Does One Size Fit All? Drug Resistance and Standard Treatments: Results of Six Tuberculosis Programmes in Former Soviet Countries.

SETTING: After the collapse of the Soviet Union, countries in the region faced a dramatic increase in tuberculosis cases and the emergence of drug resistance. OBJECTIVE: To discuss the relevance of the DOTS strategy in settings with a high prevalence of drug resistance. DESIGN: Retrospective analysis of one-year treatment outcomes of short-course chemotherapy (SCC) and results of drug susceptibility testing (DST) surveys of six programmes located in the former Soviet Union: Kemerovo prison, Russia; Abkhasia, Georgia; Nagorno-Karabagh, Azerbaijan; Karakalpakstan, Uzbekistan; Dashoguz Velayat, Turkmenistan; and South Kazakhstan Oblast, Kazakhstan. Results are reported for new and previously treated smear-positive patients. RESULTS: Treatment outcomes of 3090 patients and DST results of 1383 patients were collected. Treatment success rates ranged between 87% and 61%, in Nagorno-Karabagh and Kemerovo, respectively, and failure rates between 7% and 23%. Any drug resistance ranged between 66% and 31% in the same programmes. MDR rates ranged between 28% in Karakalpakstan and Kemerovo prison and 4% in Nagorno-Karabagh. CONCLUSION: These results show the limits of SCC in settings with a high prevalence of drug resistance. They demonstrate that adapting treatment according to resistance patterns, access to reliable culture, DST and good quality second-line drugs are necessary

Essential spectra of difference operators on \sZ^n-periodic graphs

Let (\cX, \rho) be a discrete metric space. We suppose that the group \sZ^n acts freely on $X$ and that the number of orbits of $X$ with respect to this action is finite. Then we call $X$ a \sZ^n-periodic discrete metric space. We examine the Fredholm property and essential spectra of band-dominated operators on $l^p(X)$ where $X$ is a \sZ^n-periodic discrete metric space. Our approach is based on the theory of band-dominated operators on \sZ^n and their limit operators. In case $X$ is the set of vertices of a combinatorial graph, the graph structure defines a Schr\"{o}dinger operator on $l^p(X)$ in a natural way. We illustrate our approach by determining the essential spectra of Schr\"{o}dinger operators with slowly oscillating potential both on zig-zag and on hexagonal graphs, the latter being related to nano-structures

Essential spectra and exponential estimates of eigenfunctions of lattice operators of quantum mechanics

This paper is devoted to estimates of the exponential decay of eigenfunctions of difference operators on the lattice Z^n which are discrete analogs of the Schr\"{o}dinger, Dirac and square-root Klein-Gordon operators. Our investigation of the essential spectra and the exponential decay of eigenfunctions of the discrete spectra is based on the calculus of so-called pseudodifference operators (i.e., pseudodifferential operators on the group Z^n) with analytic symbols and on the limit operators method. We obtain a description of the location of the essential spectra and estimates of the eigenfunctions of the discrete spectra of the main lattice operators of quantum mechanics, namely: matrix Schr\"{o}dinger operators on Z^n, Dirac operators on Z^3, and square root Klein-Gordon operators on Z^n

UBVI and Ha Photometry of the h & chi Persei cluster

UBVI and Ha photometry is presented for 17319 stars in vicinity of the young double cluster h & chi Persei. Our photometry extends over a 37arcmin x 1arcdeg field centered on the association. We construct reddening contours within the imaged field. We find that the two clusters share a common distance modulus of 11.75$\pm$0.05 and ages of log age(yr) = 7.1$\pm$0.1. From the V-Ha colour, a measure of the Ha emission strength, we conduct a survey for emission line objects within the association. We detect a sample of 33 Be stars, 8 of which are new detections. We present a scenario of evolutionary enhancement of the Be phenomenon to account for the peak in Be fraction towards the top of the main-sequence in the population of h & chi Persei and similar young clusters.Comment: 20 pages, 9 figures, AJ Jul

МУЛЬТИПЛЕКСНЫЙ АНАЛИЗ БИОМАРКЕРОВ НЕОАНГИОГЕНЕЗА И ВОСПАЛЕНИЯ У РЕЦИПИЕНТОВ СЕРДЦА

Aim of study: multiplex analysis of the levels of biomarkers of neoangiogenesis and inflammation in cardiac transplant recipients. Materials and methods. 59 pts. with heart failure III–IV according to NYHA FC, waiting for a heart transplant, aged 22 to 73 years, 48 males and 11 females. 41 recipient (30 men and 11 women) had dilated cardiomyopathy, 18 – coronary heart disease (CHD). The concentration of VEGF-A, VEGF-D, PlGF, PDGF-BB, FGF, sCD40L, MCP-1 was measured using xMAP technology, the sets of reagents Simplex ProcartaPlexTM (Affymetrix, USA). Results. There are four levels of seven biomarkers of neoangiogenesis and inflammation method for multiplex analysis in patients with heart failure. A year after transplantation, the mean levels of biomarkers VEGF-A (p = 0.001), PDGF-BB (p = 0.018), MCP-1 (p = 0.003) was significantly decreased, and the others had a tendency to decrease relative to the level before transplantation. It was shown individual differences of levels of VEGF-A, VEGF-D and PlGF before and after transplantation. There were found different dynamics of the concentrations of biomarkers and growth factors before and after heart transplantation in patients with cardiovascular complications and without them. Conclusion. Multiplex analysis allows to measure the concentration range of analyte biomarkers of neoangiogenesis, inflammation in one sample of blood serum of patients with severe heart failure and after transplantation. There are marked individual differences in the concentration of biomarkers in different clinical situations that may have clinical significance in the conduct and supervision of recipients after transplantation.Цель: анализ уровней биомаркеров неоангиогенеза и воспаления до и после трансплантации сердца с использованием мультиплексного анализа. Материалы и методы. 59 пациентов с сердечной недостаточностью III–IV ФК по NYHA, ожидающих трансплантацию сердца, от 22 до 73 лет, из них 48 мужчин и 11 женщин. У 41 реципиента (30 мужчин и 11 женщин) была дилатационная кардиомиопатия, у 18 – ишемическая болезнь сердца. Концентрацию факторов роста эндотелия сосудов (VEGF-A, VEGF-D, плацентарного фактора роста PlGF), факторов роста тромбоцитов (PDGF-BB) и фибробластов (FGF), растворимой формы лиганда CD40 (sCD40L), хемоаттрактантного белка макрофагов MCP-1 измеряли с использованием технологии xMAP с помощью сформированной для настоящего исследования мультиплексной панели, составленной на основе наборов реагентов Simplex ProcartaPlexTM (Affymetrix, США). Результаты. Охарактеризованы уровни биомаркеров неоангиогенеза и воспаления у пациентов с сердечной недостаточностью и их изменения после трансплантации сердца. Концентрация биомаркеров неоангиогенеза и воспаления в сыворотке крови не зависит от пола, возраста и диагноза. Степень изменения концентрации биомаркеров неоангиогенеза и воспаления после трансплантации различается у пациентов с сердечно-сосудистыми осложнениями (острое клеточное и гуморальное отторжение, васкулопатия трансплантата) и без таковых: у пациентов без сердечно-сосудистых осложнений после трансплантации сердца достоверно ниже исходные уровни VEGF-A (p = 0,009), PDGF-BB (p = 0,011) и MCP-1 (p = 0,045); у пациентов с сердечно-сосудистыми осложнениями после трансплантации достоверно ниже только уровень VEGF-A (p = 0,026). Заключение. Мультиплексный анализ концентраций биомаркеров может иметь значение при персонифицированном ведении реципиентов после трансплантации.

Конверсия на эверолимус с целью сохранения функции почек при трансплантации сердца, персонализированный подход при выборе иммуносупрессивной терапии

Heart transplantation is the «gold standard» of treatment severe heart failure. Patient survival after heart transplantation has improved dramatically since the  availability of calcineurin inhibitor (CNIs). However, nephrotoxicity of CNIs has been  largely responsible for the progressive development of renal dysfunction and  reduces long-term patient survival. Use mTOR inhibitor in immunosuppressive  therapy may improve renal function when everolimus is administered associated  with a progressive reduction of CNIs. The purpose of our report is to demonstrate  the successful case of conversion of the recipient after heart transplantation to  everolimus and to evaluate the effectiveness of this drug during the observation year after heart transplantation.На сегодняшний день трансплантация сердца остается «золотым стандартом» лечения терминальной стадии хронической сердечной недостаточности. Выживаемость пациентов после трансплантации сердца значительно улучшилась с момента внедрения в клиническую практику ингибиторов кальциневрина (CNI). Однако отдаленные результаты выживаемости ограничены,  что обусловлено развитием побочных эффектов на фоне длительного приема  иммуносупрессивной терапии. Нефротоксичность, обусловленная длительным приемом  ингибиторов кальциневрина, приводит к нарушению функции почек с развитием почечной  недостаточности, что ухудшает прогноз у реципиентов в отдаленном периоде. Применение сертикана в схемах иммуносупрессивной терапии позволяет редуцировать дозу ингибиторов  кальциневрина, тем самым оказывая положительное влияние на почечную функцию у  реципиентов после трансплантации сердца. Цель нашего сообщения: продемонстрировать  успешный случай конверсии на эверолимус у реципиента после трансплантации сердца и оценить эффективность использования данного препарата в течение года наблюдения

In COVID-19 Health Messaging, Loss Framing Increases Anxiety with Little-to-No Concomitant Benefits: Experimental Evidence from 84 Countries

The COVID-19 pandemic (and its aftermath) highlights a critical need to communicate health information effectively to the global public. Given that subtle differences in information framing can have meaningful effects on behavior, behavioral science research highlights a pressing question: Is it more effective to frame COVID-19 health messages in terms of potential losses (e.g., "If you do not practice these steps, you can endanger yourself and others") or potential gains (e.g., "If you practice these steps, you can protect yourself and others")? Collecting data in 48 languages from 15,929 participants in 84 countries, we experimentally tested the effects of message framing on COVID-19-related judgments, intentions, and feelings. Loss- (vs. gain-) framed messages increased self-reported anxiety among participants cross-nationally with little-to-no impact on policy attitudes, behavioral intentions, or information seeking relevant to pandemic risks. These results were consistent across 84 countries, three variations of the message framing wording, and 560 data processing and analytic choices. Thus, results provide an empirical answer to a global communication question and highlight the emotional toll of loss-framed messages. Critically, this work demonstrates the importance of considering unintended affective consequences when evaluating nudge-style interventions

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges