Cost-Effectiveness Analysis Of The Prevention And Treatment Of Cytomegalovirus (CMV) Infections After Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) In Adults

Целта на изследването е да се представи моделиране на локални данни за разходи и здравни ползи на алтернативните антивирусни терапии за профилактика и лечение на цитомегаловирус (CMV) - серопозитивни пациенти след алогенна трансплантация на хемопоетични стволови клетки (HSCT) и да се реализира косвено сравнение, базирано на мрежов метаанализ. Входящи данни в мо- дела са измерените и оценени клинични крайни точки в рандомизираното многоцентрово клинично изпитване МК-8228-001. Моделирането на данните за бъдещи здравни ползи и разходи след края на клиничните изпитвания е проведено чрез модел на Марков с 6 здравни и 1 абсорбиращо състояние. В модела са включени всички възможни здравни състояния, отразяващи хода на заболяването, и са предвидени всички вероятности за преход от едно здравно състояние в друго. Входящите данни в модела са първичните и вторичните крайни точки в рандомизираното клинично изпитвани МК- 8228-001 - клинично значима CMV инфекция на седмица 12-а и 24-та, превантивна терапия за CMV виремия и крайни органни заболявания, свързани с CMV. Времевият хоризонт на модела е до живот. Разходите и ползите са дисконтирани с 5% годишно. Избраната перспектива е гледната точка на третата страна платец.Заключението от проведените оценки е, че letermovir доминира valganciclovir с подобрена тера- певтична ефикасност и по-нисък разход за курс на лечение на CMV-серопозитивните пациенти след HSCT.The aim of the study was to model the local data on the costs and health benefits of alternative antiviral therapies for the prevention and treatment of CMV seropositive patients after HSCT and to perform an indirect comparison based on meta-analysis. Input data in the model are the measured and evaluated clinical endpoints in the randomized multicentre clinical trial MK-8228-001. The modeling of the data for future health benefits and costs after the end of the clinical trials was conducted using a Markov model with 6 health conditions and 1 absorbent state. The model includes all possible health conditions reflecting the course of the disease and all the probabilities of transition from one health condition to another are envisaged. Input data in the model are the primary and secondary endpoints in the randomized clinical trial MK-8228-001 - clinically significant CMV infection at weeks 12 and 24, preemptive therapy for CMV viremia and CMV-related terminal organ diseases.The time horizon of the model is lifelong. Costs and benefits are discounted at 5% per annum. The perspective chosen is the point of view of the third party payer. The conclusion of the evaluations is that letermovir dominates valganciclovir with improved therapeutic efficacy and lower cost of treatment for cytomegalovirus-seropositive patients after allogeneic hematopoietic stem cell transplantation

Stability of Direct Oral Anticoagulants Concentrations in Blood Samples for Accessibility Expansion of Chromogenic Assays

Publisher Copyright: © 2023 by the authors.Background and Objectives: Direct oral anticoagulants (DOACs) are used for minimising the risk of thromboembolic events. In clinical practice, there is no need to measure DOAC concentration in the routine. Nevertheless, there are cases where such measurements are necessary, as the European Society of Cardiology's guideline recommends. However, determining DOAC levels is not available for everyone due to chromogenic assay availability limitations from sample storage problems, as tests are performed only in a few healthcare settings. This study aimed to assess whether more applicable storage conditions could be used for transportation to provide chromogenic assays for outpatient healthcare and other hospitals' practices. Materials and Methods: Chromogenic assays measuring anti-FXa (for rivaroxaban and edoxaban) and anti-FIIa (for dabigatran) were used. Concentrations were determined immediately after blood collection as baseline value: (1) after the storage of citrated whole blood in refrigerator (+2-8 °C); (2) of citrated plasma in refrigerator (+2-8 °C); and (3) of citrated frozen plasma (-20 °C) on the third and seventh days of storage. Acceptable change limits were considered stable if the deviation did not exceed ±20% of the baseline value. Results: The median (Cl 95%) baseline value of rivaroxaban was 168 (147-236) ng/mL; of dabigatran 139 (99-178) ng/mL; and of edoxaban-174 (135-259) ng/mL. The median deviation from a baseline value stored as citrate whole blood samples (+2-8 °C) was 5.4% and 3.4%; as citrated plasma (+2-8 °C) was 0.4% and -0.6%; and as citrated frozen plasma (-20 °C) was -0.2% and 0.2% on the third and seventh days of storage, respectively. Conclusions: Our data suggest that whole blood samples stored in a refrigerator, as well as citrated plasma samples stored in both the refrigerator and freezer, preserve DOAC concentration stable at +2-8 °C or -20 °C for up to 7 days, and are suitable for transportation, except for low-concentration samples.Peer reviewe

The Impact of International Nonproprietary Names Integration on Prescribing Reimbursement Medicines for Arterial Hypertension and Analysis of Medication Errors in Latvia

Publisher Copyright: © 2022 by the authors.The use of international nonproprietary names (INNs) has been mandatory for prescriptions of state-reimbursed drugs in Latvia since 1 April 2020. In a retrospective analysis, we aimed to examine the impact of the new regulation on changes in the prescribing and dispensing practice of antihypertensive agents with an example of bisoprolol or/and perindopril and their combinations. All state-reimbursed bisoprolol and/or perindopril prescriptions for arterial hypertension were evaluated in two time periods: 1 April 2018 to 31 March 2019 and 1 April 2020 to 31 March 2021. The proportion of INN prescriptions increased from 2.1% to 92.3% ( p < 0.001, φ = 0.903). The rate of fixed-dose combinations (FDCs) increased from 60.8% to 66.5% ( p < 0.001, φ = 0.059). The rate of medication errors was 0.6%. The most common (80.6%) error was that the dispensed medicine dose was larger or smaller than indicated on the prescription. In addition, prescribing an FDC medicine increased the chance of making an error by 2.5 times on average. Regulatory changes dramatically affected the medicine-prescribing habits of INNs. The increase in FDC prescription rates may align with the recommendations of the 2018 ESC/ESH guidelines. The proportion of total errors is estimated as low, but control mechanisms are needed to prevent them.publishersversionPeer reviewe

Adherence Level to Arterial Hypertension Treatment: A Cross-Sectional Patient Survey and Retrospective Analysis of the NHS Prescription Database

Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.One of the major problems in cardiology practice is poor adherence to antihypertensive medication. This study aimed to evaluate medication adherence; we also aim to investigate the predictors of intentional and unintentional non-adherence. We issued a survey containing questions about patient demographics, blood pressure control, pharmaceutical care, and adherence level to medication. Retrospective analysis of the prescription database of the National Health Service of the Republic of Latvia was performed. The prevalence of non-adherence was 45.9%. The lowest adherence rate (38.2%) was found among patients taking medication for 2–4.9 years. Even though 84.7% of respondents had a blood pressure monitor at home, only 25.3% of them reported measuring blood pressure regularly. There were differences between the groups of adherent patients in terms of the patients’ net income (p = 0.004), medication co-payments (p = 0.007), and whether the pharmacist offered to reduce the costs of drug therapy (p = 0.002). Roughly half of the prescriptions (50.4%) containing perindopril were purchased by patients from pharmacies. The medication adherence level and blood pressure control at home were assessed as low. Intentionally non-adherent respondents discontinued their medication because of fear of getting used to medicines. The pharmacists’ behaviour in terms of offering to reduce the costs of medications used was influenced by socio-economic factors.publishersversionPeer reviewe

Knowledge about Disease, Medication Therapy, and Related Medication Adherence Levels among Patients with Hypertension

Background and Objectives: A particular problem in cardiology is poor adherence to pharmacological treatment among patients with hypertension. It is known that approximately half of these patients do not use their medications as prescribed by their doctor. Patients may choose not to follow the doctor's recommendations and regularly do not control their blood pressure, owing to many factors. A convenient method for measuring the level of adherence is the Morisky Medication Adherence Scale, which also provides insight into possible remedies for low adherence. We investigated their therapy, knowledge about the disease and its control, and demographic differences to assess the adherence of patients with hypertension. Materials and Methods: This was a cross-sectional observational study. Data were collected through a survey of 12 pharmacies in Latvia. The study involved 187 participants with hypertension. Results: The prevalence of non-adherence was 46.20% in Latvia. The oldest patients were the most adherent (p = 0.001, β = 0.27). The higher the self-rated extent from 0 to 10, to which the patient takes their antihypertensives exactly as instructed by their physician, the higher the level of adherence (p < 0.0001, β = 0.38), where at "0", the patient does not follow physician instructions at all, and at "10", the patient completely follows the physician's instructions. Non-adherent patients tend to assess their medication-taking behavior more critically than adherent patients. The longer the patient is known to suffer from hypertension, the more adherent he or she is (p = 0.014, β = 0.19). Conclusions: Medication non-adherence among patients with hypertension is high in Latvia. Further investigations are needed to better understand the reasons for this and to establish interventions for improving patient outcomes.publishersversionPeer reviewe

Anomalous Stochastic Transport of Particles with Self-Reinforcement and Mittag–Leffler Distributed Rest Times

From MDPI via Jisc Publications RouterHistory: accepted 2021-11-10, pub-electronic 2021-11-15Publication status: PublishedFunder: EPSRC; Grant(s): EP/V008641/1We introduce a persistent random walk model for the stochastic transport of particles involving self-reinforcement and a rest state with Mittag–Leffler distributed residence times. The model involves a system of hyperbolic partial differential equations with a non-local switching term described by the Riemann–Liouville derivative. From Monte Carlo simulations, we found that this model generates superdiffusion at intermediate times but reverts to subdiffusion in the long time asymptotic limit. To confirm this result, we derived the equation for the second moment and find that it is subdiffusive in the long time limit. Analyses of two simpler models are also included, which demonstrate the dominance of the Mittag–Leffler rest state leading to subdiffusion. The observation that transient superdiffusion occurs in an eventually subdiffusive system is a useful feature for applications in stochastic biological transport

Стили межпоколенного педагогического взаимодействия преподавателей и студентов разных поколенческих групп

The paper brings forward the results of an empirical study of styles of intergenerational&nbsp;pedagogical interaction of teachers (representatives of the Soviet and&nbsp;transitional generations), and students (representatives of the post-Soviet generation).&nbsp;The authors overviewed the existing research on the issue of intergenerational&nbsp;interaction. The purpose of the study was to establish the dominant styles of&nbsp;intergenerational pedagogical interaction and their socio-psychological components&nbsp;in teachers and students of the institutes of higher education.&nbsp;A. A. Bodalev’s ideas about communication and V. I. Pishchik’s concept of the&nbsp;mentality of generations formed theoretical foundations for the present work.&nbsp;The study involved teachers of two generational groups (the Soviet and transitional&nbsp;generations), and students (the post-Soviet generation); each group of the sampleconsisted of 60 persons. Applying the techniques the authors studied the following&nbsp;generational factors: identification with the generation (Soviet, transitional, post-Soviet); type of mentality of the generation (traditional, transitional, innovative,&nbsp;postinnovative); socio-sychological characteristics of interaction (interpersonal&nbsp;relations, communicative attitude, personal characteristics, and interaction&nbsp;style). The empirical study revealed that indifferent and conforming styles of&nbsp;intergenerational pedagogical communication were characteristic to teachers&nbsp;of the Soviet generation; manipulative and indifferent styles of intergenerational&nbsp;pedagogical communication were characteristic to teachers of the transitional&nbsp;generation; apathetic; manipulative and indifferent styles of intergenerational&nbsp;pedagogical communication were characteristic to students of the post-Soviet&nbsp;generation. Cluster analysis revealed the components of the preferred style of&nbsp;interaction. The study established interconnected clusters, which included the&nbsp;preferred styles of interaction and socio-psychological characteristics of interaction:&nbsp;interpersonal relations, communicative attitudes, personal characteristics.&nbsp;This paper has clearly shown that teachers and students prefer to use different&nbsp;styles of intergenerational pedagogical interaction, which depends on their&nbsp;generational identification. The components of the same style of intergenerational&nbsp;pedagogical interaction differ in students and teachers of different generationalgroups. Innovative mentality is characteristic for the teachers of the transitional&nbsp;generation and the students of the post-Soviet generation; manipulative style is&nbsp;the leading style of intergenerational pedagogical interaction, which confirms the&nbsp;hypothesis that the convergence and similarity of the mentality of teachers and&nbsp;students of different generations determines the choice of the style of pedagogicalinteraction.В статье представлены результаты эмпирического исследования стилей межпоколенного педагогического взаимодействия преподавателей, представителей поколений советского и переходного, и студентов, представителей постсоветского поколения. Рассматриваются существующие исследования по проблеме межпоколенного взаимодействия. Цель исследования – установление доминирующих стилей межпоколенного педагогического взаимодействия и их социально-психологических составляющих у преподавателей и студентов вуза. Теоретическими основами работы выступают представления об общении А.&nbsp;А.&nbsp;Бодалева, концепция ментальности поколений В.&nbsp;И.&nbsp;Пищик. Объект исследования – преподаватели двух поколенческих групп: советского и переходного поколения, и студенты, представители постсоветского поколения, по 60 человек в каждой группе. Методики были направлены на изучение поколенческих факторов: идентификации с поколением (советское, переходное, постсоветское), типа ментальности поколения (традиционная, переходная, инновационная, постинновационная); и на выявление социально-психологических особенностей взаимодействия (межличностные отношения, коммуникативная установка, личностные особенности, стиль взаимодействия). Эмпирически выявлено, что стили межпоколенного педагогического взаимодействия преподавателей советского поколения – индифферентный, конформный; переходного поколения – манипулятивный, индифферентный; студентов постсоветского поколения – манипулятивный, индифферентный. Составляющие предпочитаемого стиля взаимодействия определялись кластерным анализом. Установлены взаимосвязанные кластеры, куда вошли предпочитаемые стили взаимодействия и социально-психологические особенности взаимодействия: межличностные отношения, коммуникативные установки, личностные особенности. Делается вывод о том, что в зависимости от поколенческой идентификации преподавателей и студентов, они будут предпочтительно использовать разные стили межпоколенного педагогического взаимодействия, и даже в случае использования одного и того же стиля, его составляющие отличаются у преподавателей и студентов разных поколенческих групп. У преподавателей переходного поколения и у студентов постсоветского поколения преобладает инновационная ментальность, ведущим стилем взаимодействия является манипулятивный, что подтверждает гипотезу о том, что сближение, появление схожести в ментальности преподавателей и студентов различных поколений может быть связано с выбором стиля педагогического взаимодействия

Anomalous Stochastic Transport of Particles with Self-Reinforcement and Mittag-Leffler Distributed Rest Times

We introduce a persistent random walk model for the stochastic transport of particles involving self-reinforcement and a rest state with Mittag–Leffler distributed residence times. The model involves a system of hyperbolic partial differential equations with a non-local switching term described by the Riemann–Liouville derivative. From Monte Carlo simulations, we found that this model generates superdiffusion at intermediate times but reverts to subdiffusion in the long time asymptotic limit. To confirm this result, we derived the equation for the second moment and find that it is subdiffusive in the long time limit. Analyses of two simpler models are also included, which demonstrate the dominance of the Mittag–Leffler rest state leading to subdiffusion. The observation that transient superdiffusion occurs in an eventually subdiffusive system is a useful feature for applications in stochastic biological transport.</jats:p

GOALS OF PROFESSIONAL TRAINING FOR TECHNOLOGY STUDENTS

В статье уделяется внимание трем вопросам: развитие навыков проектирования студентов Технологического профиля обучения; развитие эстетической культуры студентов Технологического профиля обучения; формирование исследовательской компетенции студентов профессионально-педагогических направлений.По первому вопросу изучен процесс развития навыков проектирования, где выделены такие определения, как «макетирование», «проектирование», «навык».При изучении второго вопроса проанализирован процесс развития эстетической культуры при обучении художественным дисциплинам, где обозначается определение понятия «развитие эстетической культуры студентов Вуза».Рассматривая третий вопрос подробно проанализирован процесс формирования исследовательской компетенции студентов профессионально-педагогических направлений.The article looks at three issues: developing design skills in Technology students; developing aesthetic perception in Technology students; developing research competence in Pedagogy students.Regarding the first issue the process of developing design skills has been studied and definitions have been given to the following concepts – ‘modelling’, ‘design’, ‘skill’.Regarding the second issue the process of developing aesthetic skills when teaching artistic disciplines has been researched. The definition of ‘developing aesthetic perception in university students’ has been given.In the course of dealing with the third issue the process of building research competence in the students of Pedagogy has been thoroughly researched

Forgotten names

This article evaluates the book dedicated to the work of Nikolai Korolkov. The authors of the review point out the necessity to expand the database of the sources with the help of the Moscow archives, they also suggest that the references to many available sources could help create a more holistic impression of the personality of the writer. Thus, the review of the work The city of roofs, deposited in the Russian State Archive of Literature and Art, has not been mentioned. The same archive holds other documents relevant for this topic. Since Saratov Association of Proletariat Writers (SAPP) was not validated in 1924 due to the lack of charter, the filing documents of its members are in Moscow, in the place where the funds of the principal organization &ndash; All-Union Association of Proletariat Writers (VAPP) &ndash; are deposited. The record card of the VAPP member was not used, although it could have helped to compile a more thorough biographical reference about the writer, since the record cards of this type always contained profession and the place of work or study of the member of the organization. The bibliography does not mention the already arranged chronicle of SAPP activity, the works of P. A. Bugaenko, A. K. Zhuikova, A. A. Demchenko, I. Yu. Ivanyushina, E. G. Elina, A. N. Donin and many others are not touched upon either. The most recent article by A. S. Kasovich is not cited (2022). Nevertheless, it is highlighted that the authors have delivered significant material for further research. Saratov school of philology is urged to render bibliographic help to the authors for the comprehensive augmentation of knowledge