ГІПОПАРАТИРЕОЗ ЯК ОСНОВНЕ УСКЛАДНЕННЯ ПІСЛЯ ОПЕРАЦІЙ НА ЩИТОПОДІБНІЙ ЗАЛОЗІ

У світовій медицині питання профілактики гіпопаратиреозу активно вивчаються, постійно розробляються нові методи для діагностики та лікування гіпопаратиреозу. Але аналізуючи дані світової літератури, можназробити висновок, що проблема профілактики, діагностики та лікування гіпопаратиреозу в ранньому післяопераційному періоді залишається відкритою. Досі не знайдено оптимальної схеми лікування пацієнтів із післяопераційним гіпопаратиреозом, а ті схеми лікування, що уже запропоновані, носять лише рекомендаційний характер

A fresh look at introductory data science

The proliferation of vast quantities of available datasets that are large and complex in nature has challenged universities to keep up with the demand for graduates trained in both the statistical and the computational set of skills required to effectively plan, acquire, manage, analyze, and communicate the findings of such data. To keep up with this demand, attracting students early on to data science as well as providing them a solid foray into the field becomes increasingly important. We present a case study of an introductory undergraduate course in data science that is designed to address these needs. Offered at Duke University, this course has no pre-requisites and serves a wide audience of aspiring statistics and data science majors as well as humanities, social sciences, and natural sciences students. We discuss the unique set of challenges posed by offering such a course and in light of these challenges, we present a detailed discussion into the pedagogical design elements, content, structure, computational infrastructure, and the assessment methodology of the course. We also offer a repository containing all teaching materials that are open-source, along with supplemental materials and the R code for reproducing the figures found in the paper

Визначення показань та протипоказань до симультанних оперативних втручань у пацієнтів з поєднанням ендокринної та іншої хірургічної патології

The aim of the work: to develop indications and contraindications for the implementation of simultaneous surgical interventions on the example of patients with combined pathology of the thyroid gland (TG) and cholelithiasis (CL) / gallbladder polyposis, using the scale of the functional state of P-POSSUM. Materials and Methods. During the period from January 2015 to September 2018, 35 patients with combined pathology of the TG and CL / gallbladder polyposis were examined and operated. At the preoperative stage, as well as on the first day of the postoperative period, all patients evaluated on the P-POSSUM scale. Results and Discussion. In 22 (62.9 %) patients, whose functional state before the intervention was assessed by physiological subscale (FS) ≤ 17 points, there were postoperative changes in health with an average difference of 0.13 points, T (Z) = 1.21, p = 0.225. In all these patients, the complexity of surgical intervention on the surgical sub-scale (SS) on the P-POSSUM scale was estimated ≤ 14 points. In 13 (37.1 %) patients, whose condition was estimated at 17 points by FS, significant changes in functional health before and after surgery were revealed, with a difference of average 1.15 points, T (Z) = 2.67; p = 0.0077. The complexity of their operations ranged from 14 to 16 points for SS.Цель работы: разработать показания и противопоказания к выполнению симультанных оперативных вмешательств на примере пациентов с сочетанной патологией щитовидной железы (ЩЖ) и желчнокаменной болезнью (ЖКБ) / полипозом желчного пузыря, с использованием шкалы функционального состояния P-POSSUM. Материалы и методы. За период с января 2015 по сентябрь 2018 года обследовано и прооперировано 35 пациентов с сочетанной патологией щитовидной железы и ЖКБ / полипозом желчного пузыря. На дооперационном этапе, а также на первые сутки послеоперационного периода, всем пациентам проводили оценку функционального состояния по шкале P-POSSUM. Результаты исследований и их обсуждение. У 22 (62,9 %) пациентов, функциональное состояние которых до вмешательства оценивалось по физиологической субшкале (ФС) ≤ 17 баллов, имели место послеоперационные изменения состояния здоровья с разницей средних 0,13 баллов, Т (Z) = 1,21, р = 0,225. В этих больных сложность оперативного вмешательства по хирургической субшкале (ХС) шкале P-POSSUM была оценена ≤ 14 баллов. У 13 (37,1 %) больных, состояние которых было оценено в 17 баллов по ФС, выявлены значимые изменения функционального состояния здоровья до и после операции, с разницей средних 1,15 балла, Т (Z) = 2,67; р = 0,0077. Сложность операций у них колебалась от 14 до 16 баллов за ХС.Мета роботи: розробити показання та протипоказання до виконання симультанних оперативних втручань на прикладі пацієнтів з поєднаною патологією щитоподібної залози (ЩЗ) та жовчнокам’яною хворобою (ЖКХ) / поліпозом жовчного міхура, з використанням шкали функціонального стану P-POSSUM. Матеріали і методи. За період з січня 2015 до вересня 2018 року обстежено та прооперовано 35 пацієнтів з поєднаною патологією щитоподібної залози та ЖКХ / поліпозом жовчного міхура. На доопераційному етапі, а також на першу добу післяопераційного періоду всім пацієнтам проводили оцінку функціонального стану за шкалою P-POSSUM. Результати досліджень та їх обговорення. У 22 (62,9 %) пацієнтів, функціональний стан яких до втручання оцінювався за фізіологічною субшкалою (ФС) ≤ 17 балів, мали місце післяопераційні зміни стану здоров’я з різницею середніх 0,13 бала, Т (Z) = 1,21, р = 0,225. У всіх цих хворих складність оперативного втручання за хірургічною субшкалою (ХС) шкали P-POSSUM була оцінена ≤ 14 балів. У 13 (37,1 %) хворих, стан яких був оцінений в ˃ 17 балів за ФС, виявлені значущі зміни функціонального стану здоров’я до та після операції з різницею середніх 1,15 бала, Т (Z) = 2,67; р = 0,0077. Складність операцій у них коливалася від 14 до 16 балів за ХС

Построение диагностической модели сложного объекта диагностирования на основе минимизации множества вероятностно-лингвистических синдромов

The probabilistic-linguistic approach to the representation and transformation of the fuzzy information allows to show how to solve the problem of building types of numerous probabilistic-linguistic syndromes characterizing all possible technical conditions of complex object for diagnostics.На основе вероятностно-лингвистического подхода к представлению и преобразованию нечеткой информации показан порядок решения задачи типизации сформированного экспертами множества вероятностно-лингвистических синдромов, характеризующих все возможные технические состояния сложного объекта диагностирования

Comparative expression of Cbf genes in the Triticeae under different acclimation induction temperatures

In plants, the C-repeat binding factors (Cbfs) are believed to regulate low-temperature (LT) tolerance. However, most functional studies of Cbfs have focused on characterizing expression after an LT shock and have not quantified differences associated with variable temperature induction or the rate of response to LT treatment. In the Triticeae, rye (Secale cereale L.) is one of the most LT-tolerant species, and is an excellent model to study and compare Cbf LT induction and expression profiles. Here, we report the isolation of rye Cbf genes (ScCbfs) and compare their expression levels in spring- and winter-habit rye cultivars and their orthologs in two winter-habit wheat (Triticum aestivum L.) and barley (Hordeum vulgare L.) cultivars. Eleven ScCbfs were isolated spanning all four major phylogenetic groups. Nine of the ScCbfs mapped to 5RL and one to chromosome 2R. Cbf expression levels were variable, with stronger expression in winter- versus spring-habit rye cultivars but no clear relationship with cultivar differences in LT, down-stream cold-regulated gene expression and Cbf expression were detected. Some Cbfs were expressed only at warmer acclimation temperatures in all three species and their expression was repressed at the end of an 8-h dark period at warmer temperatures, which may reflect a temperature-dependent, light-regulated diurnal response. Our work indicates that Cbf expression is regulated by complex genotype by time by induction–temperature interactions, emphasizing that sample timing, induction–temperature and light-related factors must receive greater consideration in future studies involving functional characterization of LT-induced genes in cereals

Effects of photo and thermo cycles on flowering time in barley: a genetical phenomics approach

The effects of synchronous photo (16 h daylength) and thermo (2 °C daily fluctuation) cycles on flowering time were compared with constant light and temperature treatments using two barley mapping populations derived from the facultative cultivar ‘Dicktoo’. The ‘Dicktoo’בMorex’ (spring) population (DM) segregates for functional differences in alleles of candidate genes for VRN-H1, VRN-H3, PPD-H1, and PPD-H2. The first two loci are associated with the vernalization response and the latter two with photoperiod sensitivity. The ‘Dicktoo’בKompolti korai’ (winter) population (DK) has a known functional polymorphism only at VRN-H2, a locus associated with vernalization sensitivity. Flowering time in both populations was accelerated when there was no fluctuating factor in the environment and was delayed to the greatest extent with the application of synchronous photo and thermo cycles. Alleles at VRN-H1, VRN-H2, PPD-H1, and PPD-H2—and their interactions—were found to be significant determinants of the increase/decrease in days to flower. Under synchronous photo and thermo cycles, plants with the Dicktoo (recessive) VRN-H1 allele flowered significantly later than those with the Kompolti korai (recessive) or Morex (dominant) VRN-H1 alleles. The Dicktoo VRN-H1 allele, together with the late-flowering allele at PPD-H1 and PPD-H2, led to the greatest delay. The application of synchronous photo and thermo cycles changed the epistatic interaction between VRN-H2 and VRN-H1: plants with Dicktoo type VRN-H1 flowered late, regardless of the allele phase at VRN-H2. Our results are novel in demonstrating the large effects of minor variations in environmental signals on flowering time: for example, a 2 °C thermo cycle caused a delay in flowering time of 70 d as compared to a constant temperature

The Promoter of the Cereal VERNALIZATION1 Gene Is Sufficient for Transcriptional Induction by Prolonged Cold

The VERNALIZATION1 (VRN1) gene of temperate cereals is transcriptionally activated by prolonged cold during winter (vernalization) to promote flowering. To investigate the mechanisms controlling induction of VRN1 by prolonged cold, different regions of the VRN1 gene were fused to the GREEN FLUORESCENT PROTEIN (GFP) reporter and expression of the resulting gene constructs was assayed in transgenic barley (Hordeum vulgare). A 2 kb segment of the promoter of VRN1 was sufficient for GFP expression in the leaves and shoot apex of transgenic barley plants. Fluorescence increased at the shoot apex prior to inflorescence initiation and was subsequently maintained in the developing inflorescence. The promoter was also sufficient for low-temperature induction of GFP expression. A naturally occurring insertion in the proximal promoter, which is associated with elevated VRN1 expression and early flowering in some spring wheats, did not abolish induction of VRN1 transcription by prolonged cold, however. A translational fusion of the promoter and transcribed regions of VRN1 to GFP, VRN1::GFP, was localised to nuclei of cells at the shoot apex of transgenic barley plants. The distribution of VRN1::GFP at the shoot apex was similar to the expression pattern of the VRN1 promoter-GFP reporter gene. Fluorescence from the VRN1::GFP fusion protein increased in the developing leaves after prolonged cold treatment. These observations suggest that the promoter of VRN1 is targeted by mechanisms that trigger vernalization-induced flowering in economically important temperate cereal crops

The CBF gene family in hexaploid wheat and its relationship to the phylogenetic complexity of cereal CBFs

Most temperate plants tolerate both chilling and freezing temperatures whereas many species from tropical regions suffer chilling injury when exposed to temperatures slightly above freezing. Cold acclimation induces the expression of cold-regulated genes needed to protect plants against freezing stress. This induction is mediated, in part, by the CBF transcription factor family. To understand the evolution and function of this family in cereals, we identified and characterized 15 different CBF genes from hexaploid wheat. Our analyses reveal that wheat species, T. aestivum and T. monococcum, may contain up to 25 different CBF genes, and that Poaceae CBFs can be classified into 10 groups that share a common phylogenetic origin and similar structural characteristics. Six of these groups (IIIc, IIId, IVa, IVb, IVc and IVd) are found only in the Pooideae suggesting they represent the CBF response machinery that evolved recently during colonization of temperate habitats. Expression studies reveal that five of the Pooideae-specific groups display higher constitutive and low temperature inducible expression in the winter cultivar, and a diurnal regulation pattern during growth at warm temperature. The higher constitutive and inducible expression within these CBF groups is an inherited trait that may play a predominant role in the superior low temperature tolerance capacity of winter cultivars and possibly be a basis of genetic variability in freezing tolerance within the Pooideae subfamily

Genome-wide gene expression analysis supports a developmental model of low temperature tolerance gene regulation in wheat (Triticum aestivum L.)

<p>Abstract</p> <p>Background</p> <p>To identify the genes involved in the development of low temperature (LT) tolerance in hexaploid wheat, we examined the global changes in expression in response to cold of the 55,052 potentially unique genes represented in the Affymetrix Wheat Genome microarray. We compared the expression of genes in winter-habit (winter Norstar and winter Manitou) and spring-habit (spring Manitou and spring Norstar)) cultivars, wherein the locus for the vernalization gene <it>Vrn-A1 </it>was swapped between the parental winter Norstar and spring Manitou in the derived near-isogenic lines winter Manitou and spring Norstar. Global expression of genes in the crowns of 3-leaf stage plants cold-acclimated at 6°C for 0, 2, 14, 21, 38, 42, 56 and 70 days was examined.</p> <p>Results</p> <p>Analysis of variance of gene expression separated the samples by genetic background and by the developmental stage before or after vernalization saturation was reached. Using gene-specific ANOVA we identified 12,901 genes (at <it>p </it>< 0.001) that change in expression with respect to both genotype and the duration of cold-treatment. We examined in more detail a subset of these genes (2,771) where expression was highly influenced by the interaction between these two main factors. Functional assignments using GO annotations showed that genes involved in transport, oxidation-reduction, and stress response were highly represented. Clustering based on the pattern of transcript accumulation identified genes that were up or down-regulated by cold-treatment. Our data indicate that the cold-sensitive lines can up-regulate known cold-responsive genes comparable to that of cold-hardy lines. The levels of expression of these genes were highly influenced by the initial rate and the duration of the gene's response to cold. We show that the <it>Vrn-A1 </it>locus controls the duration of gene expression but not its initial rate of response to cold treatment. Furthermore, we provide evidence that <it>Ta.Vrn-A1 </it>and <it>Ta.Vrt1 </it>originally hypothesized to encode for the same gene showed different patterns of expression and therefore are distinct.</p> <p>Conclusion</p> <p>This study provides novel insight into the underlying mechanisms that regulate the expression of cold-responsive genes in wheat. The results support the developmental model of LT tolerance gene regulation and demonstrate the complex genotype by environment interactions that determine LT adaptation in winter annual cereals.</p

Transcriptome Analysis of the Vernalization Response in Barley (Hordeum vulgare) Seedlings

Temperate cereals, such as wheat (Triticum spp.) and barley (Hordeum vulgare), respond to prolonged cold by becoming more tolerant of freezing (cold acclimation) and by becoming competent to flower (vernalization). These responses occur concomitantly during winter, but vernalization continues to influence development during spring. Previous studies identified VERNALIZATION1 (VRN1) as a master regulator of the vernalization response in cereals. The extent to which other genes contribute to this process is unclear. In this study the Barley1 Affymetrix chip was used to assay gene expression in barley seedlings during short or prolonged cold treatment. Gene expression was also assayed in the leaves of plants after prolonged cold treatment, in order to identify genes that show lasting responses to prolonged cold, which might contribute to vernalization-induced flowering. Many genes showed altered expression in response to short or prolonged cold treatment, but these responses differed markedly. A limited number of genes showed lasting responses to prolonged cold treatment. These include genes known to be regulated by vernalization, such as VRN1 and ODDSOC2, and also contigs encoding a calcium binding protein, 23-KD jasmonate induced proteins, an RNase S-like protein, a PR17d secretory protein and a serine acetyltransferase. Some contigs that were up-regulated by short term cold also showed lasting changes in expression after prolonged cold treatment. These include COLD REGULATED 14B (COR14B) and the barley homologue of WHEAT COLD SPECIFIC 19 (WSC19), which were expressed at elevated levels after prolonged cold. Conversely, two C-REPEAT BINDING FACTOR (CBF) genes showed reduced expression after prolonged cold. Overall, these data show that a limited number of barley genes exhibit lasting changes in expression after prolonged cold treatment, highlighting the central role of VRN1 in the vernalization response in cereals