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The main goal of the current overview is to assess major trends in studying of fine motor skills neurobiology.Materials and techniques. PubMed (MedLine), Embase databases have been used for Information search. Search depth is 5 years (2016 – 2021). 12 papers that are more relevant to the topic have been chosen from the primary paper array (n=49). MAXQDA (Verbi Software GmbH, Germany) has been used for content analysis.Results and discussion. The current state is characterized by interdisciplinary integration using both complex experimental laboratory models and modern bionic and information technologies.Conclusion. Contemporary trends in the problem studying is the widespread utilization of information technologies and the development of approaches to neurorehabilitation with motor deficiency consideration. Fine motor skills recovery in patients with CNS lesions requires further interdisciplinary integration.

Distance learning (DL) is a completely new and unique form of education, which got forced to switch to by the current pandemic of coronavirus disease. Note that until now, distance learning technologies have been used at the department of general and clinical pathological physiology and some other departments of the Odessa National Medical University (ONMedU). The aim of this analytical article is to analyze the efficacy of ONMedU General and Clinical Pathological Physiology Department staff during the one and a half year period of the coronavirus infection pandemic with an accent to psychological approach to students modified teaching. The urgent need of time and the primary desire to protect students and their own lives during 2020-2021 requires us to improve our own pedagogical approaches in the further on-line teaching of students. We see success in systematic methodological work with students, the implementation of which will make it possible to evoke and increase their motivation to study histology. The importance of this methodological technique, supported in the senior years of medical universities by the integration of teaching theoretical and clinical disciplines, the approximation of teaching to specific clinical cases will help optimize the assimilation of morphological knowledge by students at least and, undoubtedly, in the near future will lead to a better assimilation of clinical disciplines. In connection with the ideas of individualized and developmental learning, the use of psychological capabilities of learning tools in the virtual environment brings both pedagogy and psychology to a new level of understanding the mediation of mental, creative, communicative and executive learning and learning activities. The use of distance learning helps the students to acquire skills of independent work, creates comfortable conditions for creativity, increases the creative and intellectual potential of the student through self-organization, the ability to interact with computer technology and make responsible decisions, creates favorable conditions for individual creative expression in the process of learning, for the development of the student's personality. The authors are convinced that the optimization and improvement of the educational process in medical universities is to draw students' attention to the problems that the medical community is dealing with on a daily basis today.

Objectives: Overweight and obesity among school-aged children pose a threat to both their academic performance and public health. The Healthy Primary School of the Future (HPSF) initiative was established to address this issue. Our objective was to explore the conditions that make HPSF sustainable based on the perspectives of relevant stakeholders. Design: The study utilised Group Concept Mapping, a structured methodology for conducting mixed-methods participative research, combining qualitative data collection with quantitative data analysis measures. Method: Participants included parents, teachers, school directors, politicians, labour unions, educational, nutrition and health scientists and policymakers. They were asked to respond to the prompt, 'A necessary condition to make the HPSF sustainable is . . .'. The statements generated were then assessed for their importance and feasibility. Using multidimensional scaling and hierarchical cluster analyses, we identified the shared vision among the stakeholders. Results: A total of 106 unique statements were generated and grouped statistically into 10 clusters. The most significant clusters were identified as Financing; Accessibility for everyone; and Content/Lifestyle/School Programme. The clusters that were deemed most feasible included Content/Lifestyle/School Programme; Accessibility for everyone; and Evaluation. Conclusion: Achieving sustainability for the HPSF requires a comprehensive approach that addresses the conditions outlined in all 10 clusters. Based on the ratings of feasibility and importance, our recommendation is to prioritise implementation of Content/Lifestyle/School Programme and Accessibility for everyone. Subsequently, efforts should be directed towards realising the less feasible but crucial conditions, such as Financing and Evaluation, followed by the remaining six clusters of conditions as identified.

Abstract Pituitary tumours are surrounded by critical neurovascular structures and identification of these intra-operatively can be challenging. We have previously developed an AI model capable of sellar anatomy segmentation. This study aims to apply this model, and explore the impact of AI-assistance on clinician anatomy recognition. Participants were tasked with labelling the sella on six images, initially without assistance, then augmented by AI. Mean DICE scores and the proportion of annotations encompassing the centroid of the sella were calculated. Six medical students, six junior trainees, six intermediate trainees and six experts were recruited. There was an overall improvement in sella recognition from a DICE of score 70.7% without AI assistance to 77.5% with AI assistance (+6.7; p

Background. The neck, its bone-cartilaginous and muscle apparatus, etc. high activity is well known. Cervical spine degenerative-dystrophic processes are considered to be an urgent problem. The purpose of the study was to determine the clinical and morphometric changes of the cervical spine in humans and animals with neck pain based on a clinical and neurological examination, determination of the vertebral body density, their configuration, and ratio for timely correction and prognosis of this patho­logy. Materials and methods. Pain intensity was studied in humans and animals using the adapted visual-analogue scale. The inde­xes of computer tomography with measurement of vertebral body density, and morphometric indexes with an emphasis on C5-C7 le­vel were also studied. All studies were conducted following existing bioethical standards. Results. The pathology of spine configuration was registered in 84.6 % of the examined patients in the form of angular kyphosis or straightened lordosis, more often in women. It was observed in 34.7 % of cases in dogs and cats. The normal configuration is more common: in cats — 78.6 % and in dogs of small breeds — 78.5 %, in large breed dogs — only 26.3 %, and deformations were more frequent than in cats and small dogs (2.7 times more). The cervical vertebrae bodies density in all groups decreased toward the caudal direction with a difference of 18.1 % in humans. In cats — 2.7 %, in dogs of small breeds, it was higher (7.5 %), and in large breed dogs, it reached 14.3 %. The maximum deviations of the studied indicators were found in humans and maximally coincided with those in dogs of large breeds. Conclusions. Thus, animals, especially dogs of large breeds, can serve as a model for studying etiopathogenetic factors, the course, prognosis of degeneration of the bone-cartilage apparatus.

Abstract The pathophysiology of amnestic Mild Cognitive Impairment (aMCI) is largely unknown, although some papers found signs of immune activation. To assess the cytokine network in aMCI after excluding patients with major depression (MDD) and to examine the immune profiles of quantitative aMCI (qMCI) and distress symptoms of old age (DSOA) scores. A case-control study was conducted on 61 Thai aMCI participants and 60 healthy old adults (both without MDD). The Bio-Plex Pro human cytokine 27-plex test kit was used to assay cytokines/chemokines/growth factors in fasting plasma samples. aMCI is characterized by a significant immunosuppression, and reductions in T helper 1 (Th)1 and T cell growth profiles, the immune-inflammatory responses system, interleukin (IL)1β, IL6, IL7, IL12p70, IL13, GM-CSF, and MCP-1. These 7 cytokines/chemokines exhibit neuroprotective effects at physiologic concentrations. In multivariate analyses, three neurotoxic chemokines, CCL11, CCL5, and CXCL8, emerged as significant predictors of aMCI. Logistic regression showed that aMCI was best predicted by combining IL7, IL1β, MCP-1, years of education (all inversely associated) and CCL5 (positively associated). We found that 38.2% of the variance in the qMCI score was explained by IL7, IL1β, MCP-1, IL13, years of education (inversely associated) and CCL5 (positively associated). The DSOA was not associated with any immune data. An imbalance between lowered levels of neuroprotective cytokines and chemokines, and relative increases in neurotoxic chemokines are key factors in aMCI. Future MCI research should always control for the confounding effects of affective symptoms.

Introduction: Cardiomyopathies are a clinically and genetically heterogeneous group of diseases, that are associated with significant morbidity and mortality. The aim of the present study is to clarify the molecular-genetic characteristics of cardiomyopathies in patients in Bulgaria. Material and methods: In the present study, targeted analysis of an expanded panel of 242 genes, associated with cardiomyopathy, and an additional panel of 20 genes, associated with hereditary amyloidosis, was performed in a total of 20 Bulgarian patients, diagnosed with cardiomyopathy, as follows: 12 patients with hypertrophic cardiomyopathy (HCM), including 1 pediatric patient, 6 patients with dilated cardiomyopathy (DCM), of whom 2 pediatric patients, and 2 patients with restrictive cardiomyopathy (RCM). Family segregation analyses were performed by direct Sanger sequencing. Results: Genetic findings were present in 90% of the patients. Pathogenic/likely pathogenic variants were found in 12 of the patients (60%), while genetic findings related to the clinical symptoms were not detected in the RCM patients (10%). Approximately 1/3 of the patients had a family history of sudden cardiac death or cardiomyopathy. Pathogenic/likely pathogenic variants were found in 55% of HCM patients with no family history, in ~67% of HCM patients with family history or with sporadic DCM, and in 100% of DCM patients with a positive family history. A respectively 2,5 and 4-fold higher frequency of truncating variants was found in the study group compared to the reports of around 10% in the literature, both in patients with HCM, and in patients with DCM. Pathogenic/likely pathogenic variants in the MYBPC3 gene (71%) were found with the highest frequency in HCM, while DCM is characterized by a diverse genetic profile, and genetic findings in the NDUFB11 and TAZ genes were associated with severe clinical presentation in pediatric patients in the first postnatal days. Results of segregation analyses were reported in 6 of the affected families. Conclusion: The data from the present study supports the importance of conducted genetic testing and medical-genetic counseling in patients and affected families with cardiomyopathy in Bulgaria

Introduction: Transthyretin amyloid cardiomyopathy (ATTR-CM) is a severe progressive disease, more common than previously expected. The main objectives were to evaluate hereditary and wild type ATTR-CM frequency and clinical manifestations. Material and methods: One hundred seventy-eight patients at mean age 68 ± 13 years (129 males), referred by cardiologists with suspected cardiac amyloidosis (left ventricular wall thickness ≥ 12 mm and red flags) were evaluated. Pyrophosphate scintigraphy (99mTc-PYP) grade 2-3 myocardial uptake in the absence of monoclonal protein confirmed the diagnosis. Genetic test differentiated variant from wild type ATTR-CM. Endomyocardial biopsy with amyloid typing was performed in two patients. Results: Cardiac amyloidosis was diagnosed in 69 patients: light chain in 24 (13%) and ATTR-CM in 45 patients (25%). Wild type (ATTRwt) was found in 21 (12%) male patients at mean age 81 ± 6 years and variant type (ATTRv) in 24 patients (13%) at mean age 58 ± 7 years (15 males). In all ATTRv-CM patients some degree of peripheral polyneuropathy was found. The most common clinical red flags at diagnosis in both ATTRv and ATTRwt were heart failure in all patients, atrial fibrillation (16; 36%), pacemaker (5; 11%), and carpal tunnel syndrome (8; 18%). Severe aortic stenosis (4; 19%), spinal stenosis (2;10%), biceps tendon rupture (1; 5%) were characteristic for the wild type. At follow up, four patients needed a pacemaker for high degree AV block, six patients developed new onset atrial fibrillation, seventeen patients needed either initiation or an increase of the dose of loop diuretic, another 7 patients were hospitalized for heart failure exacerbation. Eight patients (18%) died, 7 (33%) with ATTRwt-CM and 1 (4%) with ATTRv-CM, all with advanced heart failure, 4 with concomitant severe aortic stenosis. Conclusions: This study provides the first nationwide estimates of the frequency and the clinical manifestations of ATTR-CM. Confirming the severity of the disease and poor prognosis, a low threshold for screening is needed for early diagnosis and timely treatment.

Q fever, caused by infection with the bacterium Coxeilla burnetii, is an endemic disease in Israel. In 2021, a total of 341 cases of Q fever were reported to the [...]

Hiatal hernia (HH) is often seen in surgery practice. The main feature of HH is the migration of abdominal viscera in the mediastinum via the esophageal hiatus. We performed - on 53 patients from November 2009 to June 2018 in the Department of General and Digestive Surgery of General Hospital of Villarobledo. Forty-one patients were diagnosed with hiatal hernia, 9 - with gastroesophageal reflux disease (GERD), and 3 - with Barrett’s esophagus. The average operative time was 89 ± 33 minutes, and the average follow-up was four years. The following complications were recorded: perforation of the distal esophagus in 1 patient (1.9%), postoperative spleen hemorrhage requiring emergency laparotomy in 1 patient (1.9%), dysphagia in 6 patients (11.3%) in the early postoperative period (treated conservatively), one patient had small bowel obstruction in the fourth postoperative year, three patients (5.6%) had radiological signs of HH recurrence and GERD despite the fundoplication. One patient (1.9%) was reoperated for stenosis of the distal esophagus and recurrent paraesophageal hiatal hernia one year after the first intervention. Postoperative ventral hernia (POVH) was seen in 2 patients (3.8%). All recurrence rate was 7.5%, recorded in 4 patients.

Introduction: Thick histological samples are difficult to image without proper tissue clearing methods. Among these methods ethyl cinnamate (ECi)-based clearing preserves antigenicity and is compatible with immunofluorescent labeling. In contrast to many other clearing protocols, ECi-based clearing is fast and is done as a final step after standard immunofluorescent labeling protocols. Aim: We aimed to develop a simple method of ECi-based tissue clearing approach of thick (100 µm) sections attached to a slide glass. Materials and methods: Samples of human colorectal cancer underwent fixation and frozen section. We used indirect immunofluorescence to label Von-Willebrand factor, which is expressed in blood vessels. After completion of labeling and nuclear DAPI staining, the material was dehydrated using alcohols. Finally, the material was cleared and mounted with ECi and subsequently visualized via standard widefield epifluorescence microscopy. Image analysis of z-stacks were evaluated for the depth of visible signals and compared them to non-cleared samples. Results: Compared to the non-cleared sections, the ECi-cleared sections provided a 2.5-fold increase in the observable tissue thickness following immunofluorescent staining. Further, the proposed approach is time efficient (4 days from tissue preparation to final imaging) as compared to other tissue clearing methods and low cost as it minimizes the use of large amounts of reagents. Conclusion: ECi-based clearing is a very effective simple extension of standard immunofluorescent protocols and can be implemented in future experiments.

Abstract Disorders related to gut health are a significant cause of morbidity among athletes in wheelchair. This pilot feasibility trial aims to investigate whether probiotics compared to prebiotics can improve inflammatory status and gut microbiome composition in elite athletes in wheelchair. We conducted a 12-week, randomized, cross-over controlled trial involving 14 elite Swiss athletes in wheelchair. Participants were given a multispecies-multistrain probiotic or prebiotic (oat bran) daily for 4 weeks (Clinical trials.gov NCT04659408 09/12/2020). This was followed by a 4-week washout and then crossed over. Thirty inflammatory markers were assessed using bead-based multiplex immunoassays (LegendPlex) from serum samples. The gut microbiome was characterized via 16S rRNA sequencing of stool DNA samples. Statistical analyses were conducted using linear mixed-effect models (LMM). At baseline, most athletes (10/14) exhibited low levels of inflammation which associated with higher gut microbiome alpha diversity indices compared to those with high inflammation levels. The use of probiotic had higher decrease in 25 (83%) inflammatory markers measured compared to prebiotic use. Probiotic has the potential in lowering inflammation status and improving the gut microbiome diversity. The future trial should focus on having sufficient sample sizes, population with higher inflammation status, longer intervention exposure and use of differential abundance analysis.