms (SNPs) associated with adult height, identified by the IBCCardioChip, and used it for IV analysis against cardiovascular risk factors and events in 21 studies and 60 028 participants. IV analysis on CHD was supplemented by summary data from 180 height-SNPs from the GIANT consortium and their corresponding CHD estimates derived from CARDIoGRAMplusC4D. RESULTS: IV estimates from IBCCardioChip and GIANT-CARDIoGRAMplusC4D showed that a 6.5-cm increase in height reduced the odds of CHD by 10% [odds ratios 0.90; 95% confidence intervals (CIs): 0.78 to 1.03 and 0.85 to 0.95, respectively],which agrees with the estimate from the Emerging Risk Factors Collaboration (hazard ratio 0.93; 95% CI: 0.91 to 0.94). IV analysis revealed no association with stroke (odds ratio 0.97; 95% CI: 0.79 to 1.19). IV analysis showed that a 6.5-cm increase in height resulted in lower levels of body mass index (P < 0.001), triglycerides (P < 0.001), non high-density (non-HDL) cholesterol (P < 0.001), C-reactive protein (P = 0.042), and systolic blood pressure (P = 0.064) and higher levels of forced expiratory volume in 1 s and forced vital capacity (P < 0.001 for both). CONCLUSIONS: Taller individuals have a lower risk of CHD with potential explanations being that taller people have a better lung function and lower levels of body mass index, cholesterol and blood pressure

Constraints on cosmic strings using data from the first Advanced LIGO observing run

Cosmic strings are topological defects which can be formed in grand unified theory scale phase transitions in the early universe. They are also predicted to form in the context of string theory. The main mechanism for a network of Nambu-Goto cosmic strings to lose energy is through the production of loops and the subsequent emission of gravitational waves, thus offering an experimental signature for the existence of cosmic strings. Here we report on the analysis conducted to specifically search for gravitational-wave bursts from cosmic string loops in the data of Advanced LIGO 2015-2016 observing run (O1). No evidence of such signals was found in the data, and as a result we set upper limits on the cosmic string parameters for three recent loop distribution models. In this paper, we initially derive constraints on the string tension Gμ and the intercommutation probability, using not only the burst analysis performed on the O1 data set but also results from the previously published LIGO stochastic O1 analysis, pulsar timing arrays, cosmic microwave background and big-bang nucleosynthesis experiments. We show that these data sets are complementary in that they probe gravitational waves produced by cosmic string loops during very different epochs. Finally, we show that the data sets exclude large parts of the parameter space of the three loop distribution models we consider

Multiple database approach for study of associations between frequently used drugs and community-acquired pneumonia

Background: The association between communityacquired pneumonia (CAP) and commonly used drugs such as statins, ACE-inhibitors (ACE-I), and proton pump inhibitors (PPI) has been extensively studied in different settings and populations with often conflicting results. The origin of this heterogeneity is unknown and unravelling its nature is important for clinical interpretation of these pharmacoepidemiological (PE) results. Objectives: To explore sources of heterogeneity in the association between CAP and use of ACE-I, statins, and PPIs by using the same methods in a multi-database study in multiple settings. Methods: We used data from the TI PHARMA Mondriaan project providing access to various healthcare databases from hospitals, general practices (GP), and pharmacies. Ten different case-control sets in five different populations derived from both general practitioner (GP) and hospital data have been generated (2004-2010). Patients and controls were matched on age, gender, and index year. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for the associations between the three drug classes of interest and CAP. Crude associations were adjusted for comorbidity and drug use (semi-adjusted; common variables in all sets), and for all available confounders (fully adjusted). Results: In total, data of 38,742 cases and 118,019 controls have been studied. The mean age of the hospitalised patients was 63 years and 46-61 years for the GP patients. For statin use and pneumonia risk the semiadjusted OR varied from 0.82 to 1.38. A comparable range was observed for ACE-I and PPI use with ORs of 1.02-1.61 and 1.29-2.69, respectively. Overall, the associations were stronger for hospitalised CAP patients matched to population controls vs. GP CAP patients matched to population controls. Furthermore, prevalence of drug exposure was higher when assessed based on dispensing data vs. prescription data. Conclusions: Associations between statin, ACE-I, and PPI use and CAP risk were influenced by sampling population and data source and may explain the large heterogeneity observed between previous observational PE studies

Multiple database approach for study of associations between frequently used drugs and community-acquired pneumonia

Background: The association between communityacquired pneumonia (CAP) and commonly used drugs such as statins, ACE-inhibitors (ACE-I), and proton pump inhibitors (PPI) has been extensively studied in different settings and populations with often conflicting results. The origin of this heterogeneity is unknown and unravelling its nature is important for clinical interpretation of these pharmacoepidemiological (PE) results. Objectives: To explore sources of heterogeneity in the association between CAP and use of ACE-I, statins, and PPIs by using the same methods in a multi-database study in multiple settings. Methods: We used data from the TI PHARMA Mondriaan project providing access to various healthcare databases from hospitals, general practices (GP), and pharmacies. Ten different case-control sets in five different populations derived from both general practitioner (GP) and hospital data have been generated (2004-2010). Patients and controls were matched on age, gender, and index year. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for the associations between the three drug classes of interest and CAP. Crude associations were adjusted for comorbidity and drug use (semi-adjusted; common variables in all sets), and for all available confounders (fully adjusted). Results: In total, data of 38,742 cases and 118,019 controls have been studied. The mean age of the hospitalised patients was 63 years and 46-61 years for the GP patients. For statin use and pneumonia risk the semiadjusted OR varied from 0.82 to 1.38. A comparable range was observed for ACE-I and PPI use with ORs of 1.02-1.61 and 1.29-2.69, respectively. Overall, the associations were stronger for hospitalised CAP patients matched to population controls vs. GP CAP patients matched to population controls. Furthermore, prevalence of drug exposure was higher when assessed based on dispensing data vs. prescription data. Conclusions: Associations between statin, ACE-I, and PPI use and CAP risk were influenced by sampling population and data source and may explain the large heterogeneity observed between previous observational PE studies

The risk of acute myocardial infarction after discontinuation of antihypertensive agents

Background: Sudden discontinuation of some antihypertensive agents such as beta-blockers and centrally acting antihypertensive agents are associated with increased risk of acute coronary events. Objectives: The aim of this study was to assess the association between discontinuation of different antihypertensive agents and the risk of acute myocardial infarction (AMI). Methods: A nested case control study was performed in a cohort of antihypertensive drug users from the Utrecht Cardiovascular Pharmacogenetics (UCP) database. Within this cohort, patients who were hospitalized for first AMI were considered cases. Cases were matched (1 up to 4) to controls at the same AMI date (index date). Antihypertensive users were defined as current users if the index date fell within prescribed duration or as stoppers if this date fell outside the prescribed duration. According to recency of stopping, stoppers were divided into recent stoppers (≤90 days), intermediate-term stoppers (91-180 days), and longterm stoppers (>180 days). The study included only antihypertensive users who were specifically current users or stoppers of one antihypertensive agent. Logistic regression analysis was used to assess the association between the discontinuation of antihypertensive agents and the risk of AMI and to control for confounding. Results: We included 1245 cases and 4994 controls in our analysis. The risk of AMI was significantly increased with all stoppers of beta-blockers (adjusted OR: 1.54, 95%CI (1.25-1.90)), calcium channel blockers (CCBs) (adjusted OR: 2.25, 95%CI (1.53- 3.30)), and diuretics (adjusted OR: 1.76, 95%CI (1.24-2.48)) compared with current users. Moreover, the risk of AMI was significantly increased for longterm stoppers (beta-blockers, CCBs, angiotensinconverting enzyme inhibitors, and diuretics) and intermediate- term stoppers (beta-blockers and CCBs) versus current users. There was no difference in AMI risk between recent stoppers of antihypertensive agents versus current users. Conclusions: Discontinuation of antihypertensive agents increases the risk of AMI after more than 90 days of stopping. Adherence to antihypertensive agents plays an important role in reducing the risk of AMI in patients with hypertension

The impact of age and sex on the reporting of cough and angioedema with renin–angiotensin system inhibitors : a case/noncase study in VigiBase

The purpose of this study was to assess the impact of age and sex on the reporting of cough and angioedema related to renin–angiotensin system (RAS) inhibitors. A case/noncase study was performed in VigiBase. Two case groups were identified, reports of cough and reports of angioedema, and noncases were all reports of all other adverse events. Logistic regression analysis was used to assess the association between reporting of cough and angioedema with each class of RAS inhibitors stratified by age/sex and to control for confounding. The reporting of cough with angiotensin-converting enzyme (ACE) inhibitors was significantly higher in women than in men [adjusted reporting odds ratio (ROR): 44.0, 95% CI (43.2–44.8) for women vs. 29.2, 95% CI (28.5–29.9) for men]. There was no difference in reporting of cough linked to angiotensin receptor blockers (ARBs) and aliskiren between men and women. In contrast, the reporting of angioedema with ACE inhibitors and ARBs was significantly higher in men than in women, but for aliskiren, women had a significantly higher ROR than men [adjusted ROR: 5.20, 95% CI (4.18–6.46) for women vs. 3.04, 95% CI (2.30–4.02) for men]. The reporting of cough with ACE inhibitors was increased with age until reaching a plateau at middle adulthood (40–59 years) and the reporting of angioedema with ACE inhibitors was increased with age until elderly (60–79 years). Age had only a slight effect on the reporting of cough and angioedema with ARBs and aliskiren. Both age and sex have substantial effects on the reporting of cough and angioedema with RAS inhibitors and in particular ACE inhibitors. Further study is needed to determine whether these differences mainly express different adverse drug reaction risks in subgroups or also can be explained by factors influencing reporting

Improving consistency in findings from pharmacoepidemiological studies: The IMI-protect (Pharmacoepidemiological research on outcomes of therapeutics by a European consortium) project

Background: Pharmacoepidemiological (PE) research should provide consistent, reliable and reproducible results to contribute to the benefit-risk assessment of medicines. IMI-PROTECT aims to identify sources of methodological variations in PE studies using a common protocol and analysis plan across databases. In addition, differences by design, applied to a same drug-adverse event (AE) pair in different databases are examined. Results from PE studies will be evaluated on seven drug-AE pairs (i.e. (1) antibiotics and acute liver injury; (2) antidepressants and hip fracture; (3) benzodiazepines and hip fracture; (4) anticonvulsants and suicide/suicide attempts; (5) calcium channel blockers and malignancies; (6) inhaled long-acting b2 agonists and acute myocardial infarction; (7) a negative control study: antibiotics and acute myocardial infarction) conducted in eight European and one US electronic databases. These are: the UK (CPRD), UK (THIN), the Danish national registries, the Dutch Mondriaan project (NPCRD, AHC), the Spanish BIFAP, the German Bavarian Claims (KVB) database (only descriptive), PGRx and US InVision Datamart (formerly LabRx). In order to maintain the blinding of investigators from one another's results, these results will only be disclosed during the ICPE conference. Objectives: To review and understand the methodological issues encountered in these studies and to draw conclusions about their relevance for future PE research. Description: We will present data on association studies in the various databases using different designs with a focus on cohort, but also case-control, case-crossover, and self-controlled case series for some drug-AE pairs. The major methodological issues such as choice of study design, analytical methods to control for confounding, variation in operational definitions of exposure, outcome and confounders across databases with different coding systems will be discussed