ROLE OF CYTOKINE-MEDIATED MECHANISMS IN DEVELOPMENT OF POST-TRAUMATIC MANDIBULAR OSTEOMYELITIS

Osteomyelitis of the lower jaw is one of the urgent problems of modern medicine. There are many reasons for the evolvement of purulent necrotic processes of the jaw bones, including the role of disorders in the systems of innate and adaptive immunity. The aim of the study was to determine the content of TNFα, IL-17, IL-4 in serum and mixed saliva in patients with uncomplicated mandibular fractures and posttraumatic osteomyelitis to determine the possibility of using these indicators for early diagnosis of posttraumatic complications. The article presents the results of a study of tumor necrosis factor α (TNFα), interleukin-17 (IL-17) and interleukin-4 (IL-4) cytokines in serum and mixed saliva in patients with uncomplicated mandibular fracture and post-traumatic osteomyelitis at the first and tenth days of observation. By means of single-layer neural networks, binary classifiers were built, allowing patients to be stratified by the clinical form of the disease and to predict its course. The probability of uncomplicated mandibular fracture is described by the ratio P = 1/(1+e-z), where the index z is determined by the level of TNFα, IL-17, and IL-4 at the first and tenth day of observation. The simulation confirmed high prognostic significance of serum TNFα and IL-17 for early verification of posttraumatic osteomyelitis, which was confirmed by the OTC and ROC indices, which varied from 87 to 100% in different models. Models 4 and 5, where TNFα recorded on the tenth day of the study was used as predictors, and a combination of TNFα and IL-17 obtained on the first day of hospitalization, were the most accurate. Modeling the results of the study of immunological indicators in the mixed saliva showed that the predictive properties have only IL-4 and IL-17, was on the tenth day of hospitalization that distinguishes these binary classifiers from similar indexes, derive from the levels of cytokines in blood serum. The results of the study indicate the important role of disorders in the system of рro- and anti-inflammatory cytokines in pathogenesis of post-traumatic osteomyelitis

Examining the Evidence for Chytridiomycosis in Threatened Amphibian Species

Extinction risks are increasing for amphibians due to rising threats and minimal conservation efforts. Nearly one quarter of all threatened/extinct amphibians in the IUCN Red List is purportedly at risk from the disease chytridiomycosis. However, a closer look at the data reveals that Batrachochytrium dendrobatidis (the causal agent) has been identified and confirmed to cause clinical disease in only 14% of these species. Primary literature surveys confirm these findings; ruling out major discrepancies between Red List assessments and real-time science. Despite widespread interest in chytridiomycosis, little progress has been made between assessment years to acquire evidence for the role of chytridiomycosis in species-specific amphibian declines. Instead, assessment teams invoke the precautionary principle when listing chytridiomycosis as a threat. Precaution is valuable when dealing with the world's most threatened taxa, however scientific research is needed to distinguish between real and predicted threats in order to better prioritize conservation efforts. Fast paced, cost effective, in situ research to confirm or rule out chytridiomycosis in species currently hypothesized to be threatened by the disease would be a step in the right direction. Ultimately, determining the manner in which amphibian conservation resources are utilized is a conversation for the greater conservation community that we hope to stimulate here

Информативность индикаторов силы дыхательных мышц в оценке тяжести хронической обструктивной болезни легких при моделировании на основе искусственных нейронных сетей

The aim of the study was to analyze a diagnostic value of respiratory muscle (RM) strength indicators to assess severity of chronic obstructive pulmonary disease (COPD) using machine learning methods and artificial neural networks (ANN). Methods. One hundred and fifteen males with acute exacerbation  of COPD  were involved in the study. RM strength indicators (MEP,  MIP,  and SNIP), demographic  parameters,  spirometry,  blood gases, dyspnea with mMRC and CAT scales were measured. Statistical analysis was performed using Mann-Whitney’s, Fisher’s and Tukey’s tests and correlation  analysis. RM strength model was performed  using linear and nonlinear  regression analysis. COPD  stratification  model was performed using ANN. Results. RM strength models in healthy males and COPD  patients allowed estimation  the impact of different factors on the RM functional status. Comparison  of COPD  stratification  for severity using the mathematical model or expert diagnosis showed that combination of FEV1 with other indicators could increase the accuracy of ANN model. MIP,  the total body mass, partial CO2  tension in the arterial blood and serum fibrinogen concentration were the most valuable indicators.  Moreover,  MIP  was considered  as the universal predictor  increasing the accuracy of all models. Conclusion. Practical application  of ANN models in telemedicine  projects is related to the improvement  of ANN architecture and development of informational services which would allow a real-time assessment of the patient's condition.Сила дыхательных мышц (ДМ) является  основным  индикатором их функционального состояния, а ее исследование получает все большее распространение в клинической пульмонологии, в т. ч. у больных хронической обструктивной болезнью  легких (ХОБЛ). Вместе с тем в классификации ХОБЛ показатели  силы ДМ не рассматриваются как биомаркеры, характеризующие ее тяжесть,  и не используются в качестве критериев  для стратификации больных. Целью исследования явился анализ информативности показателей силы ДМ для оценки  тяжести  ХОБЛ на основе  методов  машинного обучения  и искусственных нейронных сетей (ИНС). Материал и методы. Обследованы   госпитализированные  в  стационар  мужчины   (n  = 115)  с  ХОБЛ  различной  степени   тяжести  в  стадии  обострения. Регистрировались силовые индикаторы ДМ (максимальное инспираторное (MIP), экспираторное (MEP)  и интраназальное (SNIP) давление) на аппарате MicroRPM (CareFusion, Великобритания), 9 антропометрических параметров, спирометрические и газометрические показатели, а также результаты тестирования по шкалам  выраженности одышки  (modified Medical Research Council – mMRC)  и оценочного теста по хронической обструктивной болезни  легких (COPD Assessment Test – САТ). Обработка  данных проводилась  с помощью тестов Манна–Уитни, Фишера,  Тьюки, корреляционного анализа. Моделирование силы ДМ выполнялось методами линейной и нелинейной  регрессии, а модели стратификации тяжести ХОБЛ – методом ИНС.  Результаты. При помощи  модели силы ДМ у здоровых лиц и больных ХОБЛ оценены  суммарные  эффекты влияния различных  факторов  на их функциональный статус. По данным  сравнительного анализа «модельных» результатов верификации тяжести ХОБЛ с диагнозами  экспертов-пульмонологов отмечено,  что повышение их точности  с помощью  ИНС  достигается только при комбинации показателя объема форсированного выдоха за 1-ю секунду с другими индикаторами. Наиболее  информативными из них явились  показатели  MIP,  общей массы тела, парциального давления  углекислого газа в артериальной крови и уровня фибриногена. При этом MIP выступал в качестве универсального предиктора, при помощи  которого повышается точность  всех моделей.  Заключение. Перспектива внедрения диагностических моделей  на основе  ИНС  в проекты телемедицины связана с совершенствованием их архитектуры и разработкой информационных сервисов,  при помощи  которых состояние больных будет оцениваться в реальном времени

Secondary education reform in Lesotho and Zimbabwe and the needs of rural girls: Pronouncements, policy and practice

Analysis of the educational needs of rural girls in Lesotho and Zimbabwe suggests a number of shortcomings in the current form of secondary education, and ways in which it might be modified so as to serve this sizeable group of students better. Several of the shortcomings, notably in relation to curricular irrelevance and excessive focus on examinations, have long been recognised, including by politicians. Yet political pronouncements are seldom translated into policy, and even where policy is formulated, reforms are seldom implemented in schools. This paper makes use of interviews with educational decision-makers in the two southern African countries and a range of documentary sources to explore why, despite the considerable differences between the two contexts, much needed educational reforms have been implemented in neither

Do Frogs Get Their Kicks on Route 66? Continental U.S. Transect Reveals Spatial and Temporal Patterns of Batrachochytrium dendrobatidis Infection

The chytrid fungus Batrachochytrium dendrobatidis (Bd) has been devastating amphibians globally. Two general scenarios have been proposed for the nature and spread of this pathogen: Bd is an epidemic, spreading as a wave and wiping out individuals, populations, and species in its path; and Bd is endemic, widespread throughout many geographic regions on every continent except Antarctica. To explore these hypotheses, we conducted a transcontinental transect of United States Department of Defense (DoD) installations along U.S. Highway 66 from California to central Illinois, and continuing eastward to the Atlantic Seaboard along U.S. Interstate 64 (in sum from Marine Corps Base Camp Pendleton in California to Naval Air Station Oceana in Virginia). We addressed the following questions: 1) Does Bd occur in amphibian populations on protected DoD environments? 2) Is there a temporal pattern to the presence of Bd? 3) Is there a spatial pattern to the presence of Bd? and 4) In these limited human-traffic areas, is Bd acting as an epidemic (i.e., with evidence of recent introduction and/or die-offs due to chytridiomycosis), or as an endemic (present without clinical signs of disease)? Bd was detected on 13 of the 15 bases sampled. Samples from 30 amphibian species were collected (10% of known United States' species); half (15) tested Bd positive. There was a strong temporal (seasonal) component; in total, 78.5% of all positive samples came in the first (spring/early-summer) sampling period. There was also a strong spatial component—the eleven temperate DoD installations had higher prevalences of Bd infection (20.8%) than the four arid (<60 mm annual precipitation) bases (8.5%). These data support the conclusion that Bd is now widespread, and promote the idea that Bd can today be considered endemic across much of North America, extending from coast-to-coast, with the exception of remote pockets of naïve populations

Seasonal Pattern of Batrachochytrium dendrobatidis Infection and Mortality in Lithobates areolatus: Affirmation of Vredenburg's “10,000 Zoospore Rule”

To fully comprehend chytridiomycosis, the amphibian disease caused by the chytrid fungus Batrachochytrium dendrobatidis (Bd), it is essential to understand how Bd affects amphibians throughout their remarkable range of life histories. Crawfish Frogs (Lithobates areolatus) are a typical North American pond-breeding species that forms explosive spring breeding aggregations in seasonal and semipermanent wetlands. But unlike most species, when not breeding Crawfish Frogs usually live singly—in nearly total isolation from conspecifics—and obligately in burrows dug by crayfish. Crayfish burrows penetrate the water table, and therefore offer Crawfish Frogs a second, permanent aquatic habitat when not breeding. Over the course of two years we sampled for the presence of Bd in Crawfish Frog adults. Sampling was conducted seasonally, as animals moved from post-winter emergence through breeding migrations, then back into upland burrow habitats. During our study, 53% of Crawfish Frog breeding adults tested positive for Bd in at least one sample; 27% entered breeding wetlands Bd positive; 46% exited wetlands Bd positive. Five emigrating Crawfish Frogs (12%) developed chytridiomycosis and died. In contrast, all 25 adult frogs sampled while occupying upland crayfish burrows during the summer tested Bd negative. One percent of postmetamorphic juveniles sampled were Bd positive. Zoospore equivalents/swab ranged from 0.8 to 24,436; five out of eight frogs with zoospore equivalents near or >10,000 are known to have died. In summary, Bd infection rates in Crawfish Frog populations ratchet up from near zero during the summer to over 25% following overwintering; rates then nearly double again during and just after breeding—when mortality occurs—before the infection wanes during the summer. Bd-negative postmetamorphic juveniles may not be exposed again to this pathogen until they take up residence in crayfish burrows, or until their first breeding, some years later

Clinical Guidelines of the Russian Society of Surgeons, the Russian Gastroenterological Association, the Association of Surgeons-Hepatologists and the Endoscopic Society “REndO” on Diagnostics and Treatment of Chronic Pancreatitis

Aim: to present modern methods of diagnosis and treatment of chronic pancreatitis for gastroenterologists, general practitioners and physicians.Chronic pancreatitis (CP) is a long-term inflammatory disease of the pancreas, manifested by irreversible morphological changes in the parenchyma and pancreatic ducts, which cause pain and/or persistent impairment of function. Current concept on the etiology of CP is reflected by the TIGAR-O classification. The criteria for establishing the diagnosis of CP include typical attacks of abdominal pain and/or clinical and laboratory signs of exocrine, endocrine insufficiency with the mandatory detection of characteristic morphological changes (calcifications in the parenchyma and pancreatic ductal stones, dilatation of the main pancreatic duct and its branches). CT, MRCP, and pancreatobiliary endosonography are recommended as the methods of choice to verify the diagnosis of CP. Conservative treatment of patients with CP is provided for symptom relief and prevention of complications. Individual cases with severe non-interactable abdominal pain, as well as a complicated course of the disease (development of ductal hypertension due to main pancreatic duct stones or strictures, obstructive jaundice caused by compression of the common bile duct, symptomatic postnecrotic cysts, portal hypertension due to compression of the portal vein or thrombosis of the splenic vein, persistent duodenal obstruction, pseudoaneurysm of the celiac trunk basin and the superior mesenteric artery) serve as an indication for endoscopic or surgical treatment. The Guidelines set out modern approaches to the diagnosis, conservative, endoscopic and surgical treatment of CP, and the prevention of its complications.Conclusion. The implementation of clinical guidelines can contribute to the timely diagnosis and improve the quality of medical care for patients with chronic pancreatitis