Comparative assessment of endovideosurgical accesses in treatment of congenital hydronefrosis in children

Purpose. Recently published dates has confirmed that the most widespread methods of treatment primary hydronephrosis in children are endovideosurgical. But there are no significant objective criteria for choosing the optimal access: transperitoneal or retroperitoneal. We have evaluated an outcome of laparoscopic treatment hydronephrosis utilizing different access. Material and methods. Since 2008 to 2017 331 children (95 girls, 236 boys) with congenital hydronephrosis were underwent 342 endovideoscopic operations. Mean age 3.56 years (range 3m – 18 years). In 305 children was used transperitoneal access (TPA) and in 26 – retroperitoneal (RPA). We used the technique of dismembered pyeloplasty by Anderson-Hynes. Drainage was performed by an antegrade or retrograde JJ stent. Follow-up ultrasound was performed on 2 and 5 days after the operation. The ureteral stent was removed at 6-8 weeks after the operation. The continuance of hospitalization was 5-7 day. Results. 296 patients : 297 with TPA (mean age 4,8 years) and 25 with RPA(mean age 1,9 years) undergoing pyeloplasty were examined after 1-3-6-12 months. The duration of the operation with TPA was 80 ± 40 minutes, and with RPA - 110 ± 40 minutes (p <0,05). No UTI were seen. There was no difference in renal pelvis diameter (% improvement) between the two groups (TPA- 66% and 62% in RPA; p=0,6). 3 patients (1,1%) with TPA required re-intervention (2 ps -stent replacement and 1p - re-operation ), no patients with RPA required re-operation. Conclussion. Dispite of the good clinical outcome of treatment with difference accesses and statistical significance the results, the absence peritoneal injury and probability urinary extravasation make RPA in congenital hydronephrosis optimal in young children

ROBO2 is a stroma suppressor gene in the pancreas and acts via TGF-β signalling.

Whereas genomic aberrations in the SLIT-ROBO pathway are frequent in pancreatic ductal adenocarcinoma (PDAC), their function in the pancreas is unclear. Here we report that in pancreatitis and PDAC mouse models, epithelial Robo2 expression is lost while Robo1 expression becomes most prominent in the stroma. Cell cultures of mice with loss of epithelial Robo2 (Pdx1Cre;Robo2F/F) show increased activation of Robo1+ myofibroblasts and induction of TGF-β and Wnt pathways. During pancreatitis, Pdx1Cre;Robo2F/F mice present enhanced myofibroblast activation, collagen crosslinking, T-cell infiltration and tumorigenic immune markers. The TGF-β inhibitor galunisertib suppresses these effects. In PDAC patients, ROBO2 expression is overall low while ROBO1 is variably expressed in epithelium and high in stroma. ROBO2low;ROBO1high patients present the poorest survival. In conclusion, Robo2 acts non-autonomously as a stroma suppressor gene by restraining myofibroblast activation and T-cell infiltration. ROBO1/2 expression in PDAC patients may guide therapy with TGF-β inhibitors or other stroma /immune modulating agents

A global outlook to the interruption of education due to COVID-19 Pandemic: Navigating in a time of uncertainty and crisis

Uncertain times require prompt reflexes to survive and this study is a collaborative reflex to better understand uncertainty and navigate through it. The Coronavirus (Covid-19) pandemic hit hard and interrupted many dimensions of our lives, particularly education. As a response to interruption of education due to the Covid-19 pandemic, this study is a collaborative reaction that narrates the overall view, reflections from the K12 and higher educational landscape, lessons learned and suggestions from a total of 31 countries across the world with a representation of 62.7% of the whole world population. In addition to the value of each case by country, the synthesis of this research suggests that the current practices can be defined as emergency remote education and this practice is different from planned practices such as distance education, online learning or other derivations. Above all, this study points out how social injustice, inequity and the digital divide have been exacerbated during the pandemic and need unique and targeted measures if they are to be addressed. While there are support communities and mechanisms, parents are overburdened between regular daily/professional duties and emerging educational roles, and all parties are experiencing trauma, psychological pressure and anxiety to various degrees, which necessitates a pedagogy of care, affection and empathy. In terms of educational processes, the interruption of education signifies the importance of openness in education and highlights issues that should be taken into consideration such as using alternative assessment and evaluation methods as well as concerns about surveillance, ethics, and data privacy resulting from nearly exclusive dependency on online solutions

СЛУЧАЙ ТЯЖЕЛОГО ОСЛОЖНЕННОГО ТЕЧЕНИЯ ТЕНИАРИНХОЗА С АТИПИЧНОЙ ЛОКАЛИЗАЦИЕЙ ГЕЛЬМИНТА

Documented case of the clinical observations of the complicatedcourse of beef tapeworm infection (Taenia saginata) have a child 17  years of age. Three years ago, the patient first noticed the active  isolation of the cuttings from the anus. Other clinical symptoms were absent and the disease was latent. At the end of may 2017,  symptoms of an acute abdomen developed and an appendectomy  was performed on 03.06.2017. Diagnosis after surgery: acute  gangrenous perforative appendicitis, periappendicular abscess,  diffuse purulent peritonitis. 07.06.2017 was a single vomiting. In the vomit seen the segments of the flat worm. 09.06.2017,  segments of worms found in the feces. They were identified as  arthropods of Taenia saginata. From 14.06.2017 the patient’s  condition worsened, the temperature increased, there were pains in  the left half of the chest. In the following days the condition remained grave. According to CT (from 19.06.2017) helminth was determined in the  lumen of the left lower salt bronchus. Bronchoscopy was performed  (21.06.2017), which reduced the presence of signs of inflammation  of the left lower salt bronchus. Worms are not detected. Sputum  sowing was performed, but sputum microscopy was not carried out.  Ultrasound (23.06.2017) showed the presence of fluid in the left  pleural cavity. Puncture was performed and 70 ml of serous fluid was obtained. In the future, double-prosodical puncture which was obtained 600 and 500 ml of a yellow viscous exudate. On  29.06.2017, teniid eggs were found in sputum. Praziquantelum is  prescribed 25 mg / kg once. On 04.07.2017, the fourth puncture of  the pleural cavity was performed, 200 ml of light yellow effusion was obtained. In the days following the symptoms of pleurisy had disappeared and 10.07.2018, came recovery. Lung damage, which  developed as a result of aspiration of the arthroplasty Taenia  saginata was accompanied by a  rare dry cough and moderate  severe intoxication syndrome. The severity of the patient’s condition  was determined by severe respiratory failure and pain. Auscultation  of the wheezing was not. Over the lesion was sharply pronounced  weakened breathing. In the peripheral blood was determined by high ESR, moderate leukocytosis and no eosinophilia.Подробно описан клинический случай осложненного течения тениаринхоза (Taenia saginata)  у ребенка 17 лет. Три года назад пациент впервые заметил активное выделение члеников  из анального отверстия. Другие клинические симптомы отсутствовали, и заболевание  протекало латентно. В конце мая 2017 г. развились симптомы острого живота, 03.06.2017 г.  выполнена аппендектомия. Диагноз после операции: острый гангренозный перфоративный  аппендицит, периаппендикулярный абсцесс, диффузный гнойный перитонит. 07.06.2017 г.  была однократная рвота. В рвотных массах замечены членики плоского червя. 09.06.2017 г. членики гельминта обнаружены в фекалиях. Они были идентифицированы как членики  Taenia saginata. С 14.06.2017 г. состояние больного ухудшилось, повысилась температура,  появились боли в левой половине грудной клетки. В последующие дни состояние оставалось тяжелым. По данным КТ (от 19.06.2017 г.) гельминт определялся в просвете левого  нижнедолевого бронха. Выполнена бронхоскопия (21.06.2017 г.), которая установила наличие признаков воспаления левого нижнедолевого бронха. Гельминт не обнаружен. Выполнен посев мокроты, но микроскопия мокроты не проводилась. УЗИ (23.06.2017 г.)  показало наличие жидкости в левой плевральной полости. Проведена пункция, получено 70 мл серозной жидкости. В дальнейшем дважды проводилась пункция, в результате чего было получено 600 и 500 мл желтого вязкого экссудата. 29.06.2017 г. в мокроте были  обнаружены яйца тениид. Назначен Praziquantelum 25 мг/кг однократно. 04.07.2017 г. проведена четвертая пункция плевральной полости, получено 200 мл светло-желтого  выпота. В последующие дни симптомы плеврита исчезли, 10.07.2017 г. наступило выздоровление.  Поражение легких, которое развилось в результате аспирации  членика Taenia saginata, сопровождалось редким сухим кашлем и умерено выраженным  синдромом интоксикации. При этом тяжесть состояния пациента определялась выраженной  дыхательной недостаточностью и болевым синдром. При аускультации хрипов не было. Над  очагом поражения было резко выраженное ослабленное дыхание. В периферической крови  определялась высокая СОЭ при умеренном лейкоцитозе и отсутствии эозинофилии

Plakophilin-3 Is Required for Late Embryonic Amphibian Development, Exhibiting Roles in Ectodermal and Neural Tissues

The p120-catenin family has undergone a significant expansion during the evolution of vertebrates, resulting in varied functions that have yet to be discerned or fully characterized. Likewise, members of the plakophilins, a related catenin subfamily, are found throughout the cell with little known about their functions outside the desmosomal plaque. While the plakophilin-3 (Pkp3) knockout mouse resulted in skin defects, we find larger, including lethal effects following its depletion in Xenopus. Pkp3, unlike some other characterized catenins in amphibians, does not have significant maternal deposits of mRNA. However, during embryogenesis, two Pkp3 protein products whose temporal expression is partially complimentary become expressed. Only the smaller of these products is found in adult Xenopus tissues, with an expression pattern exhibiting distinctions as well as overlaps with those observed in mammalian studies. We determined that Xenopus Pkp3 depletion causes a skin fragility phenotype in keeping with the mouse knockout, but more novel, Xenopus tailbud embryos are hyposensitive to touch even in embryos lacking outward discernable phenotypes, and we additionally resolved disruptions in certain peripheral neural structures, altered establishment and migration of neural crest, and defects in ectodermal multiciliated cells. The use of two distinct morpholinos, as well as rescue approaches, indicated the specificity of these effects. Our results point to the requirement of Pkp3 in amphibian embryogenesis, with functional roles in a number of tissue types

Personal self-determination of students with disabilities: socio-psychological analysis of factors and mechanisms

Introduction. The article examines the socio-psychological features of personal self-determination of students with disabilities and disabilities. The subject of the study were the most significant factors influencing the adaptation of such students to the academic environment, as well as the mechanisms of its optimization. The increase in the number of applicants with disabilities predetermines in the context of social and educational inclusion the development of an accessible environment in the form of barrier-free architectural and academic space, the creation of a psychologically comfortable invision. The problem of personal self-determination of students with disabilities in the process of higher vocational education is updated with the specifics of their worldview, mastering of competences, interpersonal communication.Materials and methods. The paper conducted a theoretical analysis of a set of domestic and foreign scientific sources (monographs, articles and publications on the topic of research, results of dissertation studies on psychology, sociology, pedagogy) which allowed to generalize and systematize international and Russian experience both in relation to the general situation of students with disabilities in higher education, and the specifics of personal self-determination of students with disabilities; method of theoretical generalization, content analysis, secondary analysis of empirical data.Results. As a result of the author's analysis and interpretation of available scientific sources, the data of international and Russian socio-psychological studies are summarized and systematic. The data obtained during the secondary analysis made it possible to identify and substantiate the basic factors that affect the personal self-determination of students with disabilities: resilience, internality, self-sufficiency (personal, social, professional). A number of mechanisms to improve the level of socio-psychological adaptation have been proposed.Discussion and Conclusions. The article presents the author's interpretation of international and domestic experience of socio-psychological research aimed at identifying the actual factors of personal self-determination of students with disabilities. As a real mechanism for improving adaptive abilities, students with disabilities and motivations for personal self-determination proposed the development of local (university) integrated support centers

Simultaneous topography-guided photorefractive keratectomy with accelerated collagen cross-linking in the treatment of stage I keratoconus

Purpose: to evaluate the efficiency of simultaneous topography-guided photorefractive keratectomy (PRK) with accelerated collagen cross-linking in the treatment of stage I keratoconus.Material and methods. 38 patients (49 eyes) aged 18 to 44 with stage I keratoconus were treated with simultaneous topography-guided PRK combined with accelerated corneal collagen crosslinking. Along with standard ophthalmological testing, patients underwent aberrometry, confocal microscopy, optical coherence tomography of the cornea, imaging of the anterior eye section on a Scheimpflug analyzer, and examination of the biomechanical properties of the cornea. The follow-up period was 2 years.Results. Two years after surgery, uncorrected visual acuity which originally was 0.23 ± 0.03 showed a statistically significant increase and reached 0.72 ± 0.02; best corrected visual acuity improved from 0.44 ± 0.03 to 0.89 ± 0.02; the refractive power of the cornea fell from 45.03 ± 0.28 to 42.55 ± 0.31 D; the spherical component of refraction reduced from -2.00 ± 0.19 to -0.73 ± 0.09 D; the cylinder component reduced from 2.46 ± 0.14 to 0.79 ± 0.07 mm, the thinnest point of the cornea reduced from 486.30 ± 4.78 to 406.80 ± 6.51 μm. The highest order aberrations showed the following results: Coma index reduced from 0.27 ± 0.12 to 0.08 ± 0.07, Tilt reduced from 0.53 ± 0.11 to 0.10 ± 0,09, and Trefoil reduced from 0.13 ± 0.04 to 0.05 ± 0.02.Conclusion. The analysis of clinical and functional results, biomechanical properties and structures of the cornea confirmed the efficacy and safety of the combined treatment of patients with stage I keratoconus