Model for Predicting Risk of Postpartum Purulent-Inflammatory Complications after Cesarean Section: Cohort Retrospective Study

Background. Relevance of the study is related to the lack of a unified strategy for determining the risk of infectious complications of puerperium. Currently, the specialists use the collected data from studies documenting the main factors of infection in a population or cohorts of postpartum women. However, accuracy of these factors is not established and prognosis could not be personalized. The paper analyzes significant risk factors for the infectious complications associated with cesarean section (C-Section) and develops a model for their prognosis and an individual assessment of the risk of postpartum infection in order to take timely preventive measures. Objective. To identify predictors of postpartum purulent-inflammatory complications after cesarean section, to evaluate their predictive value, and to develop a statistical model for determining the risk of their occurrence.Methods. The cohort retrospective study (January 2019 to January 2022) was conducted in four obstetric health facilities of Krasnodar and was focused on analysis of medical records. Anamnestic, clinical and laboratory data of all women after cesarean section delivery were collected. Model: a patient diagnosed with any infection associated with cesarean section within 42 days after delivery — postoperative suture infection, endometritis, peritonitis, thrombophlebitis, sepsis. Infections were grouped to carry out a single risk assessment with an internal validation test and to develop a multifactor logistic regression model. All analyses were conducted using version R 3.2.3 (SPSS Inc., Chicago, IL) and Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD).Results. Infection associated with cesarean section occurred in 2.50% of women (n = 548; 95% CI 2.6–3.5), suture disruption — in 0.59% (n = 129; 95%, CI 0.41–0.81), endometritis — 1.46% (n = 321; 95%, CI 1.15–1.94), peritonitis — 0.16% (n = 35; 95%, CI 0.11–0.20), thrombophlebitis 0.04% (n = 9; 95%, CI 0.01–0.05), sepsis 0.25% (n = 54; 95%, CI 0.15–0.35). The authors have identified 14 major variables with a high prognostic risk for the development of infectious complications of puerperium. The model differentiated women with and without purulent inflammatory complications of puerperium by internal validation (concordance index = 0.712, 95%, CI 0.672–0.755).Conclusion. The developed model can be used to accurately predict the risk of infectious complications after abdominal delivery and to identify high-risk patients. It ensures a differentiated approach with a possibility to expand studies and strengthen antibiotic therapy, which promotes reduction of surgical site puerperal infection

Chronic endometritis and infertility — in vitro fertilization outcomes: systematic review and meta-analysis

Background. The relevance of the problem is related to the high prevalence of chronic endometritis (CE); its role in female infertility, implantation failures during assisted reproductive technology procedures, and recurrent miscarriage; as well as the lack of a unified strategy in the diagnosis and treatment of this pathology. The present systematic review with a meta-analysis focuses on evaluating the impact of CE and its therapy on the outcome of in vitro fertilization. In addition, the effect of CE of various severity on the outcomes of assisted reproductive technologies is analyzed. Objective. To analyze the effect of CE of varying severity and its treatment on the outcomes of in vitro fertilization. Methods. Using PubMed, Medline, Scopus, Embase, ELibrary, Cochrane Central Register of Controlled Trials (CENTRAL), WHO International Clinical Trials Registry, and Russian Science Citation Index, a systematic search was conducted for articles published over the past 12 years that met the following criteria: randomized controlled trial examining the effect of CE of varying severity on fertility and ways to treat it. The following indicators were calculated: ongoing pregnancy/live birth, clinical pregnancy, and miscarriage rates. A total of 4145 patients (from ten studies) were included. A meta-analysis was performed using Stata 11.0 software (The Cochrane Collaboration, Oxford, UK). The heterogeneity was considered low at I2 <30%, moderate at 30–50%, and high at >50%. Results. Women with CE exhibited lower ongoing pregnancy/live birth (OR 1.97; p = 0.02) and clinical pregnancy rates (OR 2.28; p = 0.002) as compared to women without it. CE treatment increased the ongoing pregnancy/live birth (OR 5.33; p < 0.0001) and clinical pregnancy rates (OR 3.64; p = 0.0001). In vitro fertilization outcomes were comparable in women treated for CE and women without CE (ongoing pregnancy/live birth rate, clinical pregnancy rate, and miscarriage rate: p = ns). Women with severe CE exhibited lower ongoing pregnancy/live birth (OR 0.43; p = 0.003) and clinical pregnancy rates (OR 0.40; p = 0.0007). Mild CE showed no significant effect on in vitro fertilization outcomes (ongoing pregnancy/ live birth rate, clinical pregnancy rate, and miscarriage rate: p = ns). Conclusion. The conducted meta-analysis showed that CE significantly reduces the ongoing pregnancy/live birth and clinical pregnancy rates in infertile women undergoing in vitro fertilization. Noteworthy is that antimicrobial therapy in such patients improves the results of assisted reproductive technologies, which are comparable to those of patients without CE. The negative impact of this pathology on the implantation capacity of the endometrium is most often observed in the severe form, while its mild form has virtually no effect on the in vitro fertilization outcome

Methodology for knowledge portals development: background, foundations, experience of application, problems and prospects

The paper discusses an experience of using the methodology for the development of knowledge portals which provide systematization and integration of scientific and engineering knowledge and information resources as well as the content-based access to them. To provide a sufficiently complete and consistent representation of knowledge and information resources, their systematization and integration are performed on the basis of ontology. The suggested methodology has been successfully applied to the development of knowledge Internet portals on archaeology, computational linguistics, strength of materials and Antarctic data

Онтология процессов, ориентированная на верификацию

This paper presents the ontology of the concurrent processes close to Hoare communicating sequential processes. It is the part of the intellectual system for supporting verification of behavioural properties of these processes. Our ontological representation of the processes is oriented both to the application of formal verification methods and to the extraction of information from technical documentation (by our previously developed system of information extraction from a natural language text). We describe the ontology classes and domains that define communicating concurrent processes. These processes are characterized by sets of local and shared variables, a list of actions on these variables which change their values, a list of channels for the process communication (which, in turn, are characterized by the type of reading messages, capacity, ways of writing and reading, and reliability), and also a list of communication actions for sending messages. In addition to the formal mathematical definition of classes and domains of the ontology, examples of descriptions of some ontological classes as well as typical properties and axioms for them are specified in the editor Prot ́eg ́e in the OWL language with the use of the inference rules in the SWRL language. The formal operational semantics of communicating processes is determined on their ontological representation and is given as a labelled transition system. It is reduced to the local operational semantics of separate process instances in the interleaving model. We specialize several types of processes from the subject domain of automatic control systems that model the typical functional elements of the automatic control system (sensors, comparators and regulators) as well as their combinations. The concepts of the specialized ontology are illustrated by the example of a control part for a bottle-filling system.В статье представлена онтология процессов, близких взаимодействующим последовательным процессам Хоара. Она является частью интеллектуальной системы поддержки верификации свойств поведения таких процессов. Наше онтологическое представление процессов ориентировано как на применение формальных методов верификации, так и на извлечение информации из технической документации (с помощью нашей ранее разработанной системы извлечения информации из текстов на естественном языке). Мы описываем классы и домены онтологии, которые определяют взаимодействующие процессы. Эти процессы характеризуются множествами локальных и разделяемых переменных, списком действий над этими переменными, которые изменяют их значения, списком каналов взаимодействия процессов (которые, в свою очередь, характеризуются типом чтения сообщений, емкостью, способами записи и считывания, а также надежностью), списком коммуникационных действий для отправки сообщений. Помимо формального математического определения классов и доменов онтологии, приведены примеры описаний некоторых онтологических классов, а также типовых свойств и аксиом для них в редакторе Prot ́eg ́e на языке OWL с использованием правил вывода на языке SWRL. Для онтологического представления взаимодействующих процессов определяется их формальная операционная семантика, которая задается с использованием помеченной системы переходов. В интерливинговой модели она сводится к локальной операционной семантике отдельных экземпляров процессов. Представлена специализация онтологии для некоторых типов процессов из предметной области систем автоматического управления, моделирующих типовые функциональные элементы системы автоматического управления (датчики, сравнивающие устройства и регулирующие устройства), а также их комбинации. Понятия специализированной онтологии иллюстрируются на примере управляющей части системы розлива бутылок

Dynamics of indicators of quality of life during surgical treatment of metastatic lesions

The article presents the dynamics of indicators of quality of life associated with the health of metastases of the spinal column in the postoperative period.В статье представлена динамика показателей качества жизни, связанных со здоровьем, у пациентов с метастазами позвоночного столба в послеоперационном периоде

Методы специализации онтологии процессов, ориентированной на верификацию

User-friendly formal specifications and verification of parallel and distributed systems from various subject fields, such as automatic control, telecommunications, business processes, are active research topics due to its practical significance. In this paper, we present methods for the development of verification-oriented domain-specific process ontologies which are used to describe parallel and distributed systems of subject fields. One of the advantages of such ontologies is their formal semantics which make possible formal verification of the described systems. Our method is based on the abstract verification-oriented process ontology. We use two methods of specialization of the abstract process ontology. The declarative method uses the specialization of the classes of the original ontology, introduction of new declarative classes, as well as use of new axioms system, which restrict the classes and relations of the abstract ontology. The constructive method uses semantic markup and pattern matching techniques to link sublect fields with classes of the abstract process ontology. We provide detailed ontological specifications for these techniques. Our methods preserve the formal semantics of the original process ontology and, therefore, the possibility of applying formal verification methods to the specialized process ontologies. We show that the constructive method is a refinement of the declarative method. The construction of ontology of the typical elements of automatic control systems illustrates our methods: we develop a declarative description of the classes and restrictions for the specialized ontology in the Prot´eg´e system in the OWL language using the deriving rules written in the SWRL language and we construct the system of semantic markup templates which implements typical elements of automatic control systems.Удобная для пользователя формальная спецификация и верификация параллельных и распределённых систем, принадлежащих различным предметным областям, таким как системы автоматического управления, телекоммуникации, бизнес-процессы, являются активными темами исследований в силу их практической значимости. В этой статье мы представляем методы разработки специализированных ориентированных на верификацию онтологий процессов, которые используются для описания параллельных и распределенных систем предметных областей. Одним из преимуществ таких онтологий является их формальная семантика, которая делает возможной формальную верификацию описанных систем. Наш метод основан на абстрактной онтологии процессов, ориентированной на верификацию. Мы используем два метода специализации абстрактной онтологии процессов. Декларативный метод с помощью специализации классов исходной онтологии, введения новых декларативных классов, а также системы аксиом задаёт ограничения для классов и отношений абстрактной онтологии. Конструктивный метод использует техники семантической разметки и сопоставления с образцом, чтобы связать понятия предметной области с классами абстрактной онтологии процессов. Мы даём подробные онтологические спецификации этих техник. Наши методы сохраняют формальную семантику исходной онтологии процессов и, следовательно, возможность применения формальных методов верификации к специализированным онтологиям процессов. Мы показываем, что конструктивный метод является уточнением декларативного метода. Построение онтологии типовых элементов систем автоматического управления иллюстрирует наши методы: разработано декларативное описание классов и ограничений специализированной онтологии в системе Protege на языке OWL с использованием правил вывода на языке SWRL и построена система шаблонов семантической разметки, которая реализует типовые элементы систем автоматического управления

Quality of life of patients after surgical treatment of spinal metastases

The surgical approach of spinal metastases treatment is becoming more common and it requieres a certain optimal surgical critical care that at minimum surgical trauma it will increase the life quality and prolong the patients lifetime. The prospective analysis of clinical and lab data of the patient cases was carried out. The cases were reviewed from October of 2016 to August of 2018 to evaluate the life quality of the patients after their surgery for metastatic spine lesions at the Department of Neurosurgery GBUZ SO SOOD Hospital. Evaluated parameters: performance status, Karnofsky performance score, SF-36 and EQ-5D health questionnaires, Tomita, Tokuhashi, Frankel scores, VAS, SINS score. All the cases after the surgery that had a histological confirmation of metastatic spine lesions except myeloma cases were reviewed. The life quality was evaluated and the Visual Analog scale of the patients was calculated at the pre-operative stage and the post-operative stage after 3, 6 and 12 months. We found positive changes in the pain syndrome, life quality and level of functional activity in post-operative stage. This evidences the viability of the combined modality treatment of the patients with metastatic spine lesions.Хирургическая тактика лечения метастазов позвоночного столба становится всё более распространённой, что требует определения оптимального объёма помощи, приводящей к повышению качества и продолжительности жизни при минимальной операционной травме. С целью оценки качества жизни (КЖ) пациентов, прооперированных по поводу метастатического поражения позвоночника, проведён проспективный анализ объективных клинических и лабораторно-инструментальных данных пациентов с метастатическим поражением позвоночника с октября 2016 года по август 2018 года на базе нейрохирургического отделения ГБУЗ Со "Соод". В работе использованы: шкала ECOG, индекс карновского, анкеты SF-36 и EQ-5D, шкалы Bauer, Tomita, Tokuhashi, Frankel, ВАШ, SINS. критерием включения явился любой прооперированный и гистологически подтверждённый случай метастатического поражения позвоночника, кроме миеломной болезни. Проводилась оценка КЖ и болевого синдрома по ВАШ у пациентов на дооперационном этапе и в послеоперационном периоде через 3, 6 и 12 месяцев. Выявлена положительная динамика по болевому синдрому, качеству жизни и уровню функциональной активности в послеоперационном периоде, что свидетельствует о целесообразности комбинированного лечения пациентов с метастатическим поражением позвоночника

Donepezil, Anti-Alzheimer's Disease Drug, Prevents Cardiac Rupture during Acute Phase of Myocardial Infarction in Mice

Background: We have previously demonstrated that the chronic intervention in the cholinergic system by donepezil, an acetylcholinesterase inhibitor, plays a beneficial role in suppressing long-term cardiac remodeling after myocardial infarction (MI). In comparison with such a chronic effect, however, the acute effect of donepezil during an acute phase of MI remains unclear. Noticing recent findings of a cholinergic mechanism for anti-inflammatory actions, we tested the hypothesis that donepezil attenuates an acute inflammatory tissue injury following MI. Methods and Results: In isolated and activated macrophages, donepezil significantly reduced intra- and extracellular matrix metalloproteinase-9 (MMP-9). In mice with MI, despite the comparable values of heart rate and blood pressure, the donepezil-treated group showed a significantly lower incidence of cardiac rupture than the untreated group during the acute phase of MI. Immunohistochemistry revealed that MMP-9 was localized at the infarct area where a large number of inflammatory cells including macrophages infiltrated, and the expression and the enzymatic activity of MMP-9 at the left ventricular infarct area was significantly reduced in the donepezil-treated group. Conclusion: The present study suggests that donepezil inhibits the MMP-9-related acute inflammatory tissue injury in the infarcted myocardium, thereby reduces the risk of left ventricular free wall rupture during the acute phase of MI

From gut dysbiosis to altered brain function and mental illness: mechanisms and pathways

The human body hosts an enormous abundance and diversity of microbes, which perform a range of essential and beneficial functions. Our appreciation of the importance of these microbial communities to many aspects of human physiology has grown dramatically in recent years. We know, for example, that animals raised in a germ-free environment exhibit substantially altered immune and metabolic function, while the disruption of commensal microbiota in humans is associated with the development of a growing number of diseases. Evidence is now emerging that, through interactions with the gut-brain axis, the bidirectional communication system between the central nervous system and the gastrointestinal tract, the gut microbiome can also influence neural development, cognition and behaviour, with recent evidence that changes in behaviour alter gut microbiota composition, while modifications of the microbiome can induce depressive-like behaviours. Although an association between enteropathy and certain psychiatric conditions has long been recognized, it now appears that gut microbes represent direct mediators of psychopathology. Here, we examine roles of gut microbiome in shaping brain development and neurological function, and the mechanisms by which it can contribute to mental illness. Further, we discuss how the insight provided by this new and exciting field of research can inform care and provide a basis for the design of novel, microbiota-targeted, therapies.GB Rogers, DJ Keating, RL Young, M-L Wong, J Licinio, and S Wesseling