GM-CSF impairs erythropoiesis by disrupting erythroblastic island formation via macrophages

Anemia is a significant complication of chronic inflammation and may be related to dysregulated activities among erythroblastic island (EBI) macrophages. GM-CSF was reported to be upregulated and attracted as a therapeutic target in many inflammatory diseases. Among EBIs, we found that the GM-CSF receptor is preferentially and highly expressed among EBI macrophages but not among erythroblasts. GM-CSF treatment significantly decreases human EBI formation in vitro by decreasing the adhesion molecule expression of CD163. RNA-sequence analysis suggests that GM-CSF treatment impairs the supporting function of human EBI macrophages during erythropoiesis. GM-CSF treatment also polarizes human EBI macrophages from M2-like type to M1-like type. In addition, GM-CSF decreases mouse bone marrow (BM) erythroblasts as well as EBI macrophages, leading to a reduction in EBI numbers. In defining the molecular mechanism at work, we found that GM-CSF treatment significantly decreases the adhesion molecule expression of CD163 and Vcam1 in vivo. Importantly, GM-CSF treatment also decreases the phagocytosis rate of EBI macrophages in mouse BM as well as decreases the expression of the engulfment-related molecules Mertk, Axl, and Timd4. In addition, GM-CSF treatment polarizes mouse BM EBI macrophages from M2-like type to M1-like type. Thus, we document that GM-CSF impairs EBI formation in mice and humans. Our findings support that targeting GM-CSF or reprogramming EBI macrophages might be a novel strategy to treat anemia resulting from inflammatory diseases.

The Value of the Evidence Integration Triangle

The Evidence Integration Triangle involved engaging stakeholders in the 12 month FFC-AL-EIT activities including identifying community specific goals, supporting the staff implementing the intervention, and intervening when champions or staff were not engaged in intervention activities. Ongoing participation of the stakeholder team occurred through monthly meetings. Evaluation of implementation was based on the Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM) Model. Reach was based on 85 of 90 communities participating and 794 residents recruited. Effectiveness was supported based on less functional decline and more function focused care performed by residents. Adoption was based on evidence that monthly meetings were held, 77% of settings engaged as, or more than expected, and caregivers increased the amount of function focused care provided. The intervention was implemented as intended, knowledge was received, and environments and policies supporting function focused care were maintained. The Evidence Integration Triangle is an effective implementation approach for assisted living.

Stimmversagen, Sprachinfarkt und Zungenbremse? Posttridentinische Betrachtungsliteratur Italiens zwischen orazione mentale und orazione vocale

In the following, the literary potential of a counterreformation-minded uncertainty will be in focus which in turn resulted from the distinction in orazione orale and orazione mentale made in the context of the Council of Trent. The differentiation of inner-mental and external-vocal voice as well as one’s own word and the prescribed or appropriated word was accelerated by the Council and lead to a self-reflection of prayer literature and meditations concerning their voice and voicing. Whose voice speaks in prayers and contemplation and by which aesthetic qualities are they characterized? The literary crystallisation of standardization, domestication but also the emancipating obstinacy of the meditation-voice ought to be made visible hereafter in an exemplary way. Promoted by the Council of Trent, the revaluation of the spiritual ‘inner’ prayer, in comparison to the textual prayer spoken with an external voice, has become effective in the Catholic counterreformation literature as creative-conceptual freedom, but also as a practical-aesthetic challenge. Literary and lyrical meditations – as will be shown here using the example of Antonio Grillo, Gabriele Fiamma and Loreto Mattei – not only implement the spiritual voice of contemplation discursively and thematically, but also textually and performatively. The specific relationship between production aesthetics (meditating lyrical self) and reception aesthetics (meditating contemplative poetry appropriating self) has a supporting function. Conflicting voice-discourses do not become effective in the sense of reciprocal prevention, but in the sense of symbiotic coexistence. The lyrical considerations analysed here do not solve the interferences of vocal regimes conceptually-fundamentally, but performatively-concretely.

GM-CSF Impairs Erythropoiesis by Disrupting Erythroblastic Island Formation via Macrophages

Anemia is a significant complication of chronic inflammation and may be related to dysregulated activities among erythroblastic island (EBI) macrophages. GM-CSF was reported to be upregulated and attracted as a therapeutic target in many inflammatory diseases. Among EBIs, we found that the GM-CSF receptor is preferentially and highly expressed among EBI macrophages but not among erythroblasts. GM-CSF treatment significantly decreases human EBI formation in vitro by decreasing the adhesion molecule expression of CD163. RNA-sequence analysis suggests that GM-CSF treatment impairs the supporting function of human EBI macrophages during erythropoiesis. GM-CSF treatment also polarizes human EBI macrophages from M2-like type to M1-like type. In addition, GM-CSF decreases mouse bone marrow (BM) erythroblasts as well as EBI macrophages, leading to a reduction in EBI numbers. In defining the molecular mechanism at work, we found that GM-CSF treatment significantly decreases the adhesion molecule expression of CD163 and Vcam1 in vivo. Importantly, GM-CSF treatment also decreases the phagocytosis rate of EBI macrophages in mouse BM as well as decreases the expression of the engulfment-related molecules Mertk, Axl, and Timd4. In addition, GM-CSF treatment polarizes mouse BM EBI macrophages from M2-like type to M1-like type. Thus, we document that GM-CSF impairs EBI formation in mice and humans. Our findings support that targeting GM-CSF or reprogramming EBI macrophages might be a novel strategy to treat anemia resulting from inflammatory diseases.

Features of plastics of skin flaws in the supporting surface of the foot

Plastics of skin defects of the foot as a reconstructive operation has a twofold purpose: on the one hand, as a means of preserving the organ, and on the other, as a means of restoring its supporting function.

Two-stage fixation in the treatment of diabetic arthropathy of the ankle

Aim — to improve the results of treatment of diabetic anklearthropathies by using the final method of fixation by semi-rigid systems after arthrodesis and the use of extrafocal ring fixators (RF). Materials and methods. The authors presented own experience of treatment of 12 patients with diabeticankle osteoarthropathy. After arthrodesis and fixation with RF, the alternating osteosynthesis was performed with Scotchcast/Softcast bandages. The use of extrafocal RF of the needle-rod type in the first stage with low trauma wasadvantageous, however the time of fixation before the appearance of the fusion between the tibia and talus was significant, which led to a decrease in the rigidity of the fixation of the bone-needle system and development of inflammation at the exit of the spokes. This required the transition to other means of fixation, which would provide the possibility of functional use of the limb. The authors used Scotchcast/Softcast functional bandages, applied circularly, with stiffeners on the lateral surfaces, which allowed to carry out the supporting function of the limb. Interventions (arthrodesis of the ankle joint) were performed under multimodal analgesia. Vascular disorders required hematopoietic therapy (use of a tourniquet and administration of tranexamic acid solution) and bemiparin administrationfor microthrombosisprevention. Treatment of diabetic neuropathy and metabolic disorders was carried out by prescribing vitamin B and C, drugs Ca and vitamin D3, antioxidants. Results. The dynamics of the most examined indicators of the coagulation — anticoagulation system did not differ significantly (activated partial thromboplastic time, prothrombin time, international normalized ratio, platelet quantity). There was a tendency to shift the indicators to the recommended safe zone and even a significant decrease in the level of soluble fibrin monomer complexes (R2= 0.9494). Conclusions. The use of Scotchcast/Softcast immobilizing bandages in patients with diabetic arthropathy was safe after arthrodesis and RF fixation.This strategy allowed to restore limb capacity in the early stages of treatment, which improved the social adaptation of patients.

Clinical-functional and morphological parameters of purulonecrotic foci healing in diabetic foot syndrome using programmable sanitation technologies

Diabetes mellitus is currently characterised by a high progressive prevalence of patients. The purpose of this study is to evaluate the clinical, functional, and morphological parameters of purulonecrotic foci healing in diabetic foot syndrome (DFS) using programmable sanitation technologies. The patients were randomised into two groups. In the comparison group (n=51), patients received conventional local treatment after surgery. In the main group (n=55), after surgical treatment, the wound was sutured, and in the postsurgical period, programmable sanitation was conducted using the AMP-01 device. The cytological smears of the main group identified a higher rate of cellular reactions in the wound. There was a 1.3-fold reduction in the duration of hospitalisation, the number of purulent complications was significantly less (p=0.014). It was possible to preserve the supporting function of the foot in patients of the main group in a larger percentage of cases (p=0.023). There was a statistically significant increase in the frequency of high amputations in the comparison group (p=0.026). As a result, the effectiveness of the use of programmable sanitation technologies for purulent lesions of the diabetic foot has been proven.

AI-supported assistance systems in enterprise learning processes - prospects and limitations

Industry 4.0 and Smart Factory are associated with major changes in the industrial world. The innovative forms of networking, communication and collaboration between people, machines and products have led to a new type of production system in which information and knowledge are exchanged more quickly and efficiently. As a result, among other things, the role of cognitive assistance systems and their supporting function for employees within production processes has gained in importance, both in the training phase and in the active work phase. Especially for on-the-job learning, these assistance systems open up a wide range of opportunities. This paper focuses on the opportunities and challenges associated with the use of cognitive assistance systems for workplace learning. We discuss current research on the potential uses of these assistance systems, particularly for process accomplishment as well as for supporting specific groups of employees. Furthermore, we address the limitations for the use of these systems. At the end of the paper, we identify three focus areas for the future development of AI in industrial processes and for research on this.

Enhanced Wireless Grid Technologies for the Harmonized Devices in Future IoT Systems

The paper proposes the enhanced wireless grid technologies for the future Internet of Things (IoT) systems. The paper shows a realization of the wireless grid by suitably exploiting the existing wireless Smart Utility Networks (SUN) that is standardized by IEEE 802.15.4g/4e task groups and is certified by Wi-SUN alliance. Medium Access Control (MAC) layer functions that is mainly defined by IEEE 802.15.4e standard and IEEE 802.15.10 recommended practice are effectively modified according to the assumed IoT services and satisfy the requirement of harmonized mesh activities by massive radio devices. In order to realize this function, SUN radio devices that exploit Layer 2 Routing (L2R) control scheme in IEEE 802.15.10 are employed to realize the autonomous mesh management function as well as the multiple service supporting function. The performance is evaluated through the experiments by employing the developed SUN devices as well as simulator evaluations. The paper also proposes novel data retransmission schemes by exploiting the data concatenation functions in IEEE 802.15.10 as well as evaluating its performances by computer simulations and experiments. Consequently, this paper confirms that the obtained results through both simulator evaluations and experiments matches to each other.

Analysis of surgical treatment of patients with primary tumors of the thoracic and lumbar spine

Oncological radicalism (the scope of surgical treatment) and restoration of the supporting function of the spine remain the most pressing issues of surgical treatment for tumors. Purpose of the work: to analyze the outcomes of surgical treatment of patients with primary tumors of the thoracic and lumbar spine based on the appropriate rating scales. Materials and methods. Forty-three patients, 22 women and 21 men aged 18 to 72 years, with benign and malignant primary tumors and tumor-like lesions of the spine were examined; they were treated at the Department of vertebrology of the Sytenko Institute of Spine and Joint Pathology of the National Academy of Medical Sciences of Ukraine. Localization of the lesions was as follows: cervical spine — 5 patients, thoracic — 17, lumbar — 19, sacrum — 2. According to the pathomorphological classification of primary tumors and tumor-like lesions of the World Health Organization, the patients were divided into those with benign (n = 26) and malignant (n = 17) tumors. The results of surgical treatment for primary spinal tumors were analyzed using the American Spinal Injury Association (ASIA) scale, Spinal Instability Neoplastic Score (SINS), Bilsky scale; the localization of tumors in different segments of the spinal column was considered as well. Results and discussion. We evaluated the outcomes of surgical treatment of spinal tumors for the following indications: radical surgery, the presence of complications, the dynamics of neurological and orthopedic disorders, the presence of tumor recurrence and the life expectancy of patients. Radical tumor resection within healthy tissues was performed in 17 of 19 patients, who had indications for the use of this method. Twenty-four patients underwent surgical treatment in the form of decompression of the spinal canal and partial tumor resection to restore the supporting function of the spine. In 2 cases, ablasticity was not achieved. Conclusions. According to the ASIA, SINS, Birsky scales, it was found that surgical intervention in primary tumors of the spine is justified, it prevents neurological complications, significantly reduces existing neurological disorders, and prolongs the life of patients. The choice of the scope of surgical intervention aimed at restoration of the supporting function of the spine according to these scales is not shown. Treatment of primary tumors of the spine should include both radical removal of atypical tissues within the healthy tissues and palliative treatment if indicated. It is important to restore the supporting function of the spine in the area of its damaged segments.