Ukrainian Issues in Geopolitical thought of the Twentieth and Twenty-First Centuries

Ukrainian lands in the twentieth and twenty-first centuries have been in proximity of great geopolitical changes several times. During that time the Ukrainian nation – due to various factors – encountered a number of “windows of opportunity” for achieving the realization of dreams about independence and national sovereignty. The author identified in the period considered four “general moments,” of which two have been completed successfully. The first of these occurred in 1990–1991, when for the first time in modern history, Ukrainians managed to achieve a lasting and relatively stable independence. The second of the “moments” – still unresolved – are events that began in the late autumn of 2013. The process, called “Revolution of Dignity”, represents a new quality in the history of the Ukrainian nation, therefore, that the Ukrainians have to defend the status quo (independence, territorial integrity, sovereignty, etc.) but not to seek to achieve an independent being. The analysis leads to the conclusion that the ability of Ukrainians to achieve and maintain independence is largely a function of the relative power of the Russian state as measured with respect to the shape and quality of international relations

Cancer and thrombosis: Managing the risks and approaches to thromboprophylaxis

Patients with cancer are at increased risk of venous thromboembolism (VTE) compared with patients without cancer. This results from both the prothrombotic effects of the cancer itself and iatrogenic factors, such as chemotherapy, radiotherapy, indwelling central venous devices and surgery, that further increase the risk of VTE. Although cancer-associated thrombosis remains an important cause of morbidity and mortality, it is often underdiagnosed and undertreated. However, evidence is accumulating to support the use of low-molecular-weight heparins (LMWHs) in the secondary prevention of VTE in patients with cancer. Not only have LMWHs been shown to be at least as effective as coumarin derivatives in this setting, but they have a lower incidence of complications, including bleeding, and are not associated with the practical problems of warfarin therapy. Furthermore, a growing number of studies indicate that LMWHs may improve survival among patients with cancer due to a possible antitumor effect. Current evidence suggests that LMWHs should increasingly be considered for the long-term management of VTE in patients with cancer

Management of cancer-associated venous thrombosis

The association between malignancy and venous thromboembolic disease has been recognized for over a century and a half. During this time, a substantial body of literature has developed showing that malignancy is not only a hypercoagulable state characterized by an increased risk of thrombosis but also that components of blood coagulation reactions are capable of supporting tumor growth and dissemination. In recent years a succession of meticulously performed clinical trials has clarified optimal therapy intended to both prevent and treat thromboembolism that occurs in the setting of cancer. However, much remains to be accomplished in terms of practitioner education on the merits of optimal therapy. Of perhaps greater interest is the possibility that drugs capable of controlling cancer-associated hypercoagulability may provide a means for improving cancer survival while avoiding the toxicities characteristic of conventional anti-tumor therapy. Clearly, ample incentive exists for collaboration between basic and clinical scientists interested in improving the management of malignancy and its thromboembolic complications

Iron reduction response and demographic differences between diabetics and non-diabetics with cardiovascular disease entered to a controlled clinical trial

Iron-catalyzed oxygen free radical-induced oxidative stress mediates the pathogenesis of diabetes and cardiovascular disease (CVD). Diabetics (n=473) and non-diabetics (n=804) with CVD entered to a randomized trial of iron (ferritin) reduction by calibrated phlebotomy (www.clinicaltrials.gov, Identifier NCT00032357) had comparable iron measures at entry but diabetics had greater burden of CVD and comorbidities, lower hemoglobin and hematocrit levels, and higher glucose levels than non-diabetics. Entry iron measures were lower in diabetics on hypoglycemic therapy compared to diabetics untreated previously. Diabetics and non-diabetics had comparable iron measures during follow-up. Loess analysis of paired ferritin and hemoglobin, and paired ferritin and glucose levels in diabetics randomized to phlebotomy showed higher ferritin levels associated with lower hemoglobin and higher glucose levels. Progressive ferritin reduction in diabetics comported with rising hemoglobin and falling glucose levels neither of which reached levels observed in non-diabetics. We postulate that phlebotomy-triggered autophagy (ferritinophagy) released redox-active iron sequestered intracellularly worsening anemia and glucose utilization that corrected partially with ferritin reduction. Intracellular redox-active iron levels contributory to disease, not reflected in peripheral iron measures, may persist because of glycation of iron transport proteins in diabetes. These findings suggest novel strategies for disease prevention and improving outcomes in diabetes and CVD

A U-shaped relationship between haematocrit and mortality in a large prospective cohort study

Background: Only a limited number of studies have investigated the correlation between haematocrit (HCT) and mortality in the general population, and few of those studies have had data on a wide range of low and high levels of HCT. We investigated the association between baseline HCT and mortality in a prospective cohort study of 49 983 adult subjects in Iran with a broad spectrum of HCT values. Methods: Data on socio-demographic and life-style factors, past medical history, and levels of HCT were collected at enrollment. During a mean follow-up of 5 years (follow-up success rate ±99%), 2262 deaths were reported. Cox proportional hazards regression models were used to estimate hazard ratios and corresponding 95% confidence intervals. Results: There was a U-shaped relationship between categories of HCT and mortality in both sexes: both low and high levels of HCT were associated with increased overall mortality and mortality from cardiovascular disease. The U-shaped relationship persisted after several sensitivity analyses were done, including analyses restricted to non-smokers and non-users of opium; analyses excluding deaths from accidents and other external causes as well as deaths of persons with self-reported ischemic heart disease at the baseline interview for the study; and analyses excluding the first 2 years of follow-up. Self-reported past medical history and lack of data about lipids and other cellular blood components were the major limitations of the study. Conclusions: Low and high levels of HCT are associated with increased mortality in the general population. The findings in the present study can be of particular importance for low- and middle-income countries in which a substantial proportion of the population lives with suboptimal levels of HCT. © Published by Oxford University Press on behalf of the International Epidemiological Association 2013

Operational Energy [video]

NPS Defense Energy Seminar. The speaker is Director, Navy Energy Coordination Office, Great Green Fleet Coordinator, Energy & Environmental Readiness (OPNAV N45

Tożsamość bezpieczeństwa przestrzeni Bałkanów Zachodnich w świetle teorii regionalnych kompleksów bezpieczeństwa

Autor opisuje sytuację Bałkanów Zachodnich w oparciu o teorię regionalnych kompleksów bezpieczeństwa. W myśl tej koncepcji bezpieczeństwo definiowane jest przede wszystkim w regionalnych kontekstach geograficznych. Zagrożenia są uznawane za najbardziej prawdopodobne i tak postrzegane (sekurytyzowane) w bezpośrednim sąsiedztwie.Udostępnienie publikacji Wydawnictwa Uniwersytetu Łódzkiego finansowane w ramach projektu „Doskonałość naukowa kluczem do doskonałości kształcenia”. Projekt realizowany jest ze środków Europejskiego Funduszu Społecznego w ramach Programu Operacyjnego Wiedza Edukacja Rozwój; nr umowy: POWER.03.05.00-00-Z092/17-00