Pancreatic islet transplantation is a minimally invasive procedure aiming to reverse the effects of insulin deficiency in patients with type 1 diabetes(T1D)by transplanting pancreatic beta cells.Overall,pancreatic isl...Pancreatic islet transplantation is a minimally invasive procedure aiming to reverse the effects of insulin deficiency in patients with type 1 diabetes(T1D)by transplanting pancreatic beta cells.Overall,pancreatic islet transplantation has improved to a great extent,and cellular replacement will likely become the mainstay treatment.We review pancreatic islet transplantation as a treatment for T1D and the immunological challenges faced.Published data demonstrated that the time for islet cell transfusion varied between 2 and 10 h.Approximately 54%of the patients gained insulin independence at the end of the first year,while only 20%remained insulin-free at the end of the second year.Eventually,most transplanted patients return to using some form of exogenous insulin within a few years after the transplantation,which imposed the need to improve immunological factors before transplantation.We also discuss the immunosuppressive regimens,apoptotic donor lymphocytes,anti-TIM-1 antibodies,mixed chimerism-based tolerance induction,induction of antigen-specific tolerance utilizing ethylene carbodiimide-fixed splenocytes,pretransplant infusions of donor apoptotic cells,B cell depletion,preconditioning of isolated islets,inducing local immunotolerance,cell encapsulation and immunoisolation,using of biomaterials,immunomodulatory cells,etc.展开更多
Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can...Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases,including diabetes;hypertension;atherosclerosis;coronary artery disease and stroke;obstructive sleep apnea;depression;weight-related arthropathies and endometrial and breast cancer.A body weight 20%above ideal for age,gender and height is a severe health risk.Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet,increased physical activity,behavioral changes and drugs have failed.The two most common procedures currently used are sleeve gastrectomy and gastric bypass.This procedure has gained popularity recently and is generally considered safe and effective.Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved,more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures.This review aims to synthesize and summarize the growing evidence on the long-term effectiveness,outcomes and complications of bariatric surgery.展开更多
Time series analysis is a valuable tool in epidemiology that complements the classical epidemiological models in two different ways:Prediction and forecast.Prediction is related to explaining past and current data bas...Time series analysis is a valuable tool in epidemiology that complements the classical epidemiological models in two different ways:Prediction and forecast.Prediction is related to explaining past and current data based on various internal and external influences that may or may not have a causative role.Forecasting is an exploration of the possible future values based on the predictive ability of the model and hypothesized future values of the external and/or internal influences.The time series analysis approach has the advantage of being easier to use(in the cases of more straightforward and linear models such as Auto-Regressive Integrated Moving Average).Still,it is limited in forecasting time,unlike the classical models such as Susceptible-Exposed-Infectious-Removed.Its applicability in forecasting comes from its better accuracy for short-term prediction.In its basic form,it does not assume much theoretical knowledge of the mechanisms of spreading and mutating pathogens or the reaction of people and regulatory structures(governments,companies,etc.).Instead,it estimates from the data directly.Its predictive ability allows testing hypotheses for different factors that positively or negatively contribute to the pandemic spread;be it school closures,emerging variants,etc.It can be used in mortality or hospital risk estimation from new cases,seroprevalence studies,assessing properties of emerging variants,and estimating excess mortality and its relationship with a pandemic.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)pandemic affects all aspects of our lives,including children.With the advancement of the pandemic,children under five years old are at increased risk of hospitalization...BACKGROUND The coronavirus disease 2019(COVID-19)pandemic affects all aspects of our lives,including children.With the advancement of the pandemic,children under five years old are at increased risk of hospitalization relative to other age groups.This makes it paramount that we develop tools to address the two critical aspects of preserving children's health–new treatment protocols and new predictive models.For those purposes,we need to understand better the effects of COVID-19 on children,and we need to be able to predict the number of affected children as a proportion of the number of infected children.This is why our research focuses on clinical and epidemiological pictures of children with heart damage post-COVID,as a part of the general picture of post-COVID among this age group.AIM To demonstrate the role of children in the COVID-19 spread in Bulgaria and to test the hypothesis that there are no secondary transmissions in schools and from children to adults.METHODS Our modeling and data show with high probability that in Bulgaria,with our current measures,vaccination strategy and contact structure,the pandemic is driven by the children and their contacts in school.RESULTS This makes it paramount that we develop tools to address the two critical aspects of preserving children's health–new treatment protocols and new predictive models.For those purposes,we need to understand better the effects of COVID-19 on children,and we need to be able to predict the number of affected children as a proportion of the number of infected children.This is why our research focuses on clinical and epidemiological pictures of children with heart damage post-COVID,as a part of the general picture of post-Covid among this age group.CONCLUSION Our modeling rejects that hypothesis,and the epidemiological data supports that.We used epidemiological data to support the validity of our modeling.The first summer wave in 2020 from the listed here school proms endorse the idea of transmissions from students to teachers.展开更多
Managing a pandemic is a difficult task.Pandemics are part of the dynamics of nonlinear systems with multiple different interactive features that co-adapt to each other(such as humans,animals,and pathogens).The target...Managing a pandemic is a difficult task.Pandemics are part of the dynamics of nonlinear systems with multiple different interactive features that co-adapt to each other(such as humans,animals,and pathogens).The target of controlling such a nonlinear system is best achieved using the control system theory developed in engineering and applied in systems biology.But is this theory and its principles actually used in controlling the current coronavirus disease-19 pandemic?We review the evidence for applying principles in different aspects of pandemic control related to different goals such as disease eradication,disease containment,and short-or long-term economic loss minimization.Successful policies implement multiple measures in concordance with control theory to achieve a robust response.In contrast,unsuccessful policies have numerous failures in different measures or focus only on a single measure(only testing,vaccines,etc.).Successful approaches rely on predictions instead of reactions to compensate for the costs of time delay,on knowledge-based analysis instead of trial-and-error,to control complex nonlinear systems,and on risk assessment instead of waiting for more evidence.Iran is an example of the effects of delayed response due to waiting for evidence to arrive instead of a proper risk analytical approach.New Zealand,Australia,and China are examples of appropriate application of basic control theoretic principles and focusing on long-term adaptive strategies,updating measures with the evolution of the pandemic.展开更多
基金Supported by European Union-NextGenerationEU,through The National Recovery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008-C01.
文摘Pancreatic islet transplantation is a minimally invasive procedure aiming to reverse the effects of insulin deficiency in patients with type 1 diabetes(T1D)by transplanting pancreatic beta cells.Overall,pancreatic islet transplantation has improved to a great extent,and cellular replacement will likely become the mainstay treatment.We review pancreatic islet transplantation as a treatment for T1D and the immunological challenges faced.Published data demonstrated that the time for islet cell transfusion varied between 2 and 10 h.Approximately 54%of the patients gained insulin independence at the end of the first year,while only 20%remained insulin-free at the end of the second year.Eventually,most transplanted patients return to using some form of exogenous insulin within a few years after the transplantation,which imposed the need to improve immunological factors before transplantation.We also discuss the immunosuppressive regimens,apoptotic donor lymphocytes,anti-TIM-1 antibodies,mixed chimerism-based tolerance induction,induction of antigen-specific tolerance utilizing ethylene carbodiimide-fixed splenocytes,pretransplant infusions of donor apoptotic cells,B cell depletion,preconditioning of isolated islets,inducing local immunotolerance,cell encapsulation and immunoisolation,using of biomaterials,immunomodulatory cells,etc.
基金Supported by the European Union-NextGenerationEU,through the National Recovery and Resilience Plan of the Republic of Bulgaria,No. BG-RRP-2.004-0008-C01。
文摘Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases,including diabetes;hypertension;atherosclerosis;coronary artery disease and stroke;obstructive sleep apnea;depression;weight-related arthropathies and endometrial and breast cancer.A body weight 20%above ideal for age,gender and height is a severe health risk.Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet,increased physical activity,behavioral changes and drugs have failed.The two most common procedures currently used are sleeve gastrectomy and gastric bypass.This procedure has gained popularity recently and is generally considered safe and effective.Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved,more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures.This review aims to synthesize and summarize the growing evidence on the long-term effectiveness,outcomes and complications of bariatric surgery.
基金Supported by European Union-NextGenerationEU,Through the National Recovery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008-C01.
文摘Time series analysis is a valuable tool in epidemiology that complements the classical epidemiological models in two different ways:Prediction and forecast.Prediction is related to explaining past and current data based on various internal and external influences that may or may not have a causative role.Forecasting is an exploration of the possible future values based on the predictive ability of the model and hypothesized future values of the external and/or internal influences.The time series analysis approach has the advantage of being easier to use(in the cases of more straightforward and linear models such as Auto-Regressive Integrated Moving Average).Still,it is limited in forecasting time,unlike the classical models such as Susceptible-Exposed-Infectious-Removed.Its applicability in forecasting comes from its better accuracy for short-term prediction.In its basic form,it does not assume much theoretical knowledge of the mechanisms of spreading and mutating pathogens or the reaction of people and regulatory structures(governments,companies,etc.).Instead,it estimates from the data directly.Its predictive ability allows testing hypotheses for different factors that positively or negatively contribute to the pandemic spread;be it school closures,emerging variants,etc.It can be used in mortality or hospital risk estimation from new cases,seroprevalence studies,assessing properties of emerging variants,and estimating excess mortality and its relationship with a pandemic.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)pandemic affects all aspects of our lives,including children.With the advancement of the pandemic,children under five years old are at increased risk of hospitalization relative to other age groups.This makes it paramount that we develop tools to address the two critical aspects of preserving children's health–new treatment protocols and new predictive models.For those purposes,we need to understand better the effects of COVID-19 on children,and we need to be able to predict the number of affected children as a proportion of the number of infected children.This is why our research focuses on clinical and epidemiological pictures of children with heart damage post-COVID,as a part of the general picture of post-COVID among this age group.AIM To demonstrate the role of children in the COVID-19 spread in Bulgaria and to test the hypothesis that there are no secondary transmissions in schools and from children to adults.METHODS Our modeling and data show with high probability that in Bulgaria,with our current measures,vaccination strategy and contact structure,the pandemic is driven by the children and their contacts in school.RESULTS This makes it paramount that we develop tools to address the two critical aspects of preserving children's health–new treatment protocols and new predictive models.For those purposes,we need to understand better the effects of COVID-19 on children,and we need to be able to predict the number of affected children as a proportion of the number of infected children.This is why our research focuses on clinical and epidemiological pictures of children with heart damage post-COVID,as a part of the general picture of post-Covid among this age group.CONCLUSION Our modeling rejects that hypothesis,and the epidemiological data supports that.We used epidemiological data to support the validity of our modeling.The first summer wave in 2020 from the listed here school proms endorse the idea of transmissions from students to teachers.
文摘Managing a pandemic is a difficult task.Pandemics are part of the dynamics of nonlinear systems with multiple different interactive features that co-adapt to each other(such as humans,animals,and pathogens).The target of controlling such a nonlinear system is best achieved using the control system theory developed in engineering and applied in systems biology.But is this theory and its principles actually used in controlling the current coronavirus disease-19 pandemic?We review the evidence for applying principles in different aspects of pandemic control related to different goals such as disease eradication,disease containment,and short-or long-term economic loss minimization.Successful policies implement multiple measures in concordance with control theory to achieve a robust response.In contrast,unsuccessful policies have numerous failures in different measures or focus only on a single measure(only testing,vaccines,etc.).Successful approaches rely on predictions instead of reactions to compensate for the costs of time delay,on knowledge-based analysis instead of trial-and-error,to control complex nonlinear systems,and on risk assessment instead of waiting for more evidence.Iran is an example of the effects of delayed response due to waiting for evidence to arrive instead of a proper risk analytical approach.New Zealand,Australia,and China are examples of appropriate application of basic control theoretic principles and focusing on long-term adaptive strategies,updating measures with the evolution of the pandemic.
