A European research agenda for somatic symptom disorders, bodily distress disorders, and functional disorders: Results of an estimate-talk-estimate delphi expert study

Background: Somatic Symptom Disorders (SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) are associated with high medical and societal costs and pose a substantial challenge to the population and health policy of Europe. To meet this challenge, a specific research agenda is needed as one of the cornerstones of sustainable mental health research and health policy for SSD, BDD, and FD in Europe. Aim: To identify the main challenges and research priorities concerning SSD, BDD, and FD from a European perspective. Methods: Delphi study conducted from July 2016 until October 2017 in 3 rounds with 3 workshop meetings and 3 online surveys, involving 75 experts and 21 European countries. EURONET-SOMA and the European Association of Psychosomatic Medicine (EAPM) hosted the meetings. Results: Eight research priorities were identified: (1) Assessment of diagnostic profiles relevant to course and treatment outcome. (2) Development and evaluation of new, effective interventions. (3) Validation studies on questionnaires or semi-structured interviews that assess chronic medical conditions in this context. (4) Research into patients preferences for diagnosis and treatment. (5) Development of new methodologic designs to identify and explore mediators and moderators of clinical course and treatment outcomes (6). Translational research exploring how psychological and somatic symptoms develop from somatic conditions and biological and behavioral pathogenic factors. (7) Development of new, effective interventions to personalize treatment. (8) Implementation studies of treatment interventions in different settings, such as primary care, occupational care, general hospital and specialty mental health settings. The general public and policymakers will benefit from the development of new, effective, personalized interventions for SSD, BDD, and FD, that will be enhanced by translational research, as well as from the outcomes of research into patient involvement, GP-patient communication, consultation-liaison models and implementation. Conclusion: Funding for this research agenda, targeting these challenges in coordinated research networks such as EURONET-SOMA and EAPM, and systematically allocating resources by policymakers to this critical area in mental and physical well-being is urgently needed to improve efficacy and impact for diagnosis and treatment of SSD, BDD, and FD across Europe

Искусственный интеллект в офтальмологии. Нужны ли нам калькуляторы риска развития и прогрессирования глаукомы?

Artificial intelligence (AI) is rapidly entering modern medical practice. Many routine clinical tasks, from imaging and automated diagnostics to robotic surgery, cannot be imagined without the use of AI. Neural networks show impressive results when analyzing a large amount of data obtained from standard automated perimetry, optical coherence tomography (OCT) and fundus photography. Currently, both in Russia and abroad mathematical algorithms are being developed that allow detection of glaucoma based on certain signs. This article analyzes the advantages and disadvantages of employing artificial intelligence in ophthalmological practice, discusses the need for careful selection of the criteria and their influence on the accuracy of calculators, considers the specifics of using mathematical analysis in suspected glaucoma, as well as in an already established diagnosis. The article also provides clinical examples of the use of glaucoma risk calculator in the routine practice of an ophthalmologist.Искусственный интеллект (ИИ) стремительно входит в современную медицинскую практику. Многие повседневные клинические задачи, от визуализации и автоматизированной диагностики до роботизированной хирургии невозможно сегодня представить без использования ИИ. Нейронные сети показывают впечатляющие результаты при анализе большого массива данных, полученных при компьютерной периметрии, оптической когерентной томографии, фотографировании глазного дна и др. В настоящее время в России и за рубежом разрабатываются математические алгоритмы, позволяющие по тем или иным признакам определять наличие глаукомного процесса. В статье анализируются плюсы и минусы использования ИИ в офтальмологической практике. Обсуждается необходимость тщательного подбора критериев и их влияние на точность работы калькуляторов. Особенности использования математического анализа при подозрении на глаукому и при уже установленном диагнозе. Приводятся клинические примеры использования калькулятора риска развития глаукомы в рутинной практике офтальмолога.

Bio-hybridization of nanobactericides with cellulose films for effective treatment against members of ESKAPE drug resistant pathogens

The rapid expansion of drug-resistant pathogens has created huge global impact and development of novel antimicrobial leads is one of the top priority studies in the current scenario. The present study aims to develop bio-hybridized nanocellulose films which comprise of phytogenic silver nanobactericides. The nanobactericides were synthesized by treating 1 mM silver nitrate with aqueous extract of Chamerion angustifolium which reduced the metal salt to produce polydispersed nanobactericides which were tested against the members of ESKAPE drug-resistant communities. The synthesized silver nanobactericides were subjected to characterization with UV–visible spectra which displayed maximum absorbance at 408 nm. The bio-molecular interaction of phyto-constituents to mediate synthesis and stabilization of nanobactericides was studied with Fourier-transform infrared spectroscopy (FTIR) which depicted functional groups associated with nanobactericides. The crystalline nature was studied with X-ray diffraction (XRD) which showed Bragg’s intensities at 2θ angle which denoted (111), (200), (220), and (311) planes. The morphological characteristics of silver nanobactericides were defined with transmission electron Microscopy (TEM) image which displayed polydispersity of silver nanobactericides with size ranging from 2 to 40 nm. The synthesized nanobactericides showed a significant activity against MRSA strain with 21 mm zone of inhibition. The minimal inhibitory concentration of silver nanobactericides to inhibit the growth of test pathogens was also determined which ranged between 0.625 and 1.25 μg/ml. The silver nanobactericides were bio-hybridized onto nanocellulose films produced by Komagataeibacter xylinus B-12068 culture strain. The films were dried to determine the mechanical properties which showed increased in Young’s modulus and tensile strength in comparison with control bacterial cellulose films. Overall, the results obtained in the present investigation are promising enough to report bactericidal activity of bio-hybridized nanobactericidal films against ESKAPE. These communities are reported to cause severe threats to all forms of lives irrespective to their habitats which can lead to huge economical crisis