Initial results of use and prospects of hospital-substituting technologies in gynecology

Background. The first day-care hospital (DCH) in the Russian Federation with 30 beds was established in the departments of general surgery, urology, and gynecology of the Botkin Hospital in 2016 in Moscow. Aim. To analyze the six-year experience of the gynecological DCH based on the Botkin Hospital. Materials and methods. The six-year experience (20162021) of the gynecological DCH based on the Botkin Hospital was analyzed. Results. The number of patients treated in the DCH increased progressively from 2016 to 2019. Due to the gain in the experience of DCH, patients with a broader spectrum of diseases can receive care in DCH settings, the number of hospitalized patients with a higher anesthetic risk has increased, and the proportion of patients over 65 years of age has also increased. Conclusion. Analysis of the activities of the DCH based on the Botkin Hospital showed that the pilot project can be considered successful due to good clinical and economic indicators. This activity format can be widely implemented, and it is optimal to establish such hospitals in multidisciplinary clinics

Случай аденовирусной инфекции, осложненной диффузным альвеолярным кровотечением у пациента, вернувшегося из Шри-Ланки

The article describes a rare case of adenovirus infection complicated by diffuse alveolar hemorrhage in a 29 y.o. immunocompetent patient which developed during a trip to Sri Lanka. The course of the disease was accompanied by severe anemia and respiratory insufficiency, etiology of the disease was confirmed by polymerase chain reaction of pharyngeal swabs and sputum sample. After successful supportive treatment, the patient was discharged on the 13th day of hospital stay to continue treatment in the out-patient settings. This case demonstrates the possibility of severe complications in case of adenovirus infection.Представлен редкий случай аденовирусной инфекции, осложненной диффузным альвеолярным кровотечением у ранее здорового 29-летнего иммунокомпетентного пациента во время посещения Шри-Ланки. Заболевание протекало c тяжелой анемией и дыхательной недостаточностью, подтверждено ПЦР-исследованием образцов глоточных смывов и мокроты. После проведения поддерживающей терапии пациент выписался из стационара на 13-й день госпитализации в удовлетворительном состоянии.Данный случай демонстрирует возможность тяжелых осложнений при аденовирусной инфекции

Листериозный менингоэнцефалит как оппортунистическое заболевание при ВИЧ-инфекции

Aim: To identify the signs and reasons why listeriosis can be classified as opportunistic infections in HIV infection, requiring timely diagnosis and treatment to prevent the development of a severe course of the disease and minimize the risks of death.  Materials and methods: 38 hospitalized patients with listeriosis meningitis/ meningoencephalitis were examined. All patients were hospitalized in the boxed departments of neuroinfections (the diagnosis of HIV infection was not known) with a directional diagnosis of meningitis of unclear etiology, where, according to the Meningitis program, a PCR examination for L. monocytogenes was included. The comparison group consisted of patients with other most common bacterial pyogenic meningitis (BPM) – meningococcal, pneumococcal and patients with listeriosis meningitis/meningoencephalitis without HIV infection.  Results: Studies have shown that patients with HIV infection accounted for the majority – 26% (out of 38 hospitalized). Men predominated among the patients – 60 %, the average age was 34.9 ± 2.2 years (29 – 41), which differs from the well–known age status, where the risk group is primarily male patients over 70 years of age.  Conclusion: Polymorphism of clinical manifestations of neuro listeriosis in some cases presents diagnostic difficulties for primary care physicians. CNS listeriosis in patients with HIV infection belongs to the category of opportunistic infections, which clinically and in the study of cerebrospinal fluid presents difficulties for early diagnosis, which directly affects the timing of the initiation of etiotropic therapy and the further outcome of the disease. Цель: выявить признаки и причины, по которым листериоз можно отнести в разряд оппортунистических инфекций при ВИЧ-инфекции, требующих своевременной диагностики и лечения для предотвращения развития тяжелого течения заболевания, и минимизировать риски летального исхода.  Материалы и методы. Обследовано 38 госпитализированных с установленным в стационаре листериозным менингитом/менингоэнцефалитом. Все больные госпитализировались в боксированные отделения нейроинфекций (о диагнозе ВИЧ-инфекция не было известно) с направительным диагнозом «Менингит неясной этиологии», где по программе «Менингиты» в ПЦР включено обследование на L. monocytogenes. Группу сравнения составили больные другими наиболее распространенными бактериальными гнойными менингитами – менингококковым, пневмококковым и больные листериозным менингитом/менингоэнцефалитом без ВИЧ-инфекции.  Результаты. Проведенные исследования показали, что больные ВИЧ-инфекцией составили большинство – 26% (из 38 госпитализированных). Среди больных преобладали мужчины – 60 %, средний возраст 34,9±2,2 лет (29–41), что отличается от общеизвестного возрастного статуса, где группой риска, прежде всего, являются пациенты старше 70 лет мужского пола.  Заключение. Полиморфизм клинических проявлений нейролистериоза в ряде случаев представляет диагностические трудности для врачей первичного звена. Листериоз центральной нервной системы у больных ВИЧ-инфекцией относится к категории оппортунистических инфекций, которая клинически и при исследовании спинномозговой жидкости представляет трудности для ранней диагностики, что напрямую влияет на сроки начала этиотропной терапии и дальнейшего исхода заболевания.

Continuous-state reinforcement learning with fuzzy approximation

peer reviewedReinforcement learning (RL) is a widely used learning paradigm for adaptive agents. Well-understood RL algorithms with good convergence and consistency properties exist. In their original form, these algorithms require that the environment states and agent actions take values in a relatively small discrete set. Fuzzy representations for approximate, model-free RL have been proposed in the literature for the more difficult case where the state-action space is continuous. In this work, we propose a fuzzy approximation structure similar to those previously used for Q-learning, but we combine it with the model-based Q-value iteration algorithm. We show that the resulting algorithm converges. We also give a modif ed, serial variant of the algorithm that converges at least as fast as the original version. An illustrative simulation example is provided

DABS-Storm: A Data-Aware Approach for Elastic Stream Processing

International audienceIn the last decade, stream processing has become a very active research domain motivated by the growing number of stream-based applications. These applications make use of continuous queries, which are processed by a stream processing engine (SPE) to generate timely results given the ephemeral input data. Variations of input data streams, in terms of both volume and distribution of values, have a large impact on computational resource requirements. Dynamic and Automatic Balanced Scaling for Storm (DABS-Storm) is an original solution for handling dynamic adaptation of continuous queries processing according to evolution of input stream properties, while controlling the system stability. Both fluctuations in data volume and distribution of values within data streams are handled by DABS-Storm to adjust the resources usage that best meets processing needs. To achieve this goal, the DABS-Storm holistic approach combines a proactive auto-parallelization algorithm with a latency-aware load balancing strategy

Machine learning multi-omics analysis reveals cancer driver dysregulation in pan-cancer cell lines compared to primary tumors

Cancer cell lines have been widely used for decades to study biological processes driving cancer development, and to identify biomarkers of response to therapeutic agents. Advances in genomic sequencing have made possible large-scale genomic characterizations of collections of cancer cell lines and primary tumors, such as the Cancer Cell Line Encyclopedia (CCLE) and The Cancer Genome Atlas (TCGA). These studies allow for the first time a comprehensive evaluation of the comparability of cancer cell lines and primary tumors on the genomic and proteomic level. Here we employ bulk mRNA and micro-RNA sequencing data from thousands of samples in CCLE and TCGA, and proteomic data from partner studies in the MD Anderson Cell Line Project (MCLP) and The Cancer Proteome Atlas (TCPA), to characterize the extent to which cancer cell lines recapitulate tumors. We identify dysregulation of a long non-coding RNA and microRNA regulatory network in cancer cell lines, associated with differential expression between cell lines and primary tumors in four key cancer driver pathways: KRAS signaling, NFKB signaling, IL2/STAT5 signaling and TP53 signaling. Our results emphasize the necessity for careful interpretation of cancer cell line experiments, particularly with respect to therapeutic treatments targeting these important cancer pathways