Stage interventions in the treatment of patients with malignant diseases of the common bile duct terminal segment complicated by acute mechanical jaundice

Obstructive mechanical jaundice is a well-researched complication of various diseases and causes, yet considering patients` condition with malignant diseases according to the stage of the malignant process, severity of complications and etc. Selection of the most appropriate method of surgical treatment is always an option where it is essential to consider finding a way between efficiency and surgical trauma. The aim of the research is to optimize the results of surgical treatment of patients with malignant tumours of the common bile duct terminal segment complicated by acute mechanical jaundice. Materials and methods: patients over 18 y.o. with duodenal obstruction; the presence of other active cancer pathology or blood diseases. The research was performed on 2 different groups divided according to the use of biliary passability restoring method concluding the preferability of minimally invasive methods of bile duct decompression. Results: minimally invasive methods are not inferior to the effectiveness of biliary decompression comparing to open methods, have a number of advantages, such as minimal invasiveness, relative safety, low incidence of complications and mortality Conclusions: the introduction of the developed algorithm for surgical treatment of blastomatous mechanical jaundice with the consistent use of antegrade and open methods, as well as antegrade, retrograde and “rendezvous” techniques in surgically incurable patients allowed to reduce the number of early postoperative complications from 32.7 % to 13.3 %, the number of complications requiring surgery – from 5.8 % to 1.3 % and the level of postoperative mortality – from 11.5 % to 2.7 %

The analytical and numerical approaches to the theory of the Moon's librations: Modern analysis and results

© 2017 COSPAR Observing physical librations of celestial bodies and the Moon represents one of the astronomical methods of remotely assessing the internal structure of a celestial body without conducting expensive space experiments. The paper contains a review of recent advances in studying the Moon's structure using various methods of obtaining and applying the lunar physical librations (LPhL) data. In this article LPhL simulation methods of assessing viscoelastic and dissipative properties of the lunar body and lunar core parameters, whose existence has been recently confirmed during the seismic data reprocessing of “Apollo” space mission, are described. Much attention is paid to physical interpretation of the free librations phenomenon and the methods for its determination. In the paper the practical application of the most accurate analytical LPhL tables (Rambaux and Williams, 2011) is discussed. The tables were built on the basis of complex analytical processing of the residual differences obtained when comparing long-term series of laser observations with the numerical ephemeris DE421. In the paper an efficiency analysis of two approaches to LPhL theory is conducted: the numerical and the analytical ones. It has been shown that in lunar investigation both approaches complement each other in various aspects: the numerical approach provides high accuracy of the theory, which is required for the proper processing of modern observations, the analytical approach allows to comprehend the essence of the phenomena in the lunar rotation, predict and interpret new effects in the observations of lunar body and lunar core parameters

Diagnostic Parameters of Adenoviremia in Pediatric Stem Cell Transplant Recipients

Despite recent progress in the diagnostic risk assessment of human adenovirus (HAdV) infections in immunocompromised patients, clinical complications mediated by these viruses continue contributing to significant morbidity and mortality, particularly in the pediatric hematopoietic allogeneic stem cell transplant (HSCT) setting. Current data highlight the importance of monitoring stool samples to assess the risk of invasive HAdV infections in children undergoing HSCT. The advent of novel, more effective antiviral treatment options might permit successful virus control even at the stage of systemic infection, thus increasing the interest in optimized HAdV monitoring in peripheral blood (PB). We have screened over 300 pediatric HCST recipients by serial monitoring of stool and PB specimens, and identified 31 cases of invasive HAdV infection by quantitative pan-adenovirus RQ-PCR analysis of consecutive PB specimens. The diagnostic parameters assessed included HAdV peak levels (PL) and the time-averaged area under the curve (AAUC) of virus copy numbers. The predictive value for patient outcome reflected by non-relapse and HAdV-related mortality was determined. The patients were assigned to quartiles based on their PL and AAUC, and the readouts were highly correlated (p < 0.0001). Non-relapse mortality in patients by AAUC quartile (lowest to highest) was 26, 50, 75, and 86%, respectively, and AAUC was strongly correlated with non-relapse mortality (p < 0.0001), while the association between PL and non-relapse mortality was less pronounced (p = 0.013). HAdV-related mortality was absent or very low in patients within the two lower quartiles of both PL and AAUC, and increased to ≥70% in the upper two quartiles. Despite the significant correlation of PL and AAUC with patient outcome, it is necessary to consider that the risk of non-relapse mortality even within the lowest quartile was still relatively high, and it might be difficult therefore to translate the results into differential treatment approaches. By contrast, the correlation with HAdV-related mortality might permit the identification of a low-risk patient subset. Nevertheless, the well-established correlation of HAdV shedding into the stool and intestinal expansion of the virus with the risk of invasive infection will expectedly remain an essential diagnostic parameter in the pediatric HSCT setting

Modeling of gamma-pulse propagation in the "optical" thick medium with inverted population of the nuclear levels of 178Hf isotope

The nuclear superfluorescence in the "optical" medium with 178Hf in propagation channel has been modeled. The general equations system describing the nuclear superfluorescence in the "optical" medium has obtained. The numerical simulation in the propagation channel in the "optical" thick medium with Hf has been made

Modeling of gamma-avalanche formation in the "optical" thick medium with 178Hf through the nuclear diffraction channel

The formation of γ-avalanche in the medium with 178Hf isotope has modeled through the nuclear diffraction channel. The equation system describing the process under two-wave Bragg diffraction conditions has obtained. The numerical simulation for the "optical" thick medium has been made

Principles of autonomous testing of high-performance .NET application

In the landscape of software development for high-performance .NET applications, autonomous testing emerges as a critical strategy to ensure reliability, scalability, and performance. This article delves into the practice of autonomous, or unattended, testing—where automated test cases are executed independently without human intervention. Our exploration is grounded in the application of autonomous testing in environments handling large data volumes and supporting high concurrency, which are typical scenarios for mission-critical .NET applications. We discuss the benefits of autonomous testing, including its ability to significantly increase test coverage, enhance defect detection at early stages, and ensure consistent and reliable testing outcomes across various scenarios. The implementation of robust testing frameworks such as NUnit, xUnit, or MSTest, which support features like parallel test execution and test parameterization, plays a foundational role in the effective deployment of autonomous testing systems. Moreover, the article highlights the necessity of integrating autonomous testing into continuous integration and deployment pipelines to facilitate continuous testing. This integration ensures that every code change is thoroughly validated before deployment, thereby enhancing software quality and accelerating delivery cycles. We also examine the challenges and best practices in fostering a culture that supports autonomous testing within organizations. By emphasizing the strategic importance of training, cross-functional collaboration, and continuous improvement, we propose methods to overcome resistance to change and enhance the adoption of autonomous testing practices

Control of human adenovirus type 5 gene expression by cellular Daxx/ATRX chromatin-associated complexes

Death domain–associated protein (Daxx) cooperates with X-linked α-thalassaemia retardation syndrome protein (ATRX), a putative member of the sucrose non-fermentable 2 family of ATP-dependent chromatin-remodelling proteins, acting as the core ATPase subunit in this complex, whereas Daxx is the targeting factor, leading to histone deacetylase recruitment, H3.3 deposition and transcriptional repression of cellular promoters. Despite recent findings on the fundamental importance of chromatin modification in host-cell gene regulation, it remains unclear whether adenovirus type 5 (Ad5) transcription is regulated by cellular chromatin remodelling to allow efficient virus gene expression. Here, we focus on the repressive role of the Daxx/ATRX complex during Ad5 replication, which depends on intact protein–protein interaction, as negative regulation could be relieved with a Daxx mutant that is unable to interact with ATRX. To ensure efficient viral replication, Ad5 E1B-55K protein inhibits Daxx and targets ATRX for proteasomal degradation in cooperation with early region 4 open reading frame protein 6 and cellular components of a cullin-dependent E3-ubiquitin ligase. Our studies illustrate the importance and diversity of viral factors antagonizing Daxx/ATRX-mediated repression of viral gene expression and shed new light on the modulation of cellular chromatin remodelling factors by Ad5. We show for the first time that cellular Daxx/ATRX chromatin remodelling complexes play essential roles in Ad gene expression and illustrate the importance of early viral proteins to counteract cellular chromatin remodelling

Resonant nonlinear magneto-optical effects in atoms

In this article, we review the history, current status, physical mechanisms, experimental methods, and applications of nonlinear magneto-optical effects in atomic vapors. We begin by describing the pioneering work of Macaluso and Corbino over a century ago on linear magneto-optical effects (in which the properties of the medium do not depend on the light power) in the vicinity of atomic resonances, and contrast these effects with various nonlinear magneto-optical phenomena that have been studied both theoretically and experimentally since the late 1960s. In recent years, the field of nonlinear magneto-optics has experienced a revival of interest that has led to a number of developments, including the observation of ultra-narrow (1-Hz) magneto-optical resonances, applications in sensitive magnetometry, nonlinear magneto-optical tomography, and the possibility of a search for parity- and time-reversal-invariance violation in atoms.Comment: 51 pages, 23 figures, to appear in Rev. Mod. Phys. in Oct. 2002, Figure added, typos corrected, text edited for clarit

Human immunoglobulin G levels of viruses and associated glioma risk

Few consistent etiological factors have been identified for primary brain tumors. Inverse associations to asthma and low levels of varicella-zoster virus, immunoglobulin (Ig) levels in prevalent cases have indicted a role for the immune system in the development of glioma. Because samples from prevalent cases of glioma could be influenced by treatments such as steroids and chemotherapy, we investigated pre-diagnostic samples from three large Scandinavian cohorts. To test the hypothesis that immune response levels to these viruses are associated etiologically with glioma risk, we investigated pre-diagnostic immunoglobulin levels for cytomegalovirus (CMV), varicella-zoster virus (VZV), adenovirus (Ad), and Epstein-Barr virus (EBV) including the nuclear antigen (EBNA1) using plasma samples from 197 cases of adult glioma and 394 controls collected from population-based cohorts in Sweden and Denmark. Low VZV IgG levels were marginally significantly more common in glioma cases than the controls (odds ratio (OR) = 0.68, 95% CI 0.41–1.13) for the fourth compared with the first quartile (p = 0.06 for trend). These results were more prominent when analyzing cases with blood sampling at least 2 years before diagnosis (OR = 0.63, 95% CI 0.37–1.08) (p = 0.03). No association with glioma risk was observed for CMV, EBV, and adenovirus

Chronic Viral Infection and Primary Central Nervous System Malignancy

Primary central nervous system (CNS) tumors cause significant morbidity and mortality in both adults and children. While some of the genetic and molecular mechanisms of neuro-oncogenesis are known, much less is known about possible epigenetic contributions to disease pathophysiology. Over the last several decades, chronic viral infections have been associated with a number of human malignancies. In primary CNS malignancies, two families of viruses, namely polyomavirus and herpesvirus, have been detected with varied frequencies in a number of pediatric and adult histological tumor subtypes. However, establishing a link between chronic viral infection and primary CNS malignancy has been an area of considerable controversy, due in part to variations in detection frequencies and methodologies used among researchers. Since a latent viral neurotropism can be seen with a variety of viruses and a widespread seropositivity exists among the population, it has been difficult to establish an association between viral infection and CNS malignancy based on epidemiology alone. While direct evidence of a role of viruses in neuro-oncogenesis in humans is lacking, a more plausible hypothesis of neuro-oncomodulation has been proposed. The overall goals of this review are to summarize the many human investigations that have studied viral infection in primary CNS tumors, discuss potential neuro-oncomodulatory mechanisms of viral-associated CNS disease and propose future research directions to establish a more firm association between chronic viral infections and primary CNS malignancies