Retrospective Information Research Articles

#802 CENSUS-EU: a cross-sectional, study to assess the prevalence and burden of chronic kidney disease-associated pruritus in Europe

Abstract Background and Aims Chronic kidney disease-associated pruritus (CKD-aP) is a common condition that can negatively affect patients’ health-related quality of life (HRQoL). Despite this, there has been a lack of clarity on its prevalence and impact, leading to increasing interest in and need for an accurate overview of its epidemiology. Here we present the interim analyses of the real-world study CENSUS-EU to estimate the prevalence of CKD-aP and its impact on patients’ HRQoL. Method CENSUS-EU is a retrospective, cross-sectional, multicentre study across seven countries in Europe. Eligible patients (aged ≥18 years and on dialysis for ≥3 months) consenting to participate were asked to complete five patient-reported outcome questionnaires, one on CKD-aP severity (the Worst Itching Intensity Numerical Rating Scale) and four on HRQoL, including the 5-D itch scale and the integrated palliative care outcome scale symptom list for end-stage renal disease (IPOS-Renal). Patients also completed a survey on the communication and management of their pruritus, including current anti-pruritic medication use. In addition, the medical records of patients were assessed to gather retrospective information on clinical dialysis characteristics, treatment patterns and healthcare resource utilisation. In this presentation of the interim data, we report the prevalence of pruritus and the distribution of severity subgroups, how pruritus severity affects the disability score from the 5-D itch (impact on sleep, leisure, errands, and work/school), and the sleep and depression scores from the IPOS-Renal questionnaire. Results The interim analysis included 1,482 patients, of which 59.9% were ≥65 years of age and 61.2% were male. Patient characteristics were balanced across severity subgroups. Overall prevalence of CKD-aP was 52.6% (95% confidence interval 50.02, 55.10); 21.5% of patients experienced mild pruritus, 17.5% moderate pruritus, and 13.5% severe pruritus (Fig. 1). As pruritus severity increased from no pruritus to severe pruritus, patients reported greater difficulty sleeping, as shown by increasing scores for question 2 of the IPOS-Renal questionnaire (Fig. 2A). Patients with more severe pruritus also reported feeling depressed more often than those with less severe or no pruritus (Fig. 2B). There were also increasing scores for the 5-D itch disability subscale (Fig. 2C). Patients with moderate or severe pruritus were also hospitalised more often than patients with mild or no pruritus (mean 1.7 and 1.9 hospitalisations per year, respectively). Overall, 17.9% of patients were receiving at least one ongoing anti-pruritic treatment, and the proportion of patients using at least one anti-pruritic treatment became greater with increasing itch intensity. Despite the impact of pruritus on HRQoL, 40.6% of patients with severe pruritus who had ever suffered from itch while on dialysis were not receiving anti-itch treatment. Conclusion The interim results of this cross-sectional study suggest that approximately 50% of patients on haemodialysis experience CKD-aP. The data reveal that as pruritus severity increases, the effect on sleep and depression scores becomes greater, potentially impacting more deeply on patients’ HRQoL.

Concentration of critical events over the life course and life satisfaction later in life

Critical events create turning points, disrupt individuals’ life courses, and affect wellbeing. Periods of life densely populated with critical events may translate into an acute resource drain, affecting long-term wellbeing more strongly than if the same events were sparsely distributed. We investigate how the co-occurrence of critical events and their concentration in time influence life satisfaction in later life. To do so, we construct a novel indicator, the Concentration Index, based not only on the number but also on the time lag between occurrences. Using retrospective information on critical events in family, work, health, and residential trajectories in Switzerland, we show that the higher the concentration in time of critical events is, the stronger their negative long-term relation to wellbeing, net of sociodemographic characteristics, the total number of events ever experienced, and the time since the last event. Furthermore, relevant gender and social origin differences emerged with a stronger negative association with wellbeing among men and respondents from low socioeconomic backgrounds. Our work clearly shows that simply counting the number of events gives only a partial and potentially inaccurate measure of the complexity of the life course and its relationship with quality of life. Not only how many events experienced matter but also the spacing between them.

Long-Term Medication Profiles in Parkinson's Disease under Subthalamic Deep Brain Stimulation: A Controlled Study.

Subthalamic deep brain stimulation (STN-DBS) reduces antiparkinsonian medications in Parkinson's disease (PD) compared with the preoperative state. Longitudinal and comparative studies on this effect are lacking. To compare longitudinal trajectories of antiparkinsonian medication in STN-DBS treated patients to non-surgically treated control patients. We collected retrospective information on antiparkinsonian medication from PD patients that underwent subthalamic DBS between 1999 and 2010 and control PD patients similar in age at onset and baseline, sex-distribution, and comorbidities. In 74 DBS patients levodopa-equivalent daily dose (LEDD) were reduced by 33.9-56.0% in relation to the preoperative baseline over the 14-year observational period. In 61 control patients LEDDs increased over approximately 10 years, causing a significant divergence between groups. The largest difference amongst single drug-classes was observed for dopamine agonists. In PD patients, chronic STN-DBS was associated with a lower LEDD compared with control patients over 14 years.

Abstract 951: 3D-PREDICT - An ex vivo precision oncology and clinical trial enrichment platform by Nilogen Oncosystems

Abstract Background: Immuno-oncology (IO) therapy with checkpoint inhibitors has demonstrated a higher response rate, duration of response, and overall survival than chemotherapy. However, predicting which FDA approved IO therapies or pharmaceutical agents, as well as best combinations and delivery sequence, will have optimal patient response remains a significant challenge for personalized medicine. Nilogen Oncosystem’s 3D-PREDICT is a novel ex vivo therapeutic investigative platform that provides a functional model of a patient’s tumor to investigate susceptibility to different therapeutic approaches directly. Derived from core biopsies, the 3D-PREDICT model captures the tumor heterogeneity while preserving the tumor microenvironment by retaining stromal components and cell-cell and cell-extracellular matrix interactions. Here, we employed the 3D-PREDICT platform to compare the efficacy of different immunotherapeutic approaches in various solid tumor indications ex vivo. Methods: Tumoroids from 18-gauge core biopsies from solid tumors were generated using Nilogen Oncosystems’s proprietary mechanical process forgoing any enzymatic digestion or propagation while keeping the spatial contexture of stroma intact. Pooled tumoroids were treated ex vivo for 72 hours with various standard-of-care mono or combo therapy (carboplatin, anti-programmed death-ligand 1 (PD-L1) antibody atezolizumab, anti-CD47 antibody magrolimab, anti-programmed cell death receptor-1 (PD-1) antibody nivolumab, or a combination of magrolimab and atezolizumab). Treatment-mediated immune modulation in tumor microenvironment were analyzed to predict patient response to subjected therapies. Results: Treatment-mediated tumor cell killing activity was evaluated using 3D high throughput confocal imaging and Nilogen Oncosystems’s proprietary algorithm for data analysis. The ex vivo response to checkpoint inhibitors was correlated with retrospective patient clinical information. Tumoroid samples treated with atezolizumab and magrolimab demonstrated enhanced tumor cell killing. Approximately 20% of tumors showed increased CD8 T-cell activation upon ex vivo treatment, correlating with proinflammatory cytokine release in conditioned media. Conclusions: The 3D-PREDICT ex vivo tumoroid platform provides a unique resource to predict patients’ response to treatment, potentially serving as a clinical diagnostic to guide clinical care and stratifying patient procurement into clinical trials. This would allow prospective assessment of therapeutic efficacy ex vivo to match each patient to the most effective and least toxic, to improving outcomes, reducing costs, and assigning therapeutics on a more rational basis. Citation Format: Jared Ehrhart, Seth Currlin, Michelle Ataya, Alliyah Humphrey, Rikhia Chakraborty. 3D-PREDICT - An ex vivo precision oncology and clinical trial enrichment platform by Nilogen Oncosystems [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 951.

Financial assessment of the implementation of state policy measures in the field of environmental protection: macroeconomic aspect

In the current article, financial aspects of the state environmental policy in Russia at the present stage are observed. The authors study the scale of financial resources allocated for environmental protection at the macroeconomic level in the context of ensuring environmental safety. The review of periodical press materials allowed us to highlight the most pressing issues of eco-investment. When processing statistical data to conduct an analysis of the costs of implementing environmental measures and assessing dissipation of funds in the main categories of expenses, the authors used dyna mic and structural methods of economic analysis with determination of absolute and relative difference. A comparative method was implied in comparing retrospective information to monitor annual budget allocations for the needs of ecology alongside with the table method combined with the graphical one. The assessment of expenditures for environmental protection in Russia for 2017–2021 showed an annual stable growth with an almost twofold increase in the whole five years. A structural analysis in the context of environmental protection activities allowed us to identify the dominant cost items as the most significant in the implementation of state environmental policy. A comparative analysis of the unit costs of environmental protection in percentage of gross domestic product through international comparisons indicates the underfunding of this area by Russian state authorities. The limited amount of finance to ensure rational use of natural resources requires implementing principal measures in accordance with the main priorities of state policy in the field along with application of the most effective ecological and economic tools.

The effect of maternal childhood maltreatment on postpartum mother–child bonding and maternal hair glucocorticoids

ABSTRACT Background: Maternal experiences of childhood maltreatment (CM) constitute a risk factor for impairments in the mother–child relationship. One mechanism underlying this intergenerational transmission may be maternal hypothalamic–pituitary–adrenal axis dysregulation. Yet, few studies have examined different maltreatment subtypes, including emotional neglect, considered concurrent depressive symptoms, and used long-term integrated glucocorticoid measures. Objective: This study aimed to investigate associations between maternal CM history, postpartum glucocorticoids in hair, and mother–child bonding. In exploratory analyses, we tested whether specific subtypes of CM had differential implications for glucocorticoid secretion and bonding. Methods: During pregnancy, N = 269 mothers from the prospective cohort study DREAMHAIR provided retrospective information on CM and current information regarding psychological and hair-related variables. Hair samples were collected 8 weeks after delivery for quantification of maternal long-term hair cortisol and cortisone concentrations in 2-cm scalp-near hair samples. Mother–child bonding was measured 8 weeks and 14 months after birth using the Postpartum Bonding Questionnaire. Results: While bivariate correlations revealed significant associations of CM with bonding and hair cortisol, regression findings showed CM was associated with impaired bonding 8 weeks (overall CM trend-level; emotional neglect p = .038) and 14 months (emotional neglect trend level p = .041) after birth, however not after controlling for depressive symptoms at the time point of the outcome. In regression analyses, CM was not associated with maternal hair glucocorticoids 8 weeks postpartum. Maternal hair glucocorticoid concentrations were not related to mother–child bonding and did not mediate associations between CM and mother–child bonding. Conclusion: Data tentatively suggest that mothers with CM experiences, in particular emotional neglect, may be at risk for suboptimal bonding to their child, however current depressive symptoms seem to be more important. Our data provide no evidence for a crucial role of glucocorticoid secretion, yet aetiological processes of long-term glucocorticoid secretion and bonding are complex and more severely affected samples should be examined.

A Descriptive Study on the Impacts of Hyperbaric Oxygen Therapy on Autistic Individuals Using Parent Testimonies.

Introduction Hyperbaric oxygen therapy (HBOT) has been influential in treating many physical and psychological ailments, including the symptoms of autism. This current study aims to evaluate HBOT parents' goals and exit interviews describing the positive, negative, or no impacts experienced from the HBOT dives, asking the question, "Are your child's symptoms improving?" Methods Between January 2020 and July 2023, a Class B monoplace hyperbaric chamber (Sechrist 3300H, Sechrist Industries, Inc., Anaheim, California, United States) was used to administer HBOT sessions to patients with autism. Medical-grade oxygen was pressurized to 1.5-2.0 atmospheres absolute at a rate of 1-2 psi/min, with an average oxygen percentage of 100%, for up to five sessions per week. Retrospective descriptive data and patient information through parent testimonials were collected through a chart review of 30 children and one adult with autism who experienced HBOT sessions. Data were presented through exit interviews describing how parents felt about their child's progress toward goals. Four raters rated parent testimonies on a 5-point Likert scale (1 = Much worse, 2 = Somewhat worse, 3 = Stayed the same, 4 = Somewhat improved, and 5 = Much improved), and an inter-rater reliability estimate using interclass correlation (2) (r = 0.831) was derived, indicating excellent agreement between raters. Results Parents/caregivers provided testimony in an exit interview with a registered nurse after the individual with autism received an entire course of HBOT dives. Descriptive statistics resulted in Rater #1 (M = 4.19, median = 4, SD = 0.654): 87.1% of Rater #1 ratings were Somewhat improved and Much improved; Rater #2 (M = 4.23, median = 4, SD = 0.717): 83.9% of Rater #2 ratings were Somewhat improved and Much improved; Rater #3 (M = 4.23, median = 4, SD = 0.560): 93.5% of Rater #3 ratings were Somewhat improved and Much improved; and Rater #4 (M = 4.26, median = 4, SD = 0.631): 90.3% of Rater #4 ratings were Somewhat improved and Much improved. One-way ANOVA resulted in F (3,123) = 0.052, p = 0.984, which indicated a nonstatistically significant mean difference between rater groups. Conclusions The current study assessed HBOT parents'/caregivers' goals and exit interviews, describing the effects experienced from the complete course of HBOT dives on their children/individuals. A majority of parents/caregivers declared that their condition had "Much improved" or "Somewhat improved," based on the 5-point Likert scale. Based on parents'/caregivers' testimonies, HBOT was demonstrated as a safe and effective intervention, and side effects were primarily mild and did not lead to treatment discontinuation. As a result of this analysis, we recommend continued use of HBOT for treatment.

Empowered or impoverished: the impact of panic buttons on domestic violence

AbstractThis paper estimates the causal effect of a targeted panic button program—implemented in two Turkish provinces between 2012 and 2016—on domestic violence. Difference-in-differences and synthetic control estimates suggest that the program notably increased physical violence against women both at the extensive and intensive margins. The likelihood of physical violence in the treated provinces increased by more than 5 percentage points relative to the control provinces, and the number of physical violence incidents increased by about 10 percent. The increase comes almost entirely from the increase in violence against less-educated women. Employment rates and economic independence indicators improved for women in the treated provinces, which suggests that the program empowered vulnerable women. However, male partners increased physical violence in response to female empowerment. The results are consistent with the male backlash theories and a class of non-cooperative models incorporating violence as a vehicle for enhancing males’ bargaining power, but inconsistent with the models predicting that economic empowerment of women reduces violence by balancing bargaining power within the household. We also develop a method based on retrospective violence information to understand whether the increase is attributable to actual or self-reported violence and conclude that the estimates are entirely driven by the increase in actual violence.

Measures of puberty in the Avon Longitudinal Study of Parents and Children (ALSPAC) offspring cohort

Background When studying the development of children through the preteen years into adolescence, it is often important to link features of their physical and mental health to the stage of puberty at the time. This is complex since individuals vary substantially in the ages at which they reach different pubertal milestones. Methods The Avon Longitudinal Study of Parents and Children (ALSPAC) is an ongoing longitudinal cohort study based in southwest England that recruited over 14000 women in pregnancy, with expected dates of delivery between April 1991 and December 1992. From 1999, information on puberty was collected using a number of different methods : (a) A series of annual questionnaires were administered when the index children were aged between eight and 17 years; these were mainly concerned with the physical changes associated with puberty; (b) identification of the age at peak height growth using the SITAR methodology; and (c) retrospective information from the girls on their age at onset of menstruation (menarche). Results The advantages and disadvantages of each method are discussed. Conclusions The data are available for analysis by interested researchers.

Early development score as a prognostic factor in nonverbal/minimally verbal children with autism spectrum disorder: A matched case-control study in Cyprus.

Children with autism spectrum disorder (ASD) present with impairments in social interaction and stereotypic behaviors. About a third may exhibit delays in verbal expression beyond preschool age, potentially categorizing them as nonverbal/minimally verbal (NV/MV), a condition that can persist into adulthood and affect their quality of life. The risk and prognostic factors associated with this reduced verbal outcome remain uncertain. This study aims to identify such factors within children diagnosed with ASD in Cyprus. In this case-control study, 56 children aged 3-12 years, with an ASD diagnosis, participated. Among them, cases were 22 children classified as ASD-NV/MV, and controls were 34 children classified as verbal (ASD-V), matched by age group and gender. Retrospective information on familial, perinatal, and developmental risk and prognostic factors were collected to calculate the familial risk score (FRS), perinatal risk score (PRS), and developmental risk score (DRS). Early development information was collected for the Early Development Score (EDS) and Early Gesture Score (EGS), to measure the children's skill level as toddlers across milestones. A low EDS and/or low EGS reflected general developmental delays and decreased frequency of early gestures and were considered in the DRS. A parent report questionnaire was utilized to determine the current overall linguistic level and status of participants, distinguishing cases from controls. Age group and gender-matched cases and controls were similar in socioeconomic status and demographic characteristics (p > .05). Among the various familial (e.g., sibling with ASD), perinatal (e.g., prematurity), and developmental (e.g., ASD regression) factors examined individually, as well as collectively as scores in a conditional logistic regression (CLR) model, only a high DRS (p = .03), due to low EDS (p = .04) was significantly associated with linguistic status. When considering all risk scores in a multivariate CLR model, children with a high DRS were more likely to belong to the cases than to the control group (p = .02). In a subsequent model with low EDS and low EGS, only the low EDS was significantly associated with the case group. Results showed that children with ASD and a low EDS, reflecting general delays in early development, were 4.5 times more likely to belong to the cases group than those with a high EDS (p = .02). Early developmental delays in developmental milestones across various domains like gesture, motor, play, linguistic, cognition, and joint attention, in toddlerhood, were associated with later decreased verbal outcomes. Children in the sample with such early delays (low EDS), had a higher likelihood of persistent language delays (ASD-NV/MV) even at late school age. Future studies are needed to duplicate findings and explore possible contributing factors affecting linguistic outcome in ASD through prospective studies exploring within ASD differences. These findings emphasized the importance of monitoring early development closely for children at risk for ASD, pre-diagnosis, to provide additional early support for those more likely to be ASD-NV/MV. Parents and specialists like pediatricians, educators, speech-language pathologists, among others, can track the EDS score of children at risk for ASD and refer to the appropriate specialists for early stimulation, intervention, and parent consultation promptly.

Модификация модели поддержки принятия решений при распределении пожарных автомобилей

Purpose. The article deals with improving the decision making support model for fire trucks distribution to territorial fire and rescue garrisons. The necessity of this improvement is caused by the decision making dimension increase due to introducing a new criterion that allows assessing adequacy of territorial fire and rescue garrisons’ means and forces. The authors’ purpose is to modify the practice-oriented procedure for supporting decision making by officials of EMERCOM of Russia. The set purpose determines the following tasks: to analyze decisions in the field of assessing means and forces sufficiency; to improve the multi-criteria model previously developed by the authors; to derive importance coefficients for the model based on four criteria; to set a vector for further research in the proposed area. Methods. During the research methods of the relative importance of criteria in multi-criteria optimization theory have been used. Findings. The authors propose to improve methods for data acquisition and models identification, forecasting and institutes management based on retrospective, current and expert information, which was implemented by introducing a supplementary criterion into the existing decision making support model. Research application field. The results obtained can be used by decision makers in assessing territorial fire and rescue garrisons in their activities. Conclusions. The authors have contributed to developing a mathematical model basic for decision making support procedures for fire trucks distribution to territorial fire and rescue units. The multi-criteria model application will make it possible to take into account additional criteria of personnel provision in fire and rescue garrisons.

Partial observation learning-based task offloading and spectrum allocation in UAV collaborative edge computing

Capable of flexibly supporting diverse applications and providing computation services, the Mobile Edge Computing (MEC)-assisted Unmanned Aerial Vehicle (UAV) network is emerging as an innovational paradigm. In this paradigm, the heterogeneous resources of the network, including computing and communication resources, should be allocated properly to reduce computation and communication latency as well as energy consumption. However, most existing works solely focus on the optimization issues with global information, which is generally difficult to obtain in real-world scenarios. In this paper, fully considering the incomplete information resulting from diverse types of tasks, we study the joint task offloading and spectrum allocation problem in UAV network, where free UAV nodes serve as helpers for cooperative computation. The objective is to jointly optimize offloading mode, collaboration pairing, and channel allocation to minimize the weighted network cost. To achieve the purpose with only partial observation, an extensive-form game is introduced to reformulate the problem, and a regret learning-based scheme is proposed to achieve the equilibrium solution. With retrospective improvement property and information set concept, the designed algorithm is capable of combating incomplete information and obtaining more precise allocation patterns for diverse tasks. Numerical results show that our proposed algorithm outperforms the benchmarks across various settings.

Perceived Parenting Styles and College Student’s Psychosocial Adjustment

Extant literature has established the impact that parenting has on the development of children within specific domains of behavioral outcomes such as deviance, prone to depression among others. However, there are still unanswered questions regarding the role of parenting styles in the development of psychosocial skills of emerging adults. This study assessed retrospective information from college students (n=138) about their parents’ parenting styles during their early years of life and how it has impacted the development of their perceived self-esteem, self-efficacy, and academic self-efficacy. Results showed that the best optimal environment for parenting that is likely to yield positive psychosocial variables are parental responsiveness and involvement. This study further showed that, even though parents may show a higher level of involvement and responsiveness to their children, the co-occurring of these variables with higher level of parental demandingness tends to neutralize the positive effects of parental responsiveness and involvement.

Associations Between Forced Intercourse and Subsequent Depression Among Women in the U.S. General Population.

Forced intercourse is a high prevalence experience among US women, with high potential to produce subsequent major depressive episodes (MDE). However, the extent to which prior risk factors are associated with the timing of both sexual assault experiences and subsequent MDE onset is not known. The aim of this study was to document the associations between childhood depression, subsequent forced intercourse, and later MDE. We used retrospective information on childhood depression, forced intercourse, and MDE after forced intercourse from female respondents in the nationally representative 2017 US Panel Study of Income Dynamics-Transition to Adulthood Supplement (PSID-TAS, N = 1298, response rate: 87%). Multivariable logistic regression estimated these associations, controlling for age, race, poverty, religiosity, family history of depression, and adverse childhood experiences (such as parental physical abuse or parental violence). Women who experienced childhood depression (prevalence: 15%) had 2.57 times the odds of experiencing forced intercourse after depression onset, even after adjusting for these other risk factors. However, even though childhood depression is a powerful risk factor for later MDE, independent of that women who experienced forced intercourse had 2.28 times the odds of experiencing MDE after the occurrence of forced intercourse, adjusting for childhood depression and other risk factors. This study provided the first clear evidence for time-ordered associations between forced intercourse and subsequent MDE among women in the general population.

SCIENTIST PROFILE IN IDENTIFICATION SYSTEMS AS AN INDICATOR OF PUBLICATION ACTIVITY OF A SCIENTIST: THE ROLE OF THE UNIVERSITY LIBRARY

The article deals with the features of international identification systems of scientists. The author analyzes the profile of a scientist tied to a single unique number identifier as the most important criterion for identifying scientific articles of the author in databases of scientific citation. The directions of activity of the Scientific Library of the Admiral Makarov National University of Shipbuilding, which are aimed at to increase the indicators of publication activity and citations by providing information support of university scientists, popularization of the achievements of leading scientists. Conclusions. The system of accounting for scientific publications in an organization involves: identifying all author identifiers in the main scientific citation systems; combining information into a single profile with a unique identification number of each system; displaying indexed scientific publications in the ORCID system (author responsibility), and actively involving researchers in the work of reputable international professional social networks. It is proved that the formation of a package of new services provided by the Scientific Library: assistance in in the preparation of manuscripts according to the requirements of publishers; consulting on the state of the author's profile in various scientometric systems; selection of scientific journals for publication of research; maintaining retrospective and current information on the publications of higher education institutions contribute to increasing the publication activity of university researchers.

Effectiveness of using archival documents in the primary sources of information about the Irevan Khanate

Archival documents play the role of an irreplaceable source in expanding spiritual wealth, horizons, historical consciousness, national self-awareness and national pride of a person, as well as a reliable information base for conducting historical research. An analysis of information resources about the Iravan Khanate shows that our republic has accumulated significant experience and expanded the scope of this topic. The creation of information sources dedicated to the Iravan Khanate is a contribution to replenishing the documentary fund of our republic, being part of the documentary and information resources of Azerbaijan. Archival documents and archives, which are people's memory and written memory, represent a collection of cultural values of the nation. In the research work devoted to the effectiveness of using archival documents in primary sources of information about the Khanate of Iravan, we see that archival documents are sufficiently used in primary sources - books, periodicals. Archives, which play the role of an important social institution for society, as well as research centers that store multidisciplinary and universal information, provide access to retrospective information of the state and citizens, influence political, socio-economic and cultural life. Development of the country, increase management efficiency, play the role of a guarantor of social rights. The article also provides an analysis of books that use archival documents and provides examples of archival documents.

Information Potential of the Epistolary Heritage of P. Kulish in Funds of V. I. Vernadsky National Library of Ukraine

The aim of the article is to define the information potential of the epistolary heritage of P. Kulish in the funds of V. I. Vernadsky National Library of Ukraine by analysing and establishing its documentary content, which makes it possible to reproduce retrospective information that complements and expands already known facts about the personality.
 Research methods. Along with general scientific methods of analysis and synthesis, the research uses historical, systematic, typological and aesthetic ones, as well as methods of archival and source scholar heuristics, source scholar criticism of sources, their textual analysis and information reconstruction.
 The scientific novelty of the study consists in highlighting the information resources representing the epistolary heritage of P. Kulish in V. I. Vernadsky National Library of Ukraine funds. The existing document multitude, primarily letters and telegrams, in the form of manuscripts and copies (in particular, typewritten articles by researchers of P. Kulish), which are of scientific interest for studying the writer’s life and creativity, is analyzed in detail.
 Main conclusions. In the funds of IR NBUV, there are about one thousand and a half letters of P. Kulish, which cover a long chronological range and present the names of many correspondents, both well-known and unknown, as well as letters without specifying the names of the addressees. The archive of P. Kulish is not consolidated in one fund, but scattered among different funds of the scientific institution: I, II, VII, X, 63, 95, 112, 131, 170, 172, 251, 315, 338 (the total number is 12 funds). Complex funds No. I “Literary materials”, No. III “Correspondence”, and fund No. X “Archives of the Ukrainian Academy of Sciences”, in which the artist’s epistolary documents predominate, deserve special attention. The document collection of P. Kulish, which is kept in No. 315, and is represented by the author’s epistolary block, is also noteworthy. Fund No. I presents about one thousand letters of P. Kulish, many of which do not contain information about the addressees (it is a damaged document or an unidentified addressee), which prevents the full reproduction of retrospective information, but still complements and expands already known facts. The epistles of P. Kulish to his addressees recorded information of a biographical nature, which is a valuable addition to his own prosopographical portrait. For the most part, the writer’s letters are characterised by informative content, as they are aimed to be read by a definite person. In addition, at that time, correspondence was one of the most important means of communication.

Retrospective Analysis of Lipid-Lowering and Antiplatelet Therapy Regimen by Clinical Decision Support Service Based on Real-World Data from Electronic Medical Records “Intellect 3 Study”

Aim To evaluate prescription of lipid-lowering and antithrombotic therapy in clinical practice and to compare differences in recommendations using the clinical decision support service (CDSS).Material and methods Electronic medical records (EMR) of 300 patients from the Chazov National Medical Research Center of Cardiology, as well as from medical organizations controlled by the Department of Health of the Lipetsk Region and the Ministry of Health of the Voronezh Region, were analyzed for the period of August - December 2022, during the pilot implementation of CDSS. Retrospective information about the prescription of lipid-lowering and antithrombotic therapy from the EMR was compared with the CDSS guidelines under the expert supervision based on digitized clinical and laboratory profiles of patients. The study primary endpoint was a change in the initially prescribed lipid-lowering and / or antithrombotic therapy as per CDSS guidelines.ResultsOverall 292 patients were included in the final analysis; 46 (15.7 %) were from the primary prevention group and 246 (84.3 %) from the secondary prevention group. In group 1, the lipid-lowering therapy recommended by the CDSS differed by 50 % (p<0.001) from the baseline therapy recorded in the EMR. In the secondary prevention group, 78.9 % (p<0.001) differences were found in the lipid-lowering therapy recommended in the CDSS guidelines compared to the prescriptions in the EMR. In 76.8 % (p<0.001) of patients, antithrombotic therapy was significantly different from the baseline therapy in the EMR.Conclusion The use of CDSS may improve the practice of choosing lipid-lowering and antithrombotic therapy for prevention of cardiovascular complications.

Hydrocortisone-associated death and hospital length of stay in patients with sepsis: A retrospective cohort of large-scale clinical care data

PurposeSepsis is one of the leading causes of morbidity and mortality worldwide with approximately 50 million annual cases. There is ongoing debate on the clinical benefit of hydrocortisone in the prevention of death in septic patients. Here we evaluated the association between hydrocortisone treatment and mortality in patients diagnosed with sepsis in a large-scale clinical dataset. MethodsData from patients between 2008 and 2019 were extracted from the retrospective Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients who received hydrocortisone after diagnosis were matched using propensity-score matching with patients who did not, to balance confounding (by indication and contraindication) factors between the groups. 90-day mortality and survivors’ length of hospital stay was compared between patients who did or did not receive hydrocortisone. ResultsA total of 31,749 septic patients were included in the study (mean age: 67, men: 57.3%, in-hospital mortality: 15.6%). 90-day mortality was higher among the 1802 patients receiving hydrocortisone when compared with the 6348 matched non-users (hazard ratio: 1.35, 95% CI: 1.24–1.47). Hydrocortisone treatment was also associated with increased in-hospital mortality (40.9% vs. 27.6%, p < 0.0001) and prolonged hospital stay in those who survived until discharge (median 12.6 days vs. 10.8 days, p < 0.0001). Stratification for age, gender, ethnicity, occurrence of septic shock, and the need for vasopressor drug administration such as (nor)epinephrine did not reveal sub-population(s) benefiting of hydrocortisone use. ConclusionHydrocortisone treatment is associated with increased risk of death as well as prolonged hospital stay in septic patients. Although residual confounding (by indication) cannot be ruled out completely due to the observational nature of the study, the present study suggests clinical implication of hydrocortisone use in patients with sepsis.

Change in HbA1c post-transfusion is correlated to pre-transfusion HbA1c result

Abstract Hemoglobin A1c (HbA1c) results are used to diagnose and monitor patients with diabetes mellitus. As such, they have a direct impact on patient care and treatment decisions. While within the laboratory community, there is the assumption that recent red blood cell (RBC) transfusion would interfere with HbA1c measurement, there is limited published evidence regarding whether HbA1c results provide an accurate estimate of long term glycemic control in patients who have received a RBC transfusion. This retrospective laboratory information system record review aims to address this gap in the literature with a retrospective analysis of patient results. Retrospective data was obtained from the laboratory information system. The study population included all patients over 18 years of age, both inpatients and outpatients, who had at least one HbA1c result during the study period (January 2018 – December 2020), and record of a RBC transfusion in the three months prior to the A1c result. Data collected included relevant laboratory results and transfusion information. 1,752 pre- and post-transfusion HbA1c pairs were analyzed. The average age of patients at transfusion was 66.0 years. Men comprised 51.7% of subjects (n=905). Most patients were White (64.0%; n=1,104), with Black (29.7%; n=513) and Multiracial / Multicultural (4.1%; n=71) subjects making up the largest minority. Most patients had diagnoses of anemia (93.0%; n=1,629) and/or diabetes (86.2%; n=1,511), with a minority having a diagnosis of any type of cancer (40.6%; n=712). Rarely, patients had hemoglobin disorders (3.1%; n=54). Most patients were treated with some form of glycemic control medication (91.5%; n=1,603). Average pre-transfusion HbA1c for all subjects was 7.0% ± 1.9 (1 sd). Average post-transfusion HbA1c for all subjects was 6.3% ± 1.3 (1 sd). The average change in HbA1c from pre- to post-transfusion was -0.7% ± 1.5 (1 sd). In contrast, the mean change in the random blood glucose measurement closest to the pre- or post-transfusion HbA1c was only -11.5 mg/dL (CI: -16.7 mg/dL to -6.2 mg/dL; p&amp;lt;0.001). The median time between the pre-transfusion HbA1c and transfusion was 20.0 days; the median time between transfusion and the post-transfusion HbA1c was 38.0 days. There was a larger decrease in pre- to post-transfusion HbA1c in patients with diabetes (p&amp;lt;0.001), patients without anemia (p=0.040), patients without hemoglobin disorders (p=0.045), patients without cancer (p=0.005), and patients on any glycemic control medication (p&amp;lt;0.001). Overall, pre-transfusion HbA1c level was strongly associated with post-transfusion HbA1c level, with the greatest degree of negative change seen in patients with a pre-transfusion value &amp;gt; 9.0%. In contrast, patients with a pre-transfusion value of &amp;lt; 5.7% saw an average increase in HbA1c (p&amp;lt;0.001). This study provides insight into the influence of transfusion on HbA1c results and reinforces the important role that pre-analytical factors play in laboratory testing.