Virtual health care center in Georgia

Application of telemedicine systems to cover distant geographical areas has increased recently. However, the potential usefulness of similar systems for creation of national networks does not seem to be widely appreciated. The article describes the "Virtual Health Care Knowledge Center in Georgia" project. Its aim was the set up of an online integrated web-based platform to provide remote medical consultations and eLearning cycles. The project "Virtual Health Care Knowledge Center in Georgia" was the NATO Networking Infrastructure Grant dedicated for development of telemedicine in non-NATO countries. The project implemented a pilot to organize the creation of national eHealth network in Georgia and to promote the use of innovative telemedicine and eLearning services in the Georgian healthcare system. In June 2007 it was continued under the NATO Networking Infrastructure Grant "ePathology – Virtual Pathology Center in Georgia as the Continuation of Virtual Health Care Center"

High PIRCHE Scores May Allow Risk Stratification of Borderline Rejection in Kidney Transplant Recipients

BackgroundThe diagnosis of borderline rejection (BLR) ranges from mild inflammation to clinically significant TCMR and is associated with an increased risk of allograft dysfunction. Currently, there is no consensus regarding its treatment due in part to a lack of biomarkers to identify cases with increased risk for immune-mediated injury.MethodsWe identified 60 of 924 kidney transplant recipients (KTRs) with isolated and untreated BLR. We analyzed the impact of predicted indirectly recognizable HLA epitopes (PIRCHE) score on future rejection, de novo DSA development, and recovery to baseline allograft function. Additionally, we compared the outcomes of different Banff rejection phenotypes.ResultsTotal PIRCHE scores were significantly higher in KTRs with BLR compared to the entire study population (p=0.016). Among KTRs with BLR total PIRCHE scores were significantly higher in KTRs who developed TCMR/ABMR in follow-up biopsies (p=0.029). Notably, the most significant difference was found in PIRCHE scores for the HLA-A locus (p=0.010). PIRCHE scores were not associated with the development of de novo DSA or recovery to baseline allograft function among KTRs with BLR (p>0.05). However, KTRs under cyclosporine-based immunosuppression were more likely to develop de novo DSA (p=0.033) than those with tacrolimus, whereas KTRs undergoing retransplantation were less likely to recover to baseline allograft function (p=0.003).ConclusionsHigh PIRCHE scores put KTRs with BLR at an increased risk for future TCMR/ABMR and contribute to improved immunological risk stratification. The benefit of anti-rejection treatment, however, needs to be evaluated in future studies

Health risks due to intrusion into the drinking water distribution network: hydraulic modelling and quantitative microbial risk assessment

Ageing water infrastructure is prone to increased physical deficiencies. These form pathways for pathogen intrusion into drinking water distribution networks (WDNs), hence posing major health risks to consumers. This study aimed at estimating the risk of infection from pipe breaks and intermittent water supply, which are some of the major causes of sustained low pressure within the WDN and hence the triggers for pathogen intrusion. Further, the effect of groundwater level on pathogen intrusion was investigated. Three risk scenarios were evaluated on the example of a real WDN in Sweden: (i) pipe break with no intrusion from leak holes, (ii) pipe break with intrusion due to leak holes, and (iii) insufficient water supply in the presence of leak holes. Pressure distribution from hydraulic modelling, estimated groundwater levels, and pathogen concentration in intruding water (from field study) were used to estimate the intrusion and the number of pathogens entering the WDN. Reference pathogens Campylobacter, Cryptosporidium, and norovirus were used in quantitative microbial risk assessment (QMRA) for assessing the health risks. Results indicated that the daily probability of infection exceeded an acceptable target value of 10−6 for most of the WDN and for all scenarios. The findings were consistent with the estimated annual burden of acute gastrointestinal illness in Sweden. The concentration of pathogens in intruding water and the duration of the low-pressure-causing event were observed to influence the probability of infection the most. The results from this study can be used to identify vulnerable sections in the WDN, which can be targeted for additional investment in monitoring and/or renewal

Hydrodynamic modelling of the microbial water quality in a drinking water source as input for risk reduction management

To mitigate the faecal contamination of drinking water sources and, consequently, to prevent waterborne disease outbreaks, an estimation of the contribution from different sources to the total faecal contamination at the raw water intake of a drinking water treatment plant is needed. The aim of this article was to estimate how much different sources contributed to the faecal contamination at the water intake in a drinking water source, Lake Rådasjön in Sweden. For this purpose, the fate and transport of faecal indicator Escherichia coli within Lake Rådasjön were simulated by a three-dimensional hydrodynamic model. The calibrated hydrodynamic model described the measured data on vertical temperature distribution in the lake well (the Pearson correlation coefficient was 0.99). The data on the E. coli load from the identified contamination sources were gathered and the fate and transport of E. coli released from these sources within the lake were simulated using the developed hydrodynamic model, taking the decay of the E. coli into account. The obtained modelling results were compared to the observed E. coli concentrations at the water intake. The results illustrated that the sources that contributed the most to the faecal contamination at the water intake in Lake Rådasjön were the discharges from the on-site sewers and the main inflow to the lake – the river Mölndalsån. Based on the modelling results recommendations for water producers were formulated. The study demonstrated that this modelling approach is a useful tool for estimating the contribution from different sources to the faecal contamination at the water intake of a drinking water treatment plant and provided decision-support information for the reduction of risks posed to the drinking water source

Electron spin resonance study on the 4f honeycomb quantum magnet YbCl3

The local magnetic properties of Yb$^{3+}$ in the layered honeycomb material YbCl$_{3}$ were investigated by electron spin resonance on single crystals. For in-plane and out-of-plane field orientations the $g$-factor shows a clear anisotropy ($g_\|=2.97(8)$ and $g_\bot =1.53(4)$), whereas the low temperature exchange coupling and the spin relaxation display a rather isotropic character. At elevated temperatures the contribution of the first excited crystal field level ($21\pm2$~meV) dominates the spin relaxation.Comment: 10 pages, 5 figure

Stable oxygen and carbon isotopes in modern benthic foraminifera from the Laptev Sea shelf: implications for reconstructing proglacial and profluvial environments in the Arctic

Measurements of δ18O and δ13C isotopes in three benthic foraminiferal species from surface sediments of the eastern Laptev Sea are compared to water δ18O values and δ13C values of dissolved inorganic carbon (DIC). Samples investigated originate from two environmentally contrasting core locations, which are influenced by riverine freshwater runoff to a varying degree. At the river-distal site, located within relatively stable marine conditions on the outer shelf, Elphidiella groenlandica, Haynesina orbiculare and Elphidium excavatum forma clavata show a positive specific offset of 1.4‰, 1.5‰ and 1‰, respectively, in their δ18O values relative to the expected value for inorganic calcite precipitated under equilibrium conditions. At the site close to the Lena River confluence, with enhanced seasonal hydrographic contrasts, calculated δ18O offsets in E. groenlandica and in H. orbiculare remain about the same whereas E. e. clavata displays a distinctly negative offset of −1.8‰. The δ18O variation in E. e. clavata is interpreted as a vital effect, a finding which limits the potential of this species for reconstructing freshwater-influenced shelf paleoenvironments on the basis of oxygen isotopes. This interpretation gains support when comparing foraminiferal δ13C with the δ13CDIC of the water. While some of the difference in the carbonate δ13C seems to be controlled by a riverine-related admixture of DIC, clearly defined δ13C ranges in each of the three foraminifera at the river-proximal site shows that also the carbon isotopic signature in E. e. clavata is particularly affected by environmental factors

The evolution lactose tolerance in dairying populations

Among the biocultural innovations associated with the Neolithic, dairying and the evolution of lactose tolerance is the most studied. Expression of the enzyme lactase, which digests the milk sugar lactose, decreases after weaning in mammals, including most humans. However, some humans express lactase throughout adulthood—a trait known as lactase persistence (LP). Striking observations about LP evolution include: (i) a strong correlation between LP frequency and a history of herding and dairying; (ii) genetic patterns indicating LP-associated variants have increased in frequency through natural selection; (iii) two of these variants have been experimentally shown to affect lactase expression in adults; and (iv) archaeological and ancient DNA data indicate dairying pre-dated the rise of LP-associated variants. This chapter reviews the biology and archaeology of LP, examines some of the hypotheses formulated to explain its distribution, and outlines how simulation modelling has contributed to our understanding of its evolution

Estimating cardiac active tension from wall motion—An inverse problem of cardiac biomechanics

The contraction of the human heart is a complex process as a consequence of the interaction of internal and external forces. In current clinical routine, the resulting deformation can be imaged during an entire heart beat. However, the active tension development cannot be measured in vivo but may provide valuable diagnostic information. In this work, we present a novel numerical method for solving an inverse problem of cardiac biomechanics—estimating the dynamic active tension field, provided the motion of the myocardial wall is known. This ill‐posed non‐linear problem is solved using second order Tikhonov regularization in space and time. We conducted a sensitivity analysis by varying the fiber orientation in the range of measurement accuracy. To achieve RMSE 0.95). The results obtained with non‐matching input data are promising and indicate directions for further improvement of the method. In future, this method will be extended to estimate the active tension field based on motion data from clinical images, which could provide important insights in terms of a new diagnostic tool for the identification and treatment of diseased heart tissue