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Introduction. Infectious inflammatory and dysbiotic diseases of the vagina represent a major concern facing obstetric and gynecological science. Individually, the two most common specific diseases can be distinguished, namely: bacterial vaginosis (BV) and nonspecific vaginitis (NV). The therapeutic strategy for these diseases requires a word of clarification and adjustment.Objective. To conduct a comparative analysis of treatment with the combination drug Orcepol WM (ciprofloxacin (500 mg) and ornidazole (500 mg)) and a combination of monopreparations in a dosage form similar to Orcepol WM.Materials and methods. As a comparison object, we used the method of simultaneous administration by patients of tablet forms of ciprofloxacin and ornidazole as mono-preparations in a dosage of 500 mg similar to Orcepol. The study included 64 patients with diagnoses of “bacterial vaginosis” or “nonspecific vaginitis” or "decompensated mixed vaginal dysbiosis". The average age of the patients was 35.34 ± 5.95 years. The patients were divided into two groups: group 1 (n = 32) received the combination drug Orcepol WM, group 2 (n = 32) received ciprofloxacin and ornidazole with two mono-preparations. The drugs were prescribed as a five-day course, two times a day. The patients were followed up by a doctor during two visits and one remote interview on day 30–45 after the end of treatment (visit 2).Results. In both groups, all patients received a full course of antibacterial therapy. There were no adverse drug reactions. In both groups, there was an improvement in clinical symptoms from the first to the second visit: discomfort, itching, burning, dyspareunia, hyperemia of the mucous membrane against the background of normalization of laboratory findings of the vaginal microbiocenosis condition. At the same time, the best results were higher in group 1. Manifestation of mycotic vaginitis with the development of strong clinical symptomatology on days 3 and 4 of treatment respectively were recorded in 4 (12.5%) patients from group 1 and 7 (21.9%) from group 2. The results of comparative observation showed that the number of relapses after the end of therapy were the same in group 1 (8 out of 32 patients, 25%) and in group 2 (9 out of 32 patients, 28%). The relapse occurred on average day 12 and 17 after the end of therapy, respectively.Сonclusion. Thus, the use of Orcepol WM showed a greater therapeutic efficacy as compared to the use of tablet forms of ciprofloxacin and ornidazole in similar dosages as a single-drug administration, which can be explained by a stronger patients' adherence to the treatment.

Artificial neural networks (ANNs) are considered efficient tools for modeling complex, non-linear processes with uncertain dynamic models. ANNs were originally applied as effective predictors of diverse processes with static dependence on the input-output information. However, when the ANN must be applied to characterize an approximate model of time-dependent input-output relationships, then it is necessary to introduce the time effect as part of the ANN, yielding to the construction of dynamic ANN or DNN. This review establishes the variants of recurrent and differential forms of DNN, their mathematically formulation as well as the methods to adjust the network weights. The characteristics of DNNs motivate their use to represent the dynamics of decontamination processes. This review details recent findings on the DNN application for the modeling and control of treatment systems based on either biological and chemical processes. The modeling application of DNN for some common methods used in the treatment of wastewater, contaminated soil and atmosphere is described. The major benefits of using the approximate DNN-based model instead of designing the complex mathematical description for each treatment are analyzed in the context of enhancing the efficiency of the decontamination treatment. This review also highlights the remarkable efficiency of DNNs as a keystone tool for modeling and control sequence of treatments. The last section in the review introduces several open researching areas for the application of DNN for decontamination systems based on biochemical and chemical treatments.

The analysis of the designs and the principle of operation of the drive mechanisms of modern medium-voltage vacuum circuit breakers is carried out. In the known designs of vacuum switches, two types of drives are used: spring-motor and electromagnetic. In turn, electromagnetic drives, depending on the type of electromagnet used, can be monostable, unpolarized and polarized, and bistable, polarized. The spring-motor drive mechanisms of the circuit breakers consist of a drive shaft, closing and opening springs, a closing spring charging mechanism, a mechanical manual operation device, and opening and closing electromagnets for operational electrical tripping. Electromagnetic actuators consist of an electromagnet and, depending on its design, can be with or without a return spring. Monostable polarized electromagnets are used in the design of electromagnetic actuators with return springs. A feature of the designs of electromagnetic drive mechanisms with bistable electromagnets is the absence of a return spring and the presence of separate on and off coils. As a result of the analysis, the drawbacks of each of the considered types of drives were revealed. Of greatest interest for further research are electromagnetic drive mechanisms with monostable polarized electromagnets with a return spring, which contain only one turn-on coil and, due to this, allow reducing the overall dimensions of the drive.

OBJECTIVES: To develop two practice‐site‐level measures of comprehensiveness and examine their associations with patient outcomes, and how their performance differs from physician‐level measures. DATA SOURCES: Medicare fee‐for‐service claims. STUDY DESIGN: We calculated practice‐site‐level comprehensiveness measures (new problem management and involvement in patient conditions) across 5286 primary care physicians (PCPs) at 1339 practices in the Comprehensive Primary Care initiative evaluation in 2013. We assessed their associations with practices’ attributed beneficiaries’ 2014 total Medicare expenditures, hospitalization rates, ED visit rates. We also examined variation in PCPs’ comprehensiveness across PCPs within practices versus between primary care practices. Finally, we compared associations of practice‐site and PCP‐level measures with outcomes. PRINCIPAL FINDINGS: The measures had good variation across primary care practices, strong validity, and high reliability. Receiving primary care from a practice at the 75th versus 25th percentile on the involvement in patient conditions measure was associated with $21.93 (2.8%) lower total Medicare expenditures per beneficiary per month (P

Background: Atherosclerosis is a chronic inflammatory condition that affects different arteries in the human body and often leads to severe neurological complications, such as stroke and its sequelae. Affected blood vessels develop atherosclerotic lesions in the form of focal thickening of the intimal layer, so called atherosclerotic plaques. Objectives: Despite the high priority of atherosclerosis research for global health and the numerous preclinical and clinical studies conducted, currently, there is no effective pharmacological treatment that directly impacts atherosclerotic plaques. Many knowledge gaps exist in our understanding of the mechanisms of plaque formation. In this review, we discuss the role of mitochondria in different cell types involved in atherogenesis and provide information about mtDNA mutations associated with the disease. Results: Mitochondria of blood and arterial wall cells appear to be one of the important factors in disease initiation and development. Significant experimental evidence connects oxidative stress associated with mitochondrial dysfunction and vascular disease. Moreover, mitochondrial DNA (mtDNA) deletions and mutations are being considered as potential disease markers. Further study of mtDNA damage and associated dysfunction may open new perspectives for atherosclerosis treatment. Conclusion: Mitochondria can be considered as important disease-modifying factors in several chronic pathologies. Deletions and mutations of mtDNA may be used as potential disease markers. Mitochondria-targeting antioxidant therapies appear to be promising for the development of treatment of atherosclerosis and other diseases associated with oxidative stress and chronic inflammation.

The article presents quantitative characteristics of multi-tonnage technogenic wastes in Ukraine and Ivano-Frankivsk region, which cause environmental pollution. The water silts containing petroleum products are particularly dangerous wastes. It is proposed to recycle them using the method of preparation of the raw mixture in composition with the following technogenic wastes: oil sludge, ash, zeolite material, calcium-containing compounds, and organic mineral binders. They are granulated and subjected to thermal treatment at low temperatures. The granular materials made using the oil-containing silt of the model object reduce the negative impact onto the environment of the region and increase its level of environmental safety.

In 2013, the American Psychiatric Association (APA) published the 5th edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In 2019, the World Health Assembly approved the 11th revision of the International Classification of Diseases (ICD-11). It has often been suggested that the field would benefit from a single, unified classification of mental disorders, although the priorities and constituencies of the two sponsoring organizations are quite different. During the development of the ICD-11 and DSM-5, the World Health Organization (WHO) and the APA made efforts toward harmonizing the two systems, including the appointment of an ICD-DSM Harmonization Group. This paper evaluates the success of these harmonization efforts and provides a guide for practitioners, researchers and policy makers describing the differences between the two systems at both the organizational and the disorder level. The organization of the two classifications of mental disorders is substantially similar. There are nineteen ICD-11 disorder categories that do not appear in DSM-5, and seven DSM-5 disorder categories that do not appear in the ICD-11. We compared the Essential Features section of the ICD-11 Clinical Descriptions and Diagnostic Guidelines (CDDG) with the DSM-5 criteria sets for 103 diagnostic entities that appear in both systems. We rated 20 disorders (19.4%) as having major differences, 42 disorders (40.8%) as having minor definitional differences, 10 disorders (9.7%) as having minor differences due to greater degree of specification in DSM-5, and 31 disorders (30.1%) as essentially identical. Detailed descriptions of the major differences and some of the most important minor differences, with their rationale and related evidence, are provided. The ICD and DSM are now closer than at any time since the ICD-8 and DSM-II. Differences are largely based on the differing priorities and uses of the two diagnostic systems and on differing interpretations of the evidence. Substantively divergent approaches allow for empirical comparisons of validity and utility and can contribute to advances in the field.

Atherosclerosis is still one of the main causes of death around the globe. This condition leads to various life-threatening cardiovascular complications. However, no effective preventive measures are known apart from lifestyle corrections, and no cure has been developed. Despite numerous studies in the field of atherogenesis, there are still huge gaps in already poor understanding of mechanisms that underlie the disease. Inflammation and lipid metabolism violations are undoubtedly the key players, but many other factors, such as oxidative stress, endothelial dysfunction, contribute to the pathogenesis of atherosclerosis. This overview is focusing on the role of macrophages in atherogenesis, which are at the same time a part of the inflammatory response, and also tightly linked to the foam cell formation, thus taking part in both crucial for atherogenesis processes. Being essentially involved in atherosclerosis development, macrophages and foam cells have attracted attention as a promising target for therapeutic approaches.

Atherosclerosis is a well-known global health problem. Despite the high prevalence of the disease, numerous aspects of pathogenesis remain unclear. Subsequently, there are still no cure or adequate preventive measures available. Atherogenesis is now considered a complex interplay between lipid metabolism alterations, oxidative stress, and inflammation. Inflammation in atherogenesis involves cellular elements of both innate (such as macrophages and monocytes) and adaptive immunity (such as B-cells and T-cells), as well as various cytokines cascades. Because inflammation is, in general, a well-investigated therapeutic target, and strategies for controlling inflammation have been successfully used to combat a number of other diseases, inflammation seems to be the preferred target for the treatment of atherosclerosis as well. In this review, we summarized data on targeting the most studied inflammatory molecular targets, CRP, IL-1β, IL-6, IFN-γ, and TNF-α. Studies in animal models have shown the efficacy of anti-inflammatory therapy, while clinical studies revealed the incompetence of existing data, which blocks the development of an effective atheroprotective drug. However, all data on cytokine targeting give evidence that anti-inflammatory therapy can be a part of a complex treatment.

COVID-19 is a highly contagious new infection caused by the single-stranded RNA Sars-CoV-2 virus. For the first time, this infection was recorded in December 2019 in the Chinese province of Wuhan. The virus presumably crossed the interspecies barrier and passed to humans from a bat. Initially, the disease was considered exclusively in the context of damage to the respiratory system, but it quickly became clear that the disease also entails serious consequences from various systems, including the cardiovascular system. Among these consequences are myocarditis, myocardial damage, subsequent heart failure, myocardial infarction, and Takotsubo syndrome. On the other hand, clinical data indicate that the presence of chronic diseases in a patient aggravates the course and outcome of coronavirus infection. In this context, the relationship between COVID-19 and atherosclerosis, a condition preceding cardiovascular disease and other disorders of the heart and blood vessels, is particularly interesting. The renin-angiotensin system is essential for the pathogenesis of both coronavirus disease and atherosclerosis. In particular, it has been shown that ACE2, an angiotensin-converting enzyme 2, plays a key role in Sars-CoV-2 infection due to its receptor activity. It is noteworthy that this enzyme is important for the normal functioning of the cardiovascular system. Disruptions in its production and functioning can lead to various disorders, including atherosclerosis.

It is known that the shortening of the telomeres leads to cell senescence, accompanied by acquiring of pro-inflammatory phenotype. The expression of telomerase can elongate telomeres and resist the onset of senescence. The initiation of atherosclerosis is believed to be associated with local senescence of the endothelial cells of the arteries in places with either low or multidirectional oscillatory wall shear stress. The process of regeneration of the artery surface that has begun does not lead to success for several reasons. Atherosclerotic plaques are formed, which, when developed, lead to fatal consequences, which are the leading causes of death in the modern world. The pronounced age dependence of the manifestations of atherosclerosis pushes scientists to try to link the development of atherosclerosis with telomere length. The study of the role of telomere shortening in atherosclerosis is mainly limited to measuring the telomeres of blood cells, and only in rare cases (surgery or post-mortem examination) are the telomeres of local cells available for measurement. The review discusses the basic issues of cellular aging and the interpretation of telomere measurement data in atherosclerosis, as well as the prospects for the prevention and possible treatment of atherosclerosis.

Cardiovascular disease (CVD) is one of the greatest health problems affecting people worldwide. Atherosclerosis, in turn, is one of the most common causes of cardiovascular disease. Due to the high mortality rate from cardiovascular diseases, prevention and treatment at the earliest stages become especially important. This requires developing a deep understanding of the mechanisms underlying the development of atherosclerosis. It is well-known that atherogenesis is a complex multi-component process that includes lipid metabolism disorders, inflammation, oxidative stress, autophagy disorders and mitochondrial dysfunction. Autophagy is a cellular control mechanism that is critical to maintaining health and survival. One of the specific forms of autophagy is mitophagy, which aims to control and remove defective mitochondria from the cell. Particularly defective mitophagy has been shown to be associated with atherogenesis. In this review, we consider the role of autophagy, focusing on a special type of it—mitophagy—in the context of its role in the development of atherosclerosis.

Cardiovascular pathologies maintain the leading position in mortality worldwide. Atherosclerosis is a chronic disease that can result in a variety of serious complications, such as myocardial infarction, stroke, and cardiovascular disease. Inflammation and lipid metabolism alterations play a crucial role in atherogenesis, but the details of relationships and causality of these fundamental processes remain not clear. The oxidation of LDL was considered the main atherogenic modification of LDL within the vascular wall for decades. However, recent investigations provided a growing body of evidence in support of the multiple LDL modification theory. It suggests that LDL particles undergo numerous modifications that change their size, density, and chemical properties within the blood flow and vascular wall. Oxidation is the last stage in this cascade resulting in the atherogenic properties. Moreover, recent investigations have discovered that oxLDL may have both anti-inflammatory and pro-inflammatory properties. Oxidized LDL can trigger inflammation through the activation of macrophages and other cells. After all, oxidized LDL is still a promising object for further investigations that have the potential to clarify the unknown parts of the atherogenic process. In this review, we discuss the role of oxLDL in atherosclerosis development on different levels.

Following approval of the ICD‐11 by the World Health Assembly in May 2019, World Health Organization (WHO) member states will transition from the ICD‐10 to the ICD‐11, with reporting of health statistics based on the new system to begin on January 1, 2022. The WHO Department of Mental Health and Substance Abuse will publish Clinical Descriptions and Diagnostic Guidelines (CDDG) for ICD‐11 Mental, Behavioural and Neurodevelopmental Disorders following ICD‐11’s approval. The development of the ICD‐11 CDDG over the past decade, based on the principles of clinical utility and global applicability, has been the most broadly international, multilingual, multidisciplinary and participative revision process ever implemented for a classification of mental disorders. Innovations in the ICD‐11 include the provision of consistent and systematically characterized information, the adoption of a lifespan approach, and culture‐related guidance for each disorder. Dimensional approaches have been incorporated into the classification, particularly for personality disorders and primary psychotic disorders, in ways that are consistent with current evidence, are more compatible with recovery‐based approaches, eliminate artificial comorbidity, and more effectively capture changes over time. Here we describe major changes to the structure of the ICD‐11 classification of mental disorders as compared to the ICD‐10, and the development of two new ICD‐11 chapters relevant to mental health practice. We illustrate a set of new categories that have been added to the ICD‐11 and present the rationale for their inclusion. Finally, we provide a description of the important changes that have been made in each ICD‐11 disorder grouping. This information is intended to be useful for both clinicians and researchers in orienting themselves to the ICD‐11 and in preparing for implementation in their own professional contexts.

Niobium and tantalum anodic oxide nanocolumn arrays by porous anodic alumina assisted anodizing were produced and the optical reflectance was studied.

Objective: To compare the characteristics of mothers of children with Fetal Alcohol Spectrum Disorder (FASD) with mothers of typically developing control children. Methods: The study utilized a cross-sectional, observational design, using active case ascertainment. Biological mothers were interviewed using a standardized retrospective questionnaire to collect data on demographics, living environment, pregnancy history, nutrition, alcohol and other drug use prior to and following pregnancy recognition. Results: A total of 173 mothers were interviewed. Of these, 19 had a child who was diagnosed with FASD, five had a child who had received a deferred FASD diagnosis, and 37 had children who were selected into the control group as typically developing children. The remaining 112 mothers had children who did not meet diagnostic criteria for FASD. The mothers of children with FASD did not differ significantly from mothers of the control group children with respect to age, ethnicity, marital status, and employment status at the time of pregnancy. However, mothers of children with FASD had lower levels of education (p &lt, 0.01) and were more likely to have received financial support (p &lt, 0.05) at the time of pregnancy, to have smoked tobacco (p &lt, 0.001), and to have used marijuana or hashish (p &lt, 0.01) prior to pregnancy recognition, compared with mothers of control children. All mothers of children with FASD reported alcohol consumption prior to pregnancy recognition, however, only 10.5% reported alcohol consumption following pregnancy recognition. None of the mothers interviewed reported any drug use following pregnancy recognition. Conclusions: Population-based preventive interventions, including repeated screening, monitoring, and education regarding the effects of alcohol use, as well as other substances, before and during pregnancy, are needed to eliminate risk for FASD and other negative consequences on child and maternal health.

Atherosclerosis is a major cause of disease-related mortality around the globe. The main characteristic of the disease is an accumulation of plaque on the arterial wall and subsequent erosion or rupture of some plaques. Atherosclerosis often leads to cardiovascular disease and such acute complications as myocardial infarction or ischemic stroke due to thrombus formation. Most recent advances in atherosclerotic research state that the modifications of low-density lipoprotein (LDL) are one of the most significant stages in the disease initiation, and among these modifications desialylation is of particular interest. Sialic acids are widely expressed on all types of cells of many organisms and participate in numerous biological processes. Regarding atherosclerosis, sialidases that are responsible for the regulation of the sialic component of different molecules, are probably one of the most crucial enzymatic families. Sufficient sialylation of vascular endothelium defines its susceptibility to an atherogenic plaque formation. Moreover, the desialylation of LDL provokes an accumulation of cholesterol and lipids in the arterial walls. According to the multiple involvements of sialic acids and related enzymes, sialidases, in the initiation and development of atherosclerosis, the deeper understanding of their exact role, as well as cellular and molecular mechanisms, will allow creating more targeted and effective therapeutic and diagnostic approaches.

RESEARCH OBJECTIVE: More comprehensive primary care is associated with lower costs and better outcomes for patients. Several primary care interventions under the ACA target practice site level redesign. Thus, it is helpful to have measures to assess whether the comprehensiveness of the practice site is associated with beneficiary outcomes. Building on prior work developing and validating primary care physician‐level measures of comprehensiveness, we developed two practice‐level measures of primary care comprehensiveness and tested their associations with beneficiary outcomes. STUDY DESIGN: Lagged analysis of claims‐based outcomes for Medicare FFS beneficiaries during a year to practice‐level comprehensiveness measures in the previous year. Data are from 2013‐2014 from the evaluation of the Comprehensive Primary Care Initiative. The practice‐level measures assessed, across all primary care physicians in a practice site, the extent to which the physicians in the practice were involved in care for their patients’ conditions (IPC = involved in patient conditions) and managed their patients’ new problems (NPM = new problem management). Regression models controlled for beneficiary, practice, and market characteristics. POPULATION STUDIED: 1,343 primary care practices where 5,336 physicians cared for over 1 million Medicare fee‐for‐service beneficiaries. PRINCIPAL FINDINGS: The two measures varied across primary care practices and captured different aspects of comprehensiveness, as intended. Comparing practices in the 75th versus 25th percentile for each of these measures of comprehensiveness, practices where physicians had greater involvement in patient conditions (IPC) had 2.3% lower Medicare expenditures (P = .03), and 1.7% lower ED visit rates per 1000 beneficiaries (P = .08). Practices where physicians demonstrated greater new problem management (NPM) had 1.6% lower Medicare expenditures (P = .04), 1.8%, lower hospitalization rates per 1000 beneficiaries (P = .03), 2.6% lower overall ED visit rates (P = .00), and 2.6% lower ED outpatient visit rates (P = .01). CONCLUSIONS: These measures demonstrate strong content and predictive validity and reliability. Medicare beneficiaries in primary care practices where physicians deliver more comprehensive care had slightly lower Medicare expenditures, and lower rates of hospitalizations, ED visits, and ED outpatient visits. IMPLICATIONS FOR POLICY OR PRACTICE: These new measures may be useful indicators of 2 aspects of practice‐level comprehensiveness (involvement in patient conditions and new problem management) for studies that target the practice as the unit of change. Additional research should focus on the robustness of these findings for the full Medicare population as well as for other populations. Future research to test interventions to promote primary care comprehensiveness may also be useful. PRIMARY FUNDING SOURCE: Centers for Medicare and Medicaid Services.

Atherosclerosis is a serious disorder, with numerous potential complications such as cardiovascular disease, ischemic stroke, and myocardial infarction. The origin of atherosclerosis is related to chronic inflammation, lipid metabolism alterations, and oxidative stress. Inflammasomes are the cytoplasmic multiprotein complex triggering the activation of inflammatory response. NLRP3 inflammasomes have a specific activation pathway that involves numerous stimuli, including a wide range of PAMPs and DAMPs. Recent studies of atherosclerotic pathology are focused on the mitochondria that appear to be a promising target for therapeutic approach development. Mitochondria are the main source of reactive oxygen species (ROS) associated with oxidative stress. It was previously shown that NLRP3 inflammasome activation results in mitochondrial damage, but the exact mechanisms of this need to be specified. In this review, we focused on the features of NLRP3 inflammasomes and their significance for atherosclerosis, especially concerning mitochondria.

Atherosclerosis retains the leading position among the causes of global morbidity and mortality worldwide, especially in the industrialized countries. Despite the continuing efforts to investigate disease pathogenesis and find the potential points of effective therapeutic intervention, our understanding of atherosclerosis mechanisms remains limited. This is partly due to the multifactorial nature of the disease pathogenesis, when several factors so different as altered lipid metabolism, increased oxidative stress, and chronic inflammation act together leading to the formation and progression of atherosclerotic plaques. Adequate animal models are currently indispensable for studying these processes and searching for novel therapies. Animal models based on rodents, such as mice and rats, and rabbits represent important tools for studying atherosclerosis. Currently, genetically modified animals allow for previously unknown possibilities in modelling the disease and its most relevant aspects. In this review, we describe the recent progress made in creating such models and discuss the most important findings obtained with them to date.

Atherosclerosis with associated cardiovascular diseases remains one of the main causes of disability and death worldwide, requiring development of new solutions for prevention and treatment. Macrophages are the key effectors of a series of events involved in atherogenesis, such as inflammation, plaque formation, and changes in lipid metabolism. Some of these events were shown to be associated with mitochondrial dysfunction and excessive mitochondrial DNA (mtDNA) damage. Moreover, macrophages represent a promising target for novel therapeutic approaches that are based on the expression of various receptors and nanoparticle uptake. Lipid‐based gene delivery to mitochondria is considered to be an interesting strategy for mtDNA damage correction. To date, several nanocarriers and their modifications have been developed that demonstrate high transfection efficiency and low cytotoxicity. This review discusses the possibilities of lipid‐based gene delivery to macrophage mitochondria for atherosclerosis therapy.

Diabetes mellitus comprises a group of carbohydrate metabolism disorders that share a common main feature of chronic hyperglycemia that results from defects of insulin secretion, insulin action, or both. Insulin is an important anabolic hormone, and its deficiency leads to various metabolic abnormalities in proteins, lipids, and carbohydrates. Atherosclerosis develops as a result of a multistep process ultimately leading to cardiovascular disease associated with high morbidity and mortality. Alteration of lipid metabolism is a risk factor and characteristic feature of atherosclerosis. Possible links between the two chronic disorders depending on altered metabolic pathways have been investigated in numerous studies. It was shown that both types of diabetes mellitus can actually induce atherosclerosis development or further accelerate its progression. Elevated glucose level, dyslipidemia, and other metabolic alterations that accompany the disease development are tightly involved in the pathogenesis of atherosclerosis at almost every step of the atherogenic process. Chronic inflammation is currently considered as one of the key factors in atherosclerosis development and is present starting from the earliest stages of the pathology initiation. It may also be regarded as one of the possible links between atherosclerosis and diabetes mellitus. However, the data available so far do not allow for developing effective anti-inflammatory therapeutic strategies that would stop atherosclerotic lesion progression or induce lesion reduction. In this review, we summarize the main aspects of diabetes mellitus that possibly affect the atherogenic process and its relationship with chronic inflammation. We also discuss the established pathophysiological features that link atherosclerosis and diabetes mellitus, such as oxidative stress, altered protein kinase signaling, and the role of certain miRNA and epigenetic modifications.

This paper presents a novel approach for adapting attackers and defenders preferred patrolling strategies using reinforcement learning (RL) based-on average rewards in Stackelberg security games. We propose a framework that combines three different paradigms: prior knowledge, imitation and temporal-difference method. The overall RL architecture involves two highest components: the Adaptive Primary Learning architecture and the Actor–critic architecture. In this work we consider that defenders and attackers conforms coalitions in the Stackelberg security game, these are reached by computing the Strong Lp-Stackelberg/Nash equilibrium. We present a numerical example that validates the proposed RL approach measuring the benefits for security resource allocation.

To examine the empirical basis for including the diagnostic category of "a single episode of harmful substance use" in the 11th revision of theWe used data on patients admitted to emergency departments in 21 countries with alcohol-related injuries (i.e. with drinking within the preceding six hours) who had no sign of alcohol intoxication or withdrawal, no alcohol in blood and no sign of alcohol dependence or harmful drinking as described in the ICD-10. We obtained data on alcohol-related injuries, the patient's causal attribution of injury to drinking, the alcohol amount consumed, blood alcohol concentration and usual drinking pattern. Patients with and without alcohol dependence or harmful drinking were compared.We included a representative sample of 18 369 patients. After adjustment for unequal sampling, 18.8% reported drinking in the six hours before injury and 47.1% of these attributed their injury to drinking; 16.3% of those reporting drinking and 10.3% of those attributing their injury to drinking were not alcohol dependent or harmful drinkers. The majority of these last two groups reported never having had five or more drinks on one occasion during the last year and had a blood alcohol concentration less than 0.05%.Some individuals attending emergency departments had alcohol-attributable injuries due to a single episode of drinking but had no history of harmful use or dependence. These findings highlight the public health relevance of including the new diagnostic category in the ICD-11.Examiner les conditions empiriques de l'inclusion de la catégorie de diagnostic «épisode isolé de consommation nocive de substances» dans la 11Nous avons utilisé des données relatives à des patients admis dans des services d'urgence dans 21 pays pour des traumatismes liés à l'alcool (consommation au cours des six dernières heures) qui ne présentaient aucun signe d'intoxication à l'alcool ou de sevrage alcoolique, aucune trace d'alcool dans le sang et aucun signe de dépendance à l'alcool ou de consommation nocive, comme décrit dans la CIM-10. Nous avons recueilli des données sur les traumatismes liés à l'alcool, l'attribution causale du traumatisme à la consommation d'alcool par le patient, la quantité d'alcool consommée, la concentration d'alcool dans le sang et les habitudes de consommation. Nous avons comparé des patients qui présentaient une dépendance à l'alcool ou une consommation nocive à d'autres pour qui ce n'était pas le cas.Nous avons inclus un échantillon représentatif de 18 369 patients. Après ajustement pour échantillonnage inégal, 18,8% des patients ont indiqué avoir consommé de l'alcool au cours des six heures ayant précédé le traumatisme, 47,1% d'entre eux attribuant leur traumatisme à la consommation d'alcool; 16,3% des patients ayant indiqué avoir consommé de l'alcool et 10,3% de ceux attribuant leur traumatisme à la consommation d'alcool n'étaient ni dépendants à l'alcool, ni des consommateurs excessifs. La majorité des membres de ces deux derniers groupes ont signalé n'avoir jamais consommé cinq verres ou plus lors d'une même occasion au cours de l'année écoulée et présentaient une concentration d'alcool dans le sang inférieure à 0,05%.Certains patients pris en charge par des services d'urgence avaient des traumatismes attribuables à l'alcool en raison d'un épisode isolé de consommation, mais ne présentaient pas d'antécédents de consommation nocive ou de dépendance. Ces conclusions soulignent l'intérêt pour la santé publique d'inclure une nouvelle catégorie de diagnostic dans la CIM-11.Examinar las bases empíricas para incluir la categoría diagnóstica de "episodio único de consumo de sustancia nociva" en la undécima revisión de laUtilizamos datos de pacientes admitidos en salas de emergencia en 21 países con daños asociados al alcohol (es decir, consumo de alcohol en las seis horas previas) que no presentaron signos de intoxicación por alcohol o abstinencia, sin rastros de alcohol en sangre y sin signos de dependencia del alcohol o consumo nocivo según se describe en la CIE-10. Obtuvimos datos sobre daños relacionados con el alcohol, la atribución causal del daño a la bebida realizada por el paciente, la cantidad de alcohol consumido, la concentración de alcohol en sangre y el patrón habitual de consumo. Se compararon pacientes con dependencia al alcohol y sin dependencia o consumo nocivo.Incluimos una muestra representativa de 18 369 pacientes. Después del ajuste por muestreo desigual, el 18,8% informaron haber bebido en las seis horas previas al daño y el 47,1% atribuyó el daño a la bebida; el 16,3% de los que indicaron haber bebido y el 10,3% de los que atribuyeron el daño a la bebida no eran dependientes al alcohol o consumidores nocivos. La mayoría en estos últimos dos grupos dijo no haber bebido cinco o más tragos en una ocasión durante el último año y su concentración de alcohol en sangre fue inferior al 0,05%.Algunos individuos recibidos en salas de emergencia presentaron daños atribuibles al alcohol debido a un único episodio de consumo de alcohol, pero no tenían antecedentes de consumo nocivo o dependencia. Estos resultados destacan la importancia para la salud pública de la inclusión de la nueva categoría diagnóstica en la CIE-11.فحص الأسس التجريبية لتضمين الفئة التشخيصية فيما يتعلق بـ "تعاطي المواد الضارة لمرة واحدة" في المراجعة الحادية عشراستخدمنا البيانات على المرضى ممن دخلوا أقسام الطوارئ في 21 دولة نتيجة لإصابات تتعلق بتناول الكحوليات (أي من تعاطى الكحوليات خلال الست ساعات السابقة) ممن لم يظهر عليهم أي علامات تدل على تسمم الكحول أو الانسحاب، ولا يوجد أثر للكحول في الدماء ولا توجد علامة تدل على إدمان الكحوليات أو المشروبات الضارة على النحو الموصوف في ICD‑10. حصلنا على البيانات بشأن الإصابات المتعلقة بالكحول، وادعاء المريض بأن سبب الإصابة يكمن في تعاطي الكحوليات، وكمية الكحوليات المستهلكة، وتركيز الكحول في الدم، ونمط الشرب المعتاد. وتم عقد مقارنة بين المرضى من مدمني الكحوليات أو ذوي العادات الضارة لتناول الكحوليات.قمنا بتضمين عينة نموذجية تشتمل على 18369 مريضًا. بعد تعديل العينات غير المتكافئة، تم الإبلاغ عن وجود 18.8‏% من المتعاطين للكحوليات خلال الست ساعات السابقة للإصابة، وأرجع 47.1‏% من هؤلاء إصاباتهم إلى تعاطي الكحوليات؛ وأبلغ ‏16.3‏% منهم عن تعاطيهم للكحول، فيما أن ‏10.3‏% ممن أرجعوا إصابتهم إلى تعاطي الكحوليات لم يكونوا من مدمني الكحوليات ولا ممن يتناولون الكحوليات بطريقة كفيلة بالإضرار بصحتهم. وتبين أن الأغلبية من المجموعتين الأخيرتين لم يشربوا خمس مرات أو أكثر في مناسبة واحدة خلال العام السابق وبلغت نسبة تركيز الكحول في الدم أقل من 0.05‏%.تعرض بعض الأفراد ممن دخلوا أقسام الطوارئ إلى إصابات تتعلق بتناول الكحوليات نتيجة لتعاطي الكحول مرة واحدة ولم يكن لهم تاريخ سابق بإدمان الكحول أو تعاطيه. وتسلط هذه النتائج الضوء على ارتباط الصحة العامة بتضمين الفئة التشخيصية الجديدة في ICD‑11.旨在调查将“有害物质使用的单次发作”诊断类别纳入第 11 版《疾病和有关健康问题的国际统计分类》(ICD-11) 的经验基础。.我们运用来自 21 个国家因饮酒致伤（即饮酒后 6 个小时之内）而进入急诊部的患者数据。根据第 10 版《疾病和有关健康问题的国际统计分类》(ICD-10) 的描述，这些患者无酒精中毒或者戒断迹象、血液中无酒精、无酒精依赖症或者有害饮酒的迹象。我们获取有关酒精相关伤害、患者饮酒致伤的因果归因、摄入的酒精量、血液中的酒精浓度和通常饮酒模式的数据。我们对有无酒精依赖症或者是否为有害饮酒的患者进行了对比。.我们纳入了 18369 份患者样本。对不等概率抽样进行整理后，18.8% 的患者称受伤之前 6 个小时内饮过酒；其中 47.1% 的患者将其受伤归因为饮酒；16.3% 的患者称饮过酒，而且将受伤归因为饮酒的患者中，10.3% 的患者没有酒精依赖症或者不是有害饮酒者。以上两组患者中，大多数患者表示过去一年从未在一种场合喝过五杯或以上的酒，而且血液中的酒精浓度低于 0.05%。.一些因饮酒致伤进入急诊部的患者是由于饮酒单次发作，但其并无有害饮酒或者酒精依赖症病史。这些结果突出了将新的诊断类别纳入《疾病和有关健康问题的国际统计分类》(ICD-11) 的公共卫生相关性。.Изучить эмпирическую основу для включения диагностической категории «единичного эпизода употребления вредных веществ» в 11-ю редакциюАвторы использовали данные о пациентах, поступивших в отделения неотложной помощи в 21 стране с травмами, полученными после приема алкоголя (например, при потреблении алкоголя в течение предыдущих шести часов), у которых не было признаков алкогольного опьянения или синдрома абстиненции при отсутствии алкоголя в крови и признаков алкогольной зависимости или злоупотребления алкоголем, как описано в МКБ-10. Авторы получили данные о травмах, связанных с приемом алкоголя, причинно-следственных связях получения травмы и употребления алкоголя пациентом, количестве потребленного алкоголя, концентрации алкоголя в крови и обычной модели потребления алкоголя. Было проведено сравнение пациентов с алкогольной зависимостью и без нее.Авторы включили в исследование репрезентативную выборку из 18 369 пациентов. После корректировки неоднородной выборки были получены следующие данные: 18,8% респондентов сообщили о том, что употребляли алкоголь за шесть часов до получения травмы, и 47,1% из них считали получение травмы следствием приема алкоголя; 16,3% из тех респондентов, которые сообщили о приеме алкоголя, и 10,3% из тех, кто считал получение травмы следствием приема алкоголя, не имели алкогольной зависимости и не злоупотребляли алкоголем. Большинство респондентов из этих двух последних групп сообщили, что за последний год не имели случаев единовременного употребления пяти или более порций алкоголя и концентрация алкоголя в их крови составляла менее 0,05%.Некоторые пациенты, поступившие в отделения неотложной помощи, имели травмы, полученные после приема алкоголя, по причине единственного эпизода употребления алкоголя, но не имели никакой истории злоупотребления алкоголем или алкогольной зависимости. Эти результаты подчеркивают актуальность для общественного здравоохранения включения новой диагностической категории в МКБ-11.

The proposed introduction of gaming disorder (GD) in the 11th revision of the International Classification of Diseases (ICD-11) developed by the World Health Organization (WHO) has led to a lively debate over the past year. Besides the broad support for the decision in the academic press, a recent publication by van Rooij et al. (2018) repeated the criticism raised against the inclusion of GD in ICD-11 by Aarseth et al. (2017). We argue that this group of researchers fails to recognize the clinical and public health considerations, which support the WHO perspective. It is important to recognize a range of biases that may influence this debate; in particular, the gaming industry may wish to diminish its responsibility by claiming that GD is not a public health problem, a position which maybe supported by arguments from scholars based in media psychology, computer games research, communication science, and related disciplines. However, just as with any other disease or disorder in the ICD-11, the decision whether or not to include GD is based on clinical evidence and public health needs. Therefore, we reiterate our conclusion that including GD reflects the essence of the ICD and will facilitate treatment and prevention for those who need it.

This paper presents the results of the survey on the stabilization of the Triple-Link Inverted Pendulum as underactuated system. The mathematical model of the coupled electromechanical system is presented in the standard robotics format, where the geometry of its links is taken into account, further, the DC motor is considered. For the pursued aim, Attractive Ellipsoid Method is used in order to design robust stabilizing controller for electromechanical systems in a general form. In order to compare the performance for the suggested methodology, different robust Sliding Mode Control strategies are designed. The obtained algorithms are tested in numerical simulation.

Background Given the scarcity of alcohol prevention and use disorder treatments in many low- and middle-income countries (LMICs), the World Health Organization has launched an eHealth portal that includes the web-based self-help program “Alcohol e-Health.” Objective We aimed to test the effectiveness of the Alcohol e-Health program in a randomized controlled trial. Methods This was a two-arm, individually randomized, and controlled trial across four LMICs comparing the self-help program and a psychoeducation and internet access as usual waiting list. Participants were broadly recruited from community samples in Belarus, Brazil, India, and Mexico from January 2016 through January 2019. The primary outcome measure was change in the Alcohol Use Disorders Identification Test (AUDIT) score with a time frame of 6 months between baseline and follow-up. Secondary outcomes included self-reported numbers of standard drinks over the previous week and cessation of harmful or hazardous drinking (AUDIT score Results For this study, we recruited 1400 predominantly male (n=982, 70.1%) at least harmful or hazardous alcohol drinkers. The mean age was 37.6 years (SD 10.5). The participants were recruited from Brazil (n=587), Mexico (n=509), India (n=212), and Belarus (n=92). Overall, complete case analysis identified higher AUDIT changes in the intervention group (B=−4.18, 95% CI −5.42 to −2.93, P Conclusions The expansion of the Alcohol e-Health program to other LMICs with underdeveloped alcohol prevention and treatment systems for alcohol use disorders should be considered after successful replication of the present results. Trial Registration ISRCTN ISRCTN14037475; https://www.isrctn.com/ISRCTN14037475 International Registered Report Identifier (IRRID) RR2-10.1111/add.14034

Atherosclerosis is the major cause of the development of cardiovascular disease, which, in turn, is one of the leading causes of mortality worldwide. From the point of view of pathogenesis, atherosclerosis is an extremely complex disease. A huge variety of processes, such as violation of mitophagy, oxidative stress, damage to the endothelium, and others, are involved in atherogenesis; however, the main components of atherogenesis are considered to be inflammation and alterations of lipid metabolism. In this review, we want to focus on inflammation, and more specifically on the cellular elements of adaptive immunity, T and B cells. It is known that various T cells are widely represented directly in atherosclerotic plaques, while B cells can be found, for example, in the adventitia layer. Of course, such widespread and well-studied cells have attracted attention as potential therapeutic targets for the treatment of atherosclerosis. Various approaches have been developed and tested for their efficacy.

Background and aims Given the scarcity of alcohol prevention and alcohol use disorder treatments in many low and middle-income countries, theWorld Health Organization launched an e-health portal on alcohol and health that includes aWeb-based self-help program. This paper presents the protocol for a multicentre randomized controlled trial (RCT) to test the efficacy of the internet-based self-help intervention to reduce alcohol use. Design Two-arm randomized controlled trial (RCT) with follow-up 6 months after randomization. Setting Community samples in middle-income countries. Participants People aged 18+, with Alcohol Use Disorders Identification Test (AUDIT) scores of 8+ indicating hazardous alcohol consumption. Intervention and comparator Offer of an internet-based self-help intervention, ‘Alcohol e-Health’, compared with a ‘waiting list’ control group. The intervention, adapted from a previous program with evidence of effectiveness in a high-income country, consists of modules to reduce or entirely stop drinking. Measurements The primary outcome measure is change in the Alcohol Use Disorders Identification Test (AUDIT) score assessed at 6-month follow-up. Secondary outcomes include self-reported the numbers of standard drinks and alcohol-free days in a typical week during the past 6 months, and cessation of harmful or hazardous drinking (AUDIT < 8). Analysis Data analysis will be by intention-to-treat, using analysis of covariance to test if programparticipants will experience a greater reduction in their AUDIT score than controls at follow-up. Secondary outcomes will be analysed by (generalized) linear mixed models. Complier average causal effect and baseline observations carried forward will be used in sensitivity analyses. Comments If the Alcohol e-Health program is found to be effective, the potential public health impact of its expansion into countries with underdeveloped alcohol prevention and alcohol use disorder treatment systems world-wide is considerable.

To provide a highly efficient control of nonlinear systems in the presence of nonmodeled dynamics and external perturbations, a new control law with feedback based on the sliding modes with an observer of the “Super-Twist” kind was proposed. For acceptable use of the continuous observer signal in the controller, presented were adaptive laws for adjustment of the control system parameters. Using the methods of Lyapunov function, system stability (convergence to a zone) was proved. This technique was proposed as an example of control and stabilization of the position of a parallel manipulator (Gough–Stewart platform). The presented mechanism with six degrees of freedom is used to control the secondary mirror of the “Large Millimeter Telescope Alfonso Serrano” situated in the state of Puebla, Mexico.

Organizations tailor their mentoring strategies to accommodate internal resources and preferences, producing different approaches in academic, government, and corporate environments. Across these settings, three common barriers impede effective mentoring of statisticians: overspecialization, time constraints, and geographic dispersion. The authors share mentoring strategies that have emerged at their organization, Mathematica Policy Research, to overcome these obstacles. Practices include creating a methodology working group to unite researchers with diverse backgrounds, integrating mentoring into existing workflows, and harnessing modern technological infrastructure to facilitate virtual mentoring. Although these strategies emerged within a specific professional context, they suggest opportunities for statisticians to expand the channels through which mentorship can occur.

This paper considers the problem of the HIV/AIDS Infection Process filtering characterized by three compounds, namely, the number of healthy T-cells, the number of infected T-cells and free virus particles. Only the first and third of them can be measurable during the medical treatment process. Moreover, the exact parameter values are admitted to be also unknown. So, here we deal with an uncertain dynamic model that excludes the application of classical filtering theory and requires the application of robust filters successfully working in the absence of a complete mathematical model of the considered process. The problem is to estimate the number of infected T-cells based on the available information. Here we admit the presence of stochastic “white noise” in current observations. To do that we apply the Luenberger-like filter (software sensor) with a matrix gain, which should be adjusted at the beginning of the process in such a way that the filtering error would be as less as possible using the Attractive Ellipsoid Method (AEM). It is shown that the corresponding trajectories of the filtering error converge to an ellipsoidal set of a prespecified form in mean-square sense. To generate the experimental data sequences in the test-simulation example, we have used the well-known simplified HIV/ AIDS model. The obtained results confirm the effectiveness of the suggested approach.

Background Fetal alcohol spectrum disorder (FASD) is one of the most disabling potential outcomes of prenatal alcohol exposure. The population-based prevalence of FASD among the general population of Canada was unknown. The objective of this study was to determine the population-based prevalence of FASD among elementary school students, aged 7 to 9 years, in the Greater Toronto Area (GTA) in Ontario, Canada. Methods This screening study used a cross-sectional, observational design utilizing active case ascertainment, along with retrospective collection of prenatal alcohol exposure information. Data collection involved two phases. Phase I consisted of taking growth measurements, a dysmorphology examination, and obtaining a history of behavioral and/or learning problems. Phase II consisted of a neurodevelopmental assessment, maternal interview, and behavioral observations/ratings by parents/guardians. Final diagnostic screening conclusions were made by consensus by a team of experienced multidisciplinary experts during case conferences, using the 2005 Canadian guidelines for FASD diagnosis. The prevalence of FASD was estimated, taking into consideration the selection rate, which was used to account for students who dropped out or were lost to follow-up during each phase. Monte Carlo simulations were employed to derive the confidence interval (CI) for the point estimates. Results A total of 2555 students participated. A total of 21 cases of suspected FASD were identified. The prevalence of FASD was estimated to be 18.1 per 1000, or about 1.8%. Using a less conservative approach (sensitivity analysis), the prevalence of FASD was estimated to be 29.3 per 1000, or about 2.9%. Therefore, the population-based prevalence of FASD is likely to range between 2 and 3% among elementary school students in the GTA in Ontario, Canada. Conclusions This study provides the first population-based estimate of the prevalence of FASD in Canada. The estimate is approximately double or possibly even triple previous crude estimates. FASD prevalence exceeds that of other common birth defects such as Down’s syndrome, spina bifida, trisomy 18, as well as autism spectrum disorder in Canada. More effective prevention strategies targeting alcohol use during pregnancy, surveillance of FASD, and timely interventions and support to individuals with FASD and their families are urgently needed. Electronic supplementary material The online version of this article (10.1186/s12889-019-7213-3) contains supplementary material, which is available to authorized users.

Alcohol-related liver disease (ALD), which includes a range of disorders of different severity and is one of the most prevalent types of liver disease worldwide, has recently regained increased attention. Among other reasons, the realisation that any alcohol intake, regardless of type of beverage represents a health risk, and the new therapeutic strategies tested in recently published or undergoing clinical trials spur scientific interest in this area. In April 2019, Gut convened a round table panel of experts during the European Association for the Study of the Liver International Liver Congress in Vienna to discuss critical and up-to-date issues and clinical trial data regarding ALD, its epidemiology, diagnosis, management, pathomechanisms, possible future treatments and prevention. This paper summarises the discussion and its conclusions., SCOPUS: ar.j, info:eu-repo/semantics/published

The Eleventh Revision of the International Classification of Diseases (ICD-11) was formally published in May 2019. Alcohol use disorders form a key part of the section of Disorders due to Substance Use and Addictive Behaviours. This review describes and discusses the alcohol diagnoses within this section of ICD-11, including Alcohol Dependence, Harmful Pattern of Use of Alcohol, and entities such as Alcohol Intoxication, Alcohol Withdrawal, and several alcohol-induced mental disorders, and briefly covers Hazardous Alcohol Use, which is listed separately as a health risk factor. We summarize the historical background to the development of these diagnoses, including work within the World Health Organization since the 1970s, and the corresponding diagnoses in the current ICD-10. The process by which ICD-11 diagnoses have been made is described and may be summarized as a conceptual-pragmatic-confirmatory one. The available empirical data supporting the ICD-11 diagnoses are presented, particularly in relation to the diagnostic guidelines for Alcohol Dependence. Comparison is made with the corresponding diagnoses in ICD-10 and their nearest counterparts in the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders. Field testing of the ICD-11 diagnoses is currently in progress. A plea is made for matching of diagnoses, diagnostic guidelines/criteria, and the assessment tools intended to capture these diagnoses.

OBJECTIVE: To develop claims‐based measures of comprehensiveness of primary care physicians (PCPs) and summarize their associations with health care utilization and cost. DATA SOURCES AND STUDY SETTING: A total of 5359 PCPs caring for over 1 million Medicare fee‐for‐service beneficiaries from 1404 practices. STUDY DESIGN: We developed Medicare claims‐based measures of physician comprehensiveness (involvement in patient conditions and new problem management) and used a previously developed range of services measure. We analyzed the association of PCPs’ comprehensiveness in 2013 with their beneficiaries’ emergency department, hospitalizations rates, and ambulatory care‐sensitive condition (ACSC) admissions (each per 1000 beneficiaries per year), and Medicare expenditures (per beneficiary per month) in 2014, adjusting for beneficiary, physician, practice, and market characteristics, and clustering. PRINCIPAL FINDINGS: Each measure varied across PCPs and had low correlation with the other measures—as intended, they capture different aspects of comprehensiveness. For patients whose PCPs’ comprehensiveness score was at the 75th vs 25th percentile (more vs less comprehensive), patients had lower service use (P

BACKGROUND AND AIMS: The World Health Organization's (WHO's) proposed International Classification of Diseases, 11th Edition (ICD-11) includes several major revisions to substance use disorder (SUD) diagnoses. It is essential to ensure the consistency of within-subject diagnostic findings across countries, languages and cultures. To date, agreement analyses between different SUD diagnostic systems have largely been based in high-income countries and clinical samples rather than general population samples. We aimed to evaluate the prevalence of, and concordance between diagnoses using the ICD-11, The WHO's ICD 10th Edition (ICD-10), and the Diagnostic and Statistical Manual of Mental Disorders, 4th and 5th editions (DSM-IV, DSM-5); prevalence of disaggregated ICD-10 and ICD-11 symptoms; and variation in clinical features across diagnostic groups.DESIGN: Face-to-face household surveys.SETTING: Representative surveys of the general population in ten countries (Argentina, Australia, Brazil, Colombia, Iraq, Northern Ireland, Poland, Portugal, Romania and Spain) of the World Mental Health Survey Initiative.PARTICIPANTS: Questions about SUDs were asked of 12,182 regular alcohol users and 1,788 cannabis users.MEASUREMENTS: Each survey used the World Mental Health Survey Initiative version of the WHO Composite International Diagnostic Interview Version 3.0 (WMH-CIDI).FINDINGS: Among regular alcohol users, prevalence (95% confidence interval) of lifetime ICD-11 alcohol harmful use and dependence were 21.6% (20.5%-22.6%) and 7.0% (6.4%-7.7%), respectively. Among cannabis users, 9.3% (7.4%-11.1%) met criteria for ICD-11 harmful use and 3.2% (2.3%-4.0%) for dependence. For both substances, all comparisons of ICD-11 with ICD-10 and DSM-IV showed excellent concordance (all κ≥0.90). Concordance between ICD-11 and DSM-5 ranged from good (for SUD, and comparisons of dependence and severe SUD) to poor (for comparisons of harmful use and mild SUD). Very low endorsement rates were observed for new ICD-11 feature for harmful use ('harm to others'). Minimal variation in clinical features was observed across diagnostic systems.CONCLUSIONS: The World Health Organization's proposed International Classification of Diseases, 11th Edition (ICD-11) classifications for substance use disorder diagnoses are highly consistent with the ICD 10th Edition and the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). Concordance between ICD-11 and the DSM 5th Edition (DSM-5) varies, largely due to low levels of agreement for the ICD harmful use and DSM-5 mild use disorder. Diagnostic validity of self-reported "harm to others" is questionable.

Background: Atherosclerosis and related cardiovascular diseases remain the leading cause of mortality and morbidity worldwide. Atherosclerosis development involves several pathological processes, including alterations of the blood lipid profile, chronic inflammation and thrombogenesis. The existing therapies for atherosclerosis are aimed at normalization of the lipid profile, reduction of cardiovascular risks and inflammation and alleviation of symptoms. Despite the certain progress made in the field, more efficient and direct approaches are needed to battle the disease effectively. Enzymes that are up-regulated or play key roles in various pathologies are traditionally regarded as potential therapeutic targets. Methods and findings: We searched MEDLINE for recent articles reporting on the three enzymes that are involved in atherosclerosis development: matrix metallo-proteinases, neuraminidase/sialidases and NADPH oxidases. These enzymes participate in matrix remodeling, atherogenic modifications of LDL particles, and oxidative stress correspondingly. Conclusion: The enzymes involved in atherosclerosis development, such as metalloproteinases, sialidases, and NADPH oxidases, appear to be potential therapeutic targets for the disease prevention and/or treatment. However, more selective and potent inhibitors of these enzymes need to be discovered before they become relevant for clinical treatment of atherosclerosis.