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Service-learning is a critical component of public health education, especially students of Doctor of Public Health (DrPH), designed for public health professionals. As an evidence-based approach to impactful teaching improving students' learning outcomes, service-learning enables future public health practitioners to engage in the learning and reflective practices developing skills needed to be leaders of social change within their communities. E-service learning has been gaining popularity among faculty and students. This study describes a grant writing course for DrPH students of various concentrations delivered online. We draw attention to the growing need to incorporate service-learning into the public health curriculum to promote social change, address local health disparities, improve students' learning experiences and outcomes, and stay relevant with the educational landscape.

In chronic lymphocytic leukemia (CLL), the B cell receptor (BCR) plays a critical role in disease development and progression, as indicated by the therapeutic efficacy of drugs blocking BCR signaling. However, the mechanism(s) underlying BCR responsiveness are not completely defined. Selective engagement of membrane IgM or IgD on CLL cells, each coexpressed by more than 90% of cases, leads to distinct signaling events. Since both IgM and IgD carry the same antigen-binding domains, the divergent actions of the receptors are attributed to differences in immunoglobulin (Ig) structure or the outcome of signal transduction. We showed that IgM, not IgD, level and organization associated with CLL-cell birth rate and the type and consequences of BCR signaling in humans and mice. The latter IgM-driven effects were abrogated when BCR signaling was inhibited. Collectively, these studies demonstrated a critical, selective role for IgM in BCR signaling and B cell fate decisions, possibly opening new avenues for CLL therapy.

Objective: In individuals with mitochondrial disease, respiratory viral infection can result in metabolic decompensation with mitochondrial hepatopathy. Here, we used a mouse model of liver-specific Complex IV deficiency to study hepatic allostasis during respiratory viral infection. Methods: Mice with hepatic cytochrome c oxidase deficiency (LivCox10−/−) were infected with aerosolized influenza, A/PR/8 (PR8), and euthanized on day five after infection following three days of symptoms. This time course is marked by a peak in inflammatory cytokines and mimics the timing of a common clinical scenario in which caregivers may first attempt to manage the illness at home before seeking medical attention. Metabolic decompensation and mitochondrial hepatopathy in mice were characterized by serum hepatic testing, histology, electron microscopy, biochemistry, metabolomics, and bioenergetic profiling. Results: Following influenza infection, LivCox10−/− mice displayed marked liver disease including hepatitis, enlarged mitochondria with cristae loss, and hepatic steatosis. This pathophysiology was associated with viremia. Primary hepatocytes from LivCox10−/− mice cocultured with WT Kupffer cells in the presence of PR8 showed enhanced lipid accumulation. Treatment of hepatocytes with recombinant TNFα implicated Kupffer cell-derived TNFα as a precipitant of steatosis in LivCox10−/− mice. Eliminating Kupffer cells or blocking TNFα in vivo during influenza infection mitigated the steatosis and mitochondrial morphologic changes. Conclusions: Taken together, our data shift the narrative of metabolic decompensation in mitochondrial hepatopathy beyond the bioenergetic costs of infection to include an underlying susceptibility to immune-mediated damage. Moreover, our work suggests that immune modulation during metabolic decompensation in mitochondrial disease represents a future viable treatment strategy needing further exploration.

The urea cycle functions to incorporate ammonia, generated by normal metabolism, into urea. Urea cycle disorders (UCDs) are caused by loss of function in any of the enzymes responsible for ureagenesis, and are characterized by life-threatening episodes of acute metabolic decompensation with hyperammonemia (HA). A prospective analysis of interim HA events in a cohort of individuals with ornithine transcarbamylase (OTC) deficiency, the most common UCD, revealed that intercurrent infection was the most common precipitant of acute HA and was associated with markers of increased morbidity when compared with other precipitants. To further understand these clinical observations, we developed a model system of metabolic decompensation with HA triggered by viral infection (PR8 influenza) using spf-ash mice, a model of OTC deficiency. Both wild-type (WT) and spf-ash mice displayed similar cytokine profiles and lung viral titers in response to PR8 influenza infection. During infection, spf-ash mice displayed an increase in liver transaminases, suggesting a hepatic sensitivity to the inflammatory response and an altered hepatic immune response. Despite having no visible pathological changes by histology, WT and spf-ash mice had reduced CPS1 and OTC enzyme activities, and, unlike WT, spf-ash mice failed to increase ureagenesis. Depression of urea cycle function was seen in liver amino acid analysis, with reductions seen in aspartate, ornithine and arginine during infection. In conclusion, we developed a model system of acute metabolic decompensation due to infection in a mouse model of a UCD. In addition, we have identified metabolic perturbations during infection in the spf-ash mice, including a reduction of urea cycle intermediates. This model of acute metabolic decompensation with HA due to infection in UCD serves as a platform for exploring biochemical perturbations and the efficacy of treatments, and could be adapted to explore acute decompensation in other types of inborn errors of metabolism.

Objectives. Undergraduate public health education has received growing attention in recent years. This includes a Washington Post article referring to undergraduate public health education as a hot field for a global generation, the Critical Component Elements of an Undergraduate Major in Public Health developed by the Association of School and Programs in Public Health (ASPPH), and a recent report from the de Beaumont Foundation and ASPPH. To evaluate the demand for the degree and assess the current state of undergraduate public health education, the researchers examined the number and characteristics of publicly reported U.S. baccalaureate public health programs. Methods. The researchers reviewed three 2013 college directories and the ASPPH website and identified 112 institutions that used the term public health in their baccalaureate degree listings that guide prospective students in selecting an academic program. The undergraduate degree in public health was defined as a major leading to a B.S., B.A. or other baccalaureate degree in public health or public health studies that provides students with a strong general background in areas of knowledge basic to public health, or a specialized training in at least one of the five core disciplines of public health. The researchers then compared the degree contents as listed in the directories to the institutions’ websites to verify offering a public health curriculum. Carnegie Commission on Higher Education’s classifications of colleges and universities were applied to assess the characteristics of institutions offering baccalaureate degrees in public health. Results. Only 54 of the 2,968 U.S. institutions of higher education provided online information meeting the definition of an active undergraduate public health degree program. Conclusion. While public health may be a hot field in terms of the interest that it generates, the actual number of verified undergraduate programs available is relatively modest.

Entry. Disability due to injuries of the musculoskeletal system in the past two decades is on the third place behind cardiovascular disease and cancer. Key indicators of disability are grooved by Medical Expert Commission of Ukraine in the annual analytical and informational governmental references, but lack data on disability due to spinal cord injury they include. Purpose. Examining the status of disability due to spinal injuries and spinal cord in 2012 in Ukraine. Materials and methods. In a specially designed program for the first time studied the state of disability due to spinal cord injury centers based on medical and social assessment in 24 regions of Ukraine, the Autonomous Republic of Crimea, Kiev and Sevastopol in 2012. Results. The total number of recognized initially disabled due to spinal cord injury was 2637 people, or 0.7 per 10,000 adult population. Repeatedly recognized as disabled - 11783 man, or 3.1 per 10,000 adult population. When comparing the level recognized as disabled by regions noted that it is higher in the "industrial" regions (Dnepropetrovsk, Donetsk, Kharkov regions). Indicators of disability due to spinal cord injury in the Ivano-Frankovsk region, far superior to those in other areas. Conclusions. In 2012, in Ukraine the primary disability due to spinal cord injuries totaled 2,637 persons or 0.7 per 10,000 adult population. In 2012 in Ukraine again as disabled due to spinal cord injury were 11783 people or 3.1 per 10,000 of adult population.

Ornithine transcarbamylase deficiency (OTCD, OMIM# 311250) is an inherited X-linked urea cycle disorder that is characterized by hyperammonemia and orotic aciduria. In this report, we describe a new animal model of OTCD caused by a spontaneous mutation in the mouse Otc gene (c.240T>A, p.K80N). This transversion in exon 3 of ornithine transcarbamylase leads to normal levels of mRNA with low levels of mature protein and is homologous to a mutation that has also been described in a single patient affected with late-onset OTCD. With higher residual enzyme activity, spf-J were found to have normal plasma ammonia and orotate. Baseline plasma amino acid profiles were consistent with mild OTCD: elevated glutamine, and lower citrulline and arginine. In contrast to WT, spf-J displayed baseline elevations in cerebral amino acids with depletion following immune challenge with polyinosinic:polycytidylic acid. Our results indicate that the mild spf-J mutation constitutes a new mouse model that is suitable for mechanistic studies of mild OTCD and the exploration of cerebral pathophysiology during acute decompensation that characterizes proximal urea cycle dysfunction in humans.

Prostate cancer is presented as the most commonly diagnosed cancer in men. According to statistical reports, every 6th man have the prostate cancer and out of them every 34th man will have the castrate-resistant form of disease. The existing clinical and prognostic factors can explain cancer outcome in small part of patients. The prediction of individual prostate cancer prognosis and anticancer therapy effect are the main goals of the advanced personalized therapy. The modern genetic technologies development (GWAS, genome sequencing) will allow to find the effective prognostic markers of prostate cancer. During the GWAS performance it was found loci associated with the prostate cancer development. The analysis of on-line base “A Catalog of Published Genome-Wide Association Studies” (www.genome.gov), containing the full information of genome associative investigations as well as 30 studies of prostate cancer, revealed the associations of 159 SNPs in different ethnic groups of patients (Caucasian, Asian and Negroid). 86 SNPs among them located in 77 genes, 65 SNPs – had the intergenic localization. The GWAS performance in prostate cancer Caucasian patients have found the associations of 76 SNPs in 72 genes and 65 SNPs in intergenic regions. SNPs in genes were located in 81.4% of cases in introns, in 5.3% – in other locations as well as missense changes (near 5′-UTR, ncRNA). It was obtained 30 markers related to disease of different ethnic groups of patients in GWAS. 17 SNPs among them (rs10187424, rs6545977, rs7584330, rs10936632, rs651164, rs12155172, rs1512268, rs4242384, rs3123078, rs11199874, rs7127900, rs7130881, rs10875943, rs4775302, rs5759167, rs1327301, rs5919432) had the intergenic localization, 12 SNPs (rs1465618, rs12621278, rs17181170, rs6763931, rs17021918, rs12500426, rs7679673, rs2121875, rs2242652, rs6465657, rs7501939, rs1859962) were located in introns and 1 SNP (rs130067) – in exon. It was revealed the overfilled genome region was 8q24.21. Association with prostate cancer was found with 17 SNPs. 8 SNPs had the intergenic localization: SRRM1P1–CCAT1 (rs16901979, rs12682344, rs6983561, rs10505483) and CASC8–CASC11 (rs10090154, rs4242384, rs7837688, rs4242382); 9 SNPs – intragenic location: PRNCR1 (rs1016343, rs1456315, rs13254738, rs13252298), LOC101930033 (rs445114, rs16902094, rs10505477), CCAT2 (rs6983267), CASC8 (rs1447295). The early development of the disease was associated with the 9 SNPs: 4 SNPs were located in genes, 5 SNPs had the intergenic localization. It was noted among 9 SNPs 4 markers were in 11q13.3 region (rs7127900, rs7126629, rs7931342, rs11228583). 5 markers (rs6983267, rs10993994, rs7127900, rs7931342, rs17632542) have found in prostate cancer patients and in group of patients with early development. The 7 SNPs had the association with PSA level (rs16856139, rs12409639, rs10993994, rs3213764, rs1058205, rs1354774, rs2735839). 1 SNP among them was located intergenic region (KLK3–KLK2 rs2735839), 6 SNPs – were in genes (SLC45A3 rs16856139, rs12409639, MSMB rs10993994, ATF7I rs3213764, KLK3 rs1058205, KLKP1 rs1354774). 2 SNPs from 7 (rs10993994, rs2735839) had the relation to PSA level and to prostate cancer patients. Polymorphic variant rs10993994, located near 5′-UTR MSMB gene, had the associations with prostate cancer patients, patients with early start of disease and with PSA level. In conclusion, the search of genetic markers of prostate cancer development is actual inmodern oncology. These data will allow to form the groups of patients with different outcome and prognosis and perform the personalized therapy for every patient.

Meeting the health care needs of rural residents is complicated by their substantial medical burdens that frequently outstrip patient and community resources. Nowhere is this more evident than in central Appalachia. Preventive procedures are often sacrificed as patients and providers attend to more pressing medical issues. We report the results of a pilot study designed to explore the need for and appropriateness of a potential intervention placed in an emergency department (ED), with the eventual goal of using the ED to link traditionally underserved patients to preventive services. We used a convenience sample of 49 ED patients to explore their characteristics and health needs and compare them with a sample of 120 case management clients participating in the Kentucky Homeplace Program (KHP), and a general sample of 3,165 Appalachian Kentuckians. The recruited ED patients had low socio-economic status, numerous health conditions, and several unmet health needs, including need for colorectal, cervical, and breast cancer screening. Compared to their KHP counterparts, more ED patients were uninsured. Participants in the ED and KHP groups had particularly low income, were less educated, and had less insurance coverage than an average Appalachian resident. Although case management services, including the KHP have been successful in increasing access to health care by those in need, certain segments of the population remain underserved and continue to be missed by such programs. Our study suggests the need for and appropriateness of reaching out to such underserved populations in the ED and involving them into potential interventions designed to enhance preventive health services.

Abstract  Neurodynamic parameters of the human brain and their changes depending on the trimester of an individual annual cycle (IAC), which lasts from one birthday to the next, were studied. In the course of a year, fourfold examination (in February, April, July, and October) of 124 men and 242 women aged from 18 to 20 years was carried out. According to psychological characteristics, the examined subjects were divided into introverts and extroverts. The strength and mobility of nervous processes in extrovert men tended to decrease in the fourth trimester of the IAC, simultaneously with a decrease in the overall state of health. Introvert men exhibited a lower brain efficiency than extrovert men; changes in their brain functional mobility during an IAC were more pronounced than in the case of extrovert men; the lowest parameters were recorded in the second trimester. Annual changes in neurodynamic parameters in women were smaller than in men. [ABSTRACT FROM AUTHOR]

Aim. To analyze the clinical significance of the sodium level in a single urine test obtained 2 hours after the first dose of a loop diuretic was administered in patients with acute decompensation of chronic heart failure (ADHF).Material and methods. An observational study was conducted on the basis of a rapid-care hospital. The concentration of sodium in urine analysis obtained 2 hours after intravenous administration of the first dose of loop diuretic and natriuresis for the first day of hospitalization were evaluated. The development of resistance to diuretics was taken as the primary endpoint (the need to increase the daily dose of furosemide by more than 2 times compared to the initial one or the addition of another class of diuretic drugs).Results. 25 patients with ADHF were included. The average age of patients was 69.0±14.8 years, 16 (64%) of them were men. The average left ventricular ejection fraction was 49.0±13.5%. The level of the N‐terminal fragment of the brain natriuretic peptide (NT-proBNP) was 3416 (2128; 5781) pg/ml. The average sodium concentration in the urine analysis obtained 2 hours after the start of treatment was 100.6±41.0 mmol / l. The concentration of sodium in urine for the first day was 102.2±39.0 mmol/l. 2 hours after the start of treatment, the sodium concentration in a single urine test was less than 50 mmol/l in 5 (20%) patients. Upon further observation, oligoanuria (defined as diuresis of less than 400 ml within 24 hours) developed in 2 of them. Oligoanuria was not detected among patients whose sodium concentration was more than 50 mmol/l. The need for escalation (any increase in the dose of a loop diuretic and/or the addition of another class of diuretic drugs) arose in 7 (28%) patients; at the same time, we diagnosed the development of resistance to diuretics in 5 (20%) of them. Resistance to diuretics was more common among patients with a sodium concentration in a single urine test obtained 2 hours after the start of furosemide administration, less than 50 mmol/l (p=0.037); when dividing the recruited patient population into subgroups with a sodium concentration in a single urine test ≥50 mmol/l and

Introduction Despite a decline in global smoking prevalence among adolescents, around 21 million youth report current cigarette smoking. Exposure to tobacco advertising, promotion and sponsorship (TAPS) is a risk factor for smoking initiation, and therefore the Article 13 of the WHO Framework Convention on Tobacco Control (WHO FCTC) requires comprehensive TAPS bans. We examined the associations between changes in youth cigarette smoking and implementation of Article 13.Methods We used two rounds of cross-sectional data from the Global Youth Tobacco Survey (GYTS) for 42 countries: first between 2006 and 2015, and second between 2017 and 2020. The GYTS data were linked with the WHO FCTC implementation reports from 2016 and 2018. The outcome was current smoking. Multilevel binary logistic regression models, stratified by country income level, were used to test the prevalence differences between the latest and previous GYTS rounds and their associations with TAPS bans with postestimations using marginal analyses.Results The percentage of students currently smoking decreased from 10.0% (95% CI 8.0 to 12.1) to 7.7% (95% CI 6.1 to 9.3) from first to second GYTS rounds (p

Purpose. The article is devoted to developing the method of intelligent coordination control of a complex heterogeneous ensemble of dynamic objects. Methodology. The method of solving this problem is based on the case-scenario approach presenting the activity of dynamic objects as templates that adapt to changing external conditions by using scenarios. The algorithm of satisfaction of critical time constraints was used to adapt scenarios. The proposed method can adequately reflect the experience and knowledge of control of a dynamic objects’ group using similar decision stereotypes to control in similar situations. The main elements of case decisions such as control actions, operations, scenarios, and plans were described. Findings. The hybrid control system was implemented. The lower level of the system was developed based on the hybrid system BRIZ, which combining the subsystem based on cases with the subsystem that implements the movement model and so is master, while case subsystem is slave. The middle and top levels of the system were developed as the event-based hybrid system MUSSON, which includes case-scenario subsystem, storage subsystem and subsystem that calculating spatial regions based on the model. Scripts and triggers for each class of events were described by scripting language SCDL. Originality. The three-tier coordination control system for ensembles of dynamic objects based on case-scenario approach was proposed for the first time. The lower level is dedicated to control of separate dynamic objects, the second level is aimed to coordination of objects that jointly move, and the upper level provide the mission of the whole ensemble of dynamic objects. Practical value. The proposed approach is insensitive to inaccuracies and incomplete observations. It can reduce the information overload in the situation analysis, as well as decision-making time, thus increasing the efficiency of coordination of ensembles of dynamic objects during their mission’s execution process. Important conditions for the implementation of scenario-case method are to ensure sufficient competence that allows to find appropriate case and choose an adequate set of scenarios in time, and to synchronize each dynamic object’s case base in time and content.

Results of surgical treatment of 120 patients at whom disk hernia was combined with cicatricial-adhesive epiduritis are analyzed. Patients have been divided into two equal groups, at 60 patients at the finishing stage of operation polyacrylamid gels «Interfall» or «Esteform» were applied to prevent postoperative compressive cicatricial-adhesive epiduritis. Results of surgical treatment are estimated according to Nurick scale for 3 day, 6 months and 1 year. The expediency of gels application to prevent postoperative compressive cicatricial-adhesive epiduritis is shown.

Results of 100 patients with disc hernia combined with cicatrical-adhesive epiduritis surgical treatment were analyzed. Patients have been divided on two groups, at 50 patients polyacrylamid gels "Interfall" or "Esteform" were applied on the operation stage in order to preventive postoperative compressive cicatrical-adhesive epiduritis maintenance. Surgical treatment results were estimated in two groups of patients on several parameters (lumbar painful syndrome, radicular painful syndrome, motor and sensitive infringements) 3 day, 3 months and 1 year after operation. The expediency gels application for postoperative compressive cicatrical-adhesive epiduritis prevention maintenance were shown.

A quantitative assessment of published literature on the problem of pain in 2006 has been carry out. The findings have shown a degree of study, cooperation, coordination of various centers, institutes and countries working on this problem. The importance of the pain problem is also highlighted by multiple specialized printed editions, articles, and associations studying the problem.

The case of wide-spread scalping wound of head dermal integuments is described. The patient was treated by neurosurgeon and surgeon. For large defect above skull bones closing the stage-by-stage surgical treatment was applied — aponeurosis and dermal integuments plasty with subsequent autodermoplasty.