Results of surgical treatment of patients with aortoiliac atherosclerosis

АТЕРОСКЛЕРОЗАРТЕРИОСКЛЕРОЗАТЕРОСКЛЕРОЗАОРТЫ АНЕВРИЗМААОРТЫ АНЕВРИЗМЫ РАЗРЫВАОРТЫ РАЗРЫВАОРТО-ПОДВЗДОШНАЯ РЕКОНСТРУКЦИЯ /ХИРКРИТИЧЕСКАЯ ИШЕМИЯ КОНЕЧНОСТИ /ДИАГНЦель. Изучить результаты хирургического лечения пациентов с аорто-подвздошной патологией в раннем послеоперационном периоде. Материал и методы. В исследование включено 103 пациента с аортальной патологией, которые были направлены в клинику сосудистой хирургии с 2015 по 2017 гг. Прооперировано 53 пациента с аорто-подвздошным атеросклерозом и 50 пациентов с аневризмой абдоминальной аорты. Показанием к операции были перемежающаяся хромота, критическая ишемия конечности или острый тромбоз аорты у пациентов с аорто-подвздошным атеросклерозом. Показанием к операции у пациентов с аневризмой абдоминальной аорты была аневризма более 5,5 см в поперечном диаметре или разрыв аневризмы. Ранние результаты хирургического лечения пациентов оценивали по частоте послеоперационных осложнений и летальных исходов. Результаты. Из 53 пациентов с аорто-подвздошным атеросклерозом 49 (92,5%) пациентов были прооперированы в плановом порядке и 4 (7,5%) пациента были прооперированы ургентно. Выполнено 52 (98,2%) аорто-бифеморальных шунтирования и один (1,8%) аорто-феморальный (односторонний) шунт. Три осложнения (6,1%) наблюдались у пациентов, которые были прооперированы в плановом порядке, и одно осложнение (25%) у пациента, которого оперировали в ургентном порядке. Среди ургентных пациентов смертность составила 25%, среди плановых – 2,0%. Прооперированы 28 пациентов с бессимптомной аневризмой абдоминальной аорты и 22 пациента с разрывом аневризмы абдоминальной аорты. Смертность после плановой операции составила 3,6%. У пациентов с разрывом аневризмы абдоминальной аорты смертность составила 40,9%. Заключение. Хорошие и удовлетворительные результаты планового хирургического лечения симптоматического аорто-подвздошного атеросклероза в раннем послеоперационном периоде составили 98%, асимптоматической аневризмы аорты – 96,4%. Смертность после ургентной операции при разрыве аневризмы составила 40,9%. Хирургическое лечение аневризмы аорты показано у пациентов с низким и средним хирургическим риском.Objective. To investigate the results of surgical treatment of patients with aortoiliac pathology in the early postoperative period. Methods. In the study 103 patients with aortoiliac pathology were included, who were referred to the Clinic of Vascular Surgery from 2015 to 2017 years. 53 patients were operated on because of aortoiliac atherosclerosis and 50 patients – because of abdominal aortic aneurysm. The indications for surgery were limiting claudication, critical limb ischemia or acute thrombosis of the aorta in patients with aortoiliac atherosclerosis. The indication for surgery in patients with abdominal aortic aneurysm was the aneurysm over 5.5 cm in the transverse diameter or the ruptured aneurysm. Early results of patients’ surgical treatment were assessed by the frequency of postoperative complications and deaths. Results. 49 (92.5%) out of 53 patients with aortoiliac atherosclerosis were operated on as planned and 4 (7.5%) patients were operated on urgently. 52 (98.2%) aortobifemoral bypasses and one (1.8%) aortofemoral (unilateral) bypass were performed. Three complications (6.1%) occurred postoperatively in patients operated on according to plan and one complication (25%) – in patients operated urgently. The mortality rate was 25% in urgent patients and 2.0% in planned patients. 28 patients with asymptomatic abdominal aortic aneurysm and 22 with the ruptured abdominal aortic aneurysm were operated on. The mortality in the planned patients was 3.6%. 40.9% mortality rate was registered in the ruptured abdominal aortic aneurysm patients. Conclusions. Early good and satisfactory results of the routine surgical treatment of symptomatic aortoiliac atherosclerosis in the early postoperative period accounted 98%, asymptomatic aortic aneurysm – 96.4%. Mortality after urgent surgery with aneurysm rupture made up 40.9%. Surgical treatment of aortic aneurysm is indicated in patients with low and moderate surgical risk

Результаты симультанных операций у пациентов с атеросклеротическим поражением сонных и коронарных артерий

СОННЫЕ АРТЕРИИАТЕРОСКЛЕРОЗАРТЕРИОСКЛЕРОЗКОРОНАРНЫХ АРТЕРИЙ СТЕНОЗКАРОТИДНАЯ ЭНДАРТЕРЭКТОМИЯСОННОЙ АРТЕРИИ ЭНДАРТЕРЭКТОМИЯСТЕНОКАРДИЯАОРТОКОРОНАРНОЕ ШУНТИРОВАНИЕКОРОНАРНОЙ АРТЕРИИ ШУНТИРОВАНИ

What is the effect of a low literacy talking book on patient knowledge, anxiety and communication before radiation therapy starts? A pilot study

Introduction: Radiation therapy is a common cancer treatment, requiring timely information to help patients prepare for treatment. We pilot tested a low literacy, psycho-educational talking book (written booklet, with accompanying audio recording) to examine (i) the effect of the tool on knowledge, anxiety and communication; (ii) acceptability, and (iii) how it was used in appointments. Methods: A pre-post design was employed. Patients scheduled to receive radiation therapy for any cancer were recruited from two hospitals in Sydney, Australia. Participants were sent the talking book before treatment planning and completed baseline and follow-up surveys, before and after the intervention. Results: Forty participants were recruited, and 39 completed all study assessments. Overall, knowledge increased after receiving the talking book by 3.8 points from 13.9 to 17.7/20 (95% confidence interval (CI) 2.7, 4.8, P < 0.001). Anxiety and concerns were significantly lower after receiving the talking book (P = 0.015 and P = 0.004, respectively). Nearly half of participants (s = 17, 48%) reported using the book during appointments. Most reported finding it easier to communicate (n = 31, 89%) and to ask more questions (n = 21, 62%). Conclusion: The talking book shows promise in improving knowledge, reducing anxiety and enhancing communication. Strategies to support the implementation of the talking book are required. Further studies to translate the book into different languages are also planned

Application-infrastructure co-programming: managing the entire complex application lifecycle

With an estimated 20 billion connected devices by 2020 generating enormous amounts of data, more data-centric ways of working are needed to cope with the dynamic load and reconfigurability of on-demand computing. There is a growing range of complex, specialised means by which this flexibility can be achieved, e.g. Software-defined networking (SDN). Specification of Quality of Service (QoS) constraints for time-critical characteristics, such as network availability and bandwidth, will be needed, in the same way that compute requirements can be specified in today's infrastructures. This is the motivation for SWITCH -- an EU-funded H2020 project addressing the entire lifecycle of time-critical, self-adaptive cloud applications by developing new middleware and tools for interactive specification of such applications. This paper presents a user-facing perspective on SWITCH by discussing the SWITCH Interactive Development Environment (SIDE) Workbench. SIDE provides a programmable and dynamic graphical modeling environment for cloud applications that ensures efficient use of compute and network resources while satisfying time-critical QoS requirements. SIDE enables a user to specify the software components, properties and requirements, QoS parameters, machine requirements and their composition into a fully operational, multi-tier cloud application. In order to enable SIDE to represent the software and infrastructure constraints and to communicate them to other SWITCH components, we have defined a co-programming model using TOSCA that is capable of representing the application's state during the entire lifecycle of the application. We show how the SIDE Web GUI, along with TOSCA and the other subsystems, can support three use cases and provide a walk-through of one of these use cases to illustrate the power of such an approach

Application-infrastructure co-programming: managing the entire complex application lifecycle

With an estimated 20 billion connected devices by 2020 generating enormous amounts of data, more data-centric ways of working are needed to cope with the dynamic load and reconfigurability of on-demand computing. There is a growing range of complex, specialised means by which this flexibility can be achieved, e.g. Software-defined networking (SDN). Specification of Quality of Service (QoS) constraints for time-critical characteristics, such as network availability and bandwidth, will be needed, in the same way that compute requirements can be specified in today's infrastructures. This is the motivation for SWITCH -- an EU-funded H2020 project addressing the entire lifecycle of time-critical, self-adaptive cloud applications by developing new middleware and tools for interactive specification of such applications. This paper presents a user-facing perspective on SWITCH by discussing the SWITCH Interactive Development Environment (SIDE) Workbench. SIDE provides a programmable and dynamic graphical modeling environment for cloud applications that ensures efficient use of compute and network resources while satisfying time-critical QoS requirements. SIDE enables a user to specify the software components, properties and requirements, QoS parameters, machine requirements and their composition into a fully operational, multi-tier cloud application. In order to enable SIDE to represent the software and infrastructure constraints and to communicate them to other SWITCH components, we have defined a co-programming model using TOSCA that is capable of representing the application's state during the entire lifecycle of the application. We show how the SIDE Web GUI, along with TOSCA and the other subsystems, can support three use cases and provide a walk-through of one of these use cases to illustrate the power of such an approach

Kin discrimination promotes horizontal gene transfer between unrelated strains in Bacillus subtilis.

This is the final version. Available from Nature Research via the DOI in this record. The data that support the findings of this study are available from the corresponding author upon reasonable request and in Source Data file. Genome sequences are available in the NCBI database under genome accession numbers VBRL00000000, VBRM00000000, VBRN00000000, VBRO00000000, VBRQ00000000 and VBRR00000000. Source data are provided with this paper.Bacillus subtilis is a soil bacterium that is competent for natural transformation. Genetically distinct B. subtilis swarms form a boundary upon encounter, resulting in killing of one of the strains. This process is mediated by a fast-evolving kin discrimination (KD) system consisting of cellular attack and defence mechanisms. Here, we show that these swarm antagonisms promote transformation-mediated horizontal gene transfer between strains of low relatedness. Gene transfer between interacting non-kin strains is largely unidirectional, from killed cells of the donor strain to surviving cells of the recipient strain. It is associated with activation of a stress response mediated by sigma factor SigW in the donor cells, and induction of competence in the recipient strain. More closely related strains, which in theory would experience more efficient recombination due to increased sequence homology, do not upregulate transformation upon encounter. This result indicates that social interactions can override mechanistic barriers to horizontal gene transfer. We hypothesize that KD-mediated competence in response to the encounter of distinct neighbouring strains could maximize the probability of efficient incorporation of novel alleles and genes that have proved to function in a genomically and ecologically similar context.Slovenian Research Agency (ARRS

Selective Condensation Drives Partitioning and Sequential Secretion of Cyst Wall Proteins in Differentiating Giardia lamblia

Controlled secretion of a protective extracellular matrix is required for transmission of the infective stage of a large number of protozoan and metazoan parasites. Differentiating trophozoites of the highly minimized protozoan parasite Giardia lamblia secrete the proteinaceous portion of the cyst wall material (CWM) consisting of three paralogous cyst wall proteins (CWP1–3) via organelles termed encystation-specific vesicles (ESVs). Phylogenetic and molecular data indicate that Diplomonads have lost a classical Golgi during reductive evolution. However, neogenesis of ESVs in encysting Giardia trophozoites transiently provides basic Golgi functions by accumulating presorted CWM exported from the ER for maturation. Based on this “minimal Golgi” hypothesis we predicted maturation of ESVs to a trans Golgi-like stage, which would manifest as a sorting event before regulated secretion of the CWM. Here we show that proteolytic processing of pro-CWP2 in maturing ESVs coincides with partitioning of CWM into two fractions, which are sorted and secreted sequentially with different kinetics. This novel sorting function leads to rapid assembly of a structurally defined outer cyst wall, followed by slow secretion of the remaining components. Using live cell microscopy we find direct evidence for condensed core formation in maturing ESVs. Core formation suggests that a mechanism controlled by phase transitions of the CWM from fluid to condensed and back likely drives CWM partitioning and makes sorting and sequential secretion possible. Blocking of CWP2 processing by a protease inhibitor leads to mis-sorting of a CWP2 reporter. Nevertheless, partitioning and sequential secretion of two portions of the CWM are unaffected in these cells. Although these cysts have a normal appearance they are not water resistant and therefore not infective. Our findings suggest that sequential assembly is a basic architectural principle of protective wall formation and requires minimal Golgi sorting functions

Morphology and Photoluminescence of HfO2Obtained by Microwave-Hydrothermal

In this letter, we report on the obtention of hafnium oxide (HfO2) nanostructures by the microwave-hydrothermal method. These nanostructures were analyzed by X-ray diffraction (XRD), field-emission gum scanning electron microscopy (FEG-SEM), transmission electron microscopy (TEM), energy dispersive X-ray spectrometry (EDXS), ultraviolet–visible (UV–vis) spectroscopy, and photoluminescence (PL) measurements. XRD patterns confirmed that this material crystallizes in a monoclinic structure. FEG-SEM and TEM micrographs indicated that the rice-like morphologies were formed due to an increase in the effective collisions between the nanoparticles during the MH processing. The EDXS spectrum was used to verify the chemical compositional of this oxide. UV–vis spectrum revealed that this material have an indirect optical band gap. When excited with 488 nm wavelength at room temperature, the HfO2nanostructures exhibited only one broad PL band with a maximum at around 548 nm (green emission)

A barrier to homologous recombination between sympatric strains of the cooperative soil bacterium Myxococcus xanthus

The bacterium Myxococcus xanthus glides through soil in search of prey microbes, but when food sources run out, cells cooperatively construct and sporulate within multicellular fruiting bodies. M. xanthus strains isolated from a 16 × 16-cm-scale patch of soil were previously shown to have diversified into many distinct compatibility types that are distinguished by the failure of swarming colonies to merge upon encounter. We sequenced the genomes of 22 isolates from this population belonging to the two most frequently occurring multilocus sequence type (MLST) clades to trace patterns of incipient genomic divergence, specifically related to social divergence. Although homologous recombination occurs frequently within the two MLST clades, we find an almost complete absence of recombination events between them. As the two clades are very closely related and live in sympatry, either ecological or genetic barriers must reduce genetic exchange between them. We find that the rate of change in the accessory genome is greater than the rate of amino-acid substitution in the core genome. We identify a large genomic tract that consistently differs between isolates that do not freely merge and therefore is a candidate region for harbouring gene(s) responsible for self/non-self discrimination

Detection of Echinococcus multilocularis in Carnivores in Razavi Khorasan Province, Iran Using Mitochondrial DNA

Echinococcus multilocularis causes alveolar echinococcosis, a serious zoonotic disease present in many areas of the world. The parasite is maintained in nature through a life cycle in which adult worms in the intestine of carnivores transmit infection to small mammals, predominantly rodents, via eggs in the feces. Humans may accidentally ingest eggs of E. multilocularis through contact with the definitive host or by direct ingestion of contaminated water or foods, causing development of a multivesicular cyst in the viscera, especially liver and lung. We found adult E. multilocularis in the intestine and/or eggs in feces of all wild carnivores examined and in some stray and domestic dogs in villages of Chenaran region, northeastern Iran. The life cycle of E. multilocularis is being maintained in this area by wild carnivores, and the local population and visitors are at risk of infection with alveolar echinococcosis. Intensive health initiatives for control of the parasite and diagnosis of this potentially fatal disease in humans, in this area of Iran, are needed