Clinical and demographic characteristics, management of patients with type 2 diabetes mellitus and vascular complications: analysis of the Ukrainian cohort of the DISCOVER Global Registry

The aim – to describe baseline data of the Ukraine cohort of DISCOVER Global Registry (DGR) with real-world insights on current treatment practices, complications, and associated clinical outcomes in people with type 2 diabetes mellitus (T2DM).Materials and methods. This healthcare provider-led prospective registry involves non‑interventional data collection from adults (aged ≥ 18 years) with T2DM receiving standard medical care as part of routine clinical practice per their treating physician’s discretion.Results and discussion. The initial data of 353 people with T2DM, who were included in the Ukrainian cohort of the DGR Register, were analyzed. The mean (±standard deviation) age of the study population was 58.85±10.02 years with female predominance (64 % [n=226]). The mean T2DM duration was 10.27±12.15 years with a mean glycated hemoglobin (HbA1c) level of 8.62±1.89 %. Only one-fifth (20.5 %, n=59) of the patients had glycemic control (HbA1c < 7.0 %). Among those with any complication, 73.8 % had microvascular and 79.3 % had cardiovascular complications. Retinopathy and heart failure were the most common microvascular and cardiovascular complications, respectively. Overall, 88 % of the patients were taking any antidiabetic therapy; of these, 27.3 % received insulin (monotherapy: n=28; combination therapy: n=57). As oral antidiabetic drugs (OAD), 32.2 % and 12.9 % received metformin and sulphonylurea monotherapies, respectively; minor proportions received newer OAD monotherapy (sodium-glucose co-transporter-2 inhibitors [4.8 %] and dipeptidyl peptidase-4 inhibitor [1 %]).Conclusions. Baseline data from the Ukraine cohort of DGR reveals poor glycemic control, with a higher mean HbA1c and proportion of patients with micro- and cardiovascular complications than that of the global cohort. The landscape of therapeutic agents displayed marked diversities in the management strategies. Robust real-world data from the DGR can help understand the gaps in care of T2DM patients and lights the need of the formulation of region-specific holistic therapeutic strategies to optimize glycemic control and improving clinical patients’ outcomes.

Russia’s high-tech export during the coronavirus infection spread

Based on data from the Russian Export Centre, Federal Service for Supervision of Consumer Rights Protection and Human Welfare (Rospotrebnadzor) the article analyses the state of hightech exports of the Russian Federation under restrictive measures related to the spread of coronavirus infection. High-tech exports for the period January 2013 to August 2021 and the number of coronavirus infections for the period March 2020 to August 2021 were used as baseline data. The dynamics and volumes of high-tech exports have been considered, the leading and trailing regions in terms of this indicator have been highlighted. A correlation between the number of coronavirus infection cases and the volume of high-tech exports of the regions of the Russian Federation has been revealed, from which it can be concluded that high-tech exporters have so far managed to adapt to the current coronavirus environment.

Making Known the Real: An Exploration of Academic Advising Practices in a South African Higher Education Context

This is the first in a series of papers that emanate from the author’s doctoral research. This research explores academic advising as a profession and academic advisors as practitioners in the South African Higher Education sector; it focuses on advising within the Faculty of Commerce, Law and Management (FCLM) at a research-intensive public university in South Africa. During the period of investigation, academic advising engagements between students and the author were logged, thus forming a baseline dataset for the doctoral study. In phase one of the data analysis, baseline data were coded and clustered into overarching and subsidiary categories. The baseline dataset consists of 34 subsidiary categories, which form part of seven overarching categories; it contains 2240 entries based on 1023 consultations with 614 individual students during the three-year period under investigation. Using Archer’s (1995, 2000, 2005) notions about Social Realism as a theoretical framework, the author critically scrutinises the complex nature of the work that academic advisors do in a layered analysis of the baseline data. The author posits that it is through these layers of interpretation that one moves from the layer of the Empirical (experiences), through the layer of the Actual (events), to what Archer calls “the Real”, that is, the layer of mechanisms or underlying driving forces that brings about what happens in the layers of the Empirical and the Actual. This paper focuses specifically on the role of the academic advisor; it postulates inferential observations about academic advising by using the baseline dataset as a way in, while keeping the academic advisor central to the discussion.

Mental health indicators in Sweden over a 12-month period during the COVID-19 pandemic

BackgroundThe ongoing COVID-19 pandemic has had an unprecedented impact on the lives of people globally and is expected to have profound effects on mental health. Yet, self-reported large-scale online surveys on mental health are still relatively uncommon. Here we aim to describe the mental health burden experienced in Sweden using baseline data of the Omtanke2020 Study.MethodSelf-reported baseline data collected over a 12-month period (June 9, 2020-June 8, 2021) from the longitudinal online survey of the Omtanke2020 Study including 27,950 adults in Sweden. Participants were volunteers or actively recruited through existing cohorts and after providing informed consent responded to monthly online questionnaires on socio-demographics, mental and physical health, COVID-19 infection, and impact. Poisson regression was fitted to assess the relative risk of high mental health burden (depression, anxiety, and COVID-19 specific PTSD).ResultThe overall proportion of persons with high level of symptoms was 15.6%, 9.5% and 24.5% for depression, anxiety, and COVID-19 specific PTSD, respectively. Overall, 43.4% of the participants had significant, clinically relevant symptoms for at least one mental health outcome and 7.3% had significant symptoms for all three outcomes. We also observed differences in the prevalence of these symptoms across strata of sex, age, recruitment type, COVID-19 status, region, and seasonality.ConclusionWhile the proportion of persons with high mental health burden remains higher than in pre-pandemic publications, our estimates are lower than previously reported levels of depression, anxiety, and PTSD during the pandemic in Sweden and elsewhere.

Steroid hormonal endpoints in goats carrying single or twin fetuses reared in semi-extensive systems

The study provides baseline data regarding 17-β-estradiol (E2), progesterone (P4), and cortisol profile of 30 Nicastrese goats during different physiological periods. Animals were evaluated monthly from the pre-mating period (non-pregnant), during pregnancy, and from 30 to 105 d of lactation. The effects of single or twin births and the kid's sex were also considered. Serum E2, P4, and cortisol concentrations were measured using immunoenzymatic assay kits. The highest concentrations of E2 and P4 (P<0.0001) were found during pregnancy and their lowest values (P<0.0001) in the non-pregnant period. E2 was negatively correlated with P4 (r=-0.41; P<0.01) during lactation. The mothers with twin kids showed the highest concentration of P4 (P<0.04) at > 95–115 d of gestation and the lowest of E2 (P<0.04) at > 50–70 d of lactation. Pregnant goats carrying male kid(s) presented the highest E2 concentrations (P<0.02) at > 130–150 d of gestation. Different physiological conditions induced a temporal relationship with the endocrine profile in Nicastrese goats. Understanding the effects of single or twin fetuses on the gestation and lactation will also be helpful to improve the managemental approach for the health of mothers and their kids.

P-OGC89 Peri-operative blood use in Upper GI surgery

Background One group and hold sample costs approximately £18 to process whilst it costs £170 to prepare and administer 1 unit of cross matched blood. We aimed to quantify the amount of blood cross-matched for elective oesophagectomy and gastrectomy cases and compare this to the number of units transfused in the peri-operative setting (within 24 hours of surgery). Current unit guidance required all patients to be cross matched for 2 units of blood pre-operatively. Methods Baseline data was collected retrospectively over a 10 week period (08/07/19-16/09/19). A new blood ordering protocol, made in agreement with oesophago-gastric and anaesthetic consultants was produced. Blood was only to be requested if: antibodies on group and hold, pre-op Hb &lt; 120g/l, operative team concerns or previous radiotherapy. Data was recollected using the same parameters post -intervention over a 10 week period (23/12/19-08/03/20). Results Before implementation of the protocol 24 patients were included, mean age 67 (range 40-84). All patients were cross matched between 2 and 4 units, with a total of 52 units requested and only 1 transfused. After implementation of the protocol 27 patients were included, mean age 69 (range 51-87). 36 units were ordered for 15 patients and 3 units were transfused. The new protocol was correctly implemented in 19 patients (70%). If implemented correctly in all patients in this group a saving of approximately £6120 could have been made. This could equate to a saving of as much as £20,400 per year based on 90 OG operative cases. Conclusions Patients were cross-matched far in excess of their transfusion needs. There was significant reduction in the number of patients being cross-matched post intervention. Rationalising this is important to reduce waste, reduce cost and cut down on delays to maximise theatre time.

Non-communicable diseases in the southwest of Iran: profile and baseline data from the Shahrekord PERSIAN Cohort Study

Background Critical inter-provincial differences within Iran in the pattern of non-communicable diseases (NCDs) and difficulties inherent to identifying prevention methods to reduce mortality from NCDs have challenged the implementation of the provincial health system plan. The Shahrekord Cohort Study (SCS) was designed to address these gaps in Chaharmahal and Bakhtiari, a province of high altitude in the southwest of Iran, characterized by its large Bakhtiari population, along with Fars and Turk ethnicity groups. Methods This ongoing cohort, a prospective, large-scale longitudinal study, includes a unique, rich biobank and was conducted for the first time in Chaharmahal and Bakhtiari Province in Iran. SCS is a part of the PERSIAN (Prospective Epidemiological Research Studies in IrAN) cohort. The study began in 2015, recruited 10075 participants (52.8% female, 47.2% male) from both urban (n=7034) and rural (n=3041) areas, and participants will be annually followed up for at least 15 years. A cross-sectional analysis was conducted using baseline data from the SCS, using descriptive statistics and logistic regression. Data analysis was performed using Stata software. Results The prevalence of NCDs was 9.8% for type 2 diabetes, 17.1% for hypertension, 11.6% for thyroid disease, 0.2% for multiple sclerosis and 5.7, 0.9 and 1.3% for ischemic heart disease, stroke and myocardial infarction, respectively. The prevalence of multimorbidity (≥2 NCDs) was higher in women (39.1%) than men (24.9%). The means (standard deviations) of age, BMI, systolic blood pressure and fasting blood glucose were 49.5 (9) years, 27.6 (4.6) kg/m2, 115.4 (17.3) mmHg and 96.7 (27.3) mg/dL, respectively. Logistic regression models showed that older age, female gender, living in an urban area, non-native ethnicity, high wealth index, unemployment, obesity, low physical activity, hypertriglyceridemia, high fasting blood sugar, alkaline urine pH and high systolic and diastolic blood pressure were associated with increased prevalence of NCDs. Conclusions The SCS provides a platform for epidemiological studies that will be useful to better control NCDs in the southwest of Iran and to foster research collaboration. The SCS will be an essential resource for identifying NCD risk factors in this region and designing relevant public health interventions.