Charcot osteoarthropathy: one disease, two presentations

Charcot osteoarthropathy or Charcot foot is a disabling complication of diabetes and is associated with poor prognosis and high mortality. Its pathogenesis is not fully understood and its treatment is at best symptomatic. Furthermore, it is not known whether there is a specific type of neuropathy which affects osteoclastic activity, and thereby leads to reduction of bone mineral density and the development of Charcot osteoarthropathy. Recently it has been proposed that there is a difference in the presentation of Charcot osteoarthropathy between type 1 and type 2 diabetes. This article reviews the link between underlying osteopenia, abnormal biomechanical forces and type of neuropathy, and their varying interaction in the pathogenesis of Charcot osteoarthropathy in type 1 and type 2 diabetes. Further attention is drawn to the newly discovered osteoprotegerin/receptor activator of nuclear factor kappaB ligand (OPG/RANKL) cytokine system, which controls bone resorption. Increased osteoclastic activity in the acute Charcot foot may be associated with altered expression of OPG/RANKL signaling pathway and modulation of the OPG/RANKL equilibrium in Charcot osteoarthropathy may provide additional therapeutical option to manage this difficult condition.Biomedical Reviews 2005; 16: 43-48

The Contribution of Social Entrepreneurship to the Development of Human Capital of Students

The article presents the author’s vision of the place and role of social entrepreneurship in the development of the human capital of students. The authors note that the ongoing changes in society and the economy pose the most important task - the study of a phenomenon such as human capital. Training in social entrepreneurship of students can somehow contribute to the formation of the individual human capital of a student to more successfully adapt to the modern labor market. The authors proposed a model of human capital consisting of seven components, which served as the basis for the development and implementation of a modular curriculum in the work of several universities. The article presents a pedagogical experiment on testing a modular program at universities in the South and North Caucasus Federal Districts and evaluates its results. Suggestions were made for the development of an urgent and state-important strategic direction for universities - a focus on the formation of positive human capital for students

The origins and spread of domestic horses from the Western Eurasian steppes

This is the final version. Available on open access from Nature Research via the DOI in this recordData availability: All collapsed and paired-end sequence data for samples sequenced in this study are available in compressed fastq format through the European Nucleotide Archive under accession number PRJEB44430, together with rescaled and trimmed bam sequence alignments against both the nuclear and mitochondrial horse reference genomes. Previously published ancient data used in this study are available under accession numbers PRJEB7537, PRJEB10098, PRJEB10854, PRJEB22390 and PRJEB31613, and detailed in Supplementary Table 1. The genomes of ten modern horses, publicly available, were also accessed as indicated in their corresponding original publications57,61,85-87.NOTE: see the published version available via the DOI in this record for the full list of authorsDomestication of horses fundamentally transformed long-range mobility and warfare. However, modern domesticated breeds do not descend from the earliest domestic horse lineage associated with archaeological evidence of bridling, milking and corralling at Botai, Central Asia around 3500 BC. Other longstanding candidate regions for horse domestication, such as Iberia and Anatolia, have also recently been challenged. Thus, the genetic, geographic and temporal origins of modern domestic horses have remained unknown. Here we pinpoint the Western Eurasian steppes, especially the lower Volga-Don region, as the homeland of modern domestic horses. Furthermore, we map the population changes accompanying domestication from 273 ancient horse genomes. This reveals that modern domestic horses ultimately replaced almost all other local populations as they expanded rapidly across Eurasia from about 2000 BC, synchronously with equestrian material culture, including Sintashta spoke-wheeled chariots. We find that equestrianism involved strong selection for critical locomotor and behavioural adaptations at the GSDMC and ZFPM1 genes. Our results reject the commonly held association between horseback riding and the massive expansion of Yamnaya steppe pastoralists into Europe around 3000 BC driving the spread of Indo-European languages. This contrasts with the scenario in Asia where Indo-Iranian languages, chariots and horses spread together, following the early second millennium BC Sintashta culture

Antimicrobial Strategies and Economic Considerations for Polymeric Medical Implants.

Healthcare acquired infections (HAI's) are a worldwide problem that can be exacerbated by surgery and the implantation of polymeric medical devices. The use of polymer based medical devices which incorporate antimicrobial strategies are now becoming an increasingly routine way of trying to prevent the potential for reduce chronic infection and device failure. There are a wide range of potential antimicrobial agents currently being incorporated into such polymers. However, it is difficult to determine which antimicrobial agent provides the greatest infection control. The economics of replacing current methods with impregnated polymer materials further complicates matters. It has been suggested that the use of a holistic system wide approach should to be developed around the implantation of medical devices which minimises the potential risk of infection. However, the use of such different approaches is still being developed. The control of such infections is important for individual patient health and the economic implications for healthcare services

Synergies and Trade-Offs in Reaching the Sustainable Development Goals

The Sustainable Development Goals (SDGs) adopted in 2015 integrate diverse issues such as addressing hunger, gender equality and clean energy and set a common agenda for all United Nations member states until 2030. The 17 SDGs interact and by working towards achieving one goal countries may further—or jeopardise—progress on others. However, the direction and strength of these interactions are still poorly understood and it remains an analytical challenge to capture the relationships between the multi-dimensional goals, comprising 169 targets and over 200 indicators. Here, we use principal component analysis (PCA), an in this context novel approach, to summarise each goal and interactions in the global SDG agenda. Applying PCA allows us to map trends, synergies and trade-offs at the level of goals for all SDGs while using all available information on indicators. While our approach does not allow us to investigate causal relationships, it provides important evidence of the degree of compatibility of goal attainment over time. Based on global data 2000–2016, our results indicate that synergies between and within the SDGs prevail, both in terms of levels and over time change. An exception is SDG 10 ‘Reducing inequalities’ which has not progressed in tandem with other goals.All authors contributed equally to this work</p

Autochthonous and Imported Visceral Leishmaniasis in Bulgaria—Clinical Experience and Treatment of Patients

Visceral leishmaniasis (VL) is a severe endemic disease with a fatal outcome if left untreated. The symptoms of patients are diverse and atypical. Against the background of anemia and pancytopenia, the condition of the patients gradually worsens with marked cachexia. Through sharing our experience, we aim to draw attention to this deadly disease. Clinical and laboratory data for 58 patients with VL treated over a forty-five-year period are presented. The diagnosis was established within a duration of 1 to 28 months of illness. Continuous fever (38–42 °C), splenomegaly, hepatomegaly, severe anemia (decreased hemoglobin to lowest values of 31 g/L), leucopenia (lowest values of leucocytes et 0.5 g/L), and thrombocytopenia (reduced thrombocyte count to 29 g/L) were observed. The diagnosis was made on the basis of microscopic evidence of amastigote forms in bone marrow smears and serological tests. The patients were treated with Glucantime for 17 to 21 days. Relapses were observed in seven patients (12.1%) and fatal outcome was observed in two patients (3.5%) during treatment, who developed acute respiratory and cardiovascular failure. In Bulgaria, Visceral leishmaniasis is primarily endemic in the southern regions and should be suspected not only in patients who have returned from tropical and subtropical countries, but also in those who have not traveled abroad. The challenges associated with VL stem from delayed diagnosis of patients, as this disease remains unrecognized by physicians