Sham-controlled randomized multicentre trial of transcranial direct current stimulation for prolonged disorders of consciousness.

BACKGROUND AND PURPOSE: Transcranial direct current stimulation (tDCS) has been shown to improve signs of consciousness in a subset of patients with disorders of consciousness (DoC). However, no multicentre study confirmed its efficacy when applied during rehabilitation. In this randomized controlled double-blind study, the effects of tDCS whilst patients were in rehabilitation were tested at the group level and according to their diagnosis and aetiology to better target DoC patients who might repond to tDCS. METHODS: Patients received 2 mA tDCS or sham applied over the left prefrontal cortex for 4 weeks. Behavioural assessments were performed weekly and up to 3 months' follow-up. Analyses were conducted at the group and subgroup levels based on the diagnosis (minimally conscious state [MCS] and unresponsive wakefulness syndrome) and the aetiology (traumatic or non-traumatic). Interim analyses were planned to continue or stop the trial. RESULTS: The trial was stopped for futility when 62 patients from 10 centres were enrolled (44 ± 14 years, 37 ± 24.5 weeks post-injury, 18 women, 32 MCS, 39 non-traumatic). Whilst, at the group level, no treatment effect was found, the subgroup analyses at 3 months' follow-up revealed a significant improvement for patients in MCS and with traumatic aetiology. CONCLUSIONS: Transcranial direct current stimulation during rehabilitation does not seem to enhance patients' recovery. However, diagnosis and aetiology appear to be important factors leading to a response to the treatment. These findings bring novel insights into possible cortical plasticity changes in DoC patients given these differential results according to the subgroups of patients.

Opportunities for combining data of Estonian and Russian monitoring to reflect on water quality in large transboundary Lake Peipsi.

Lake Peipsi, one of the world's largest lakes, is shared between Estonia and Russia. The water quality in different parts of the lake has so far been assessed independently. Here we explore opportunities for combining data of Estonian and Russian monitoring. For that, we 1) analysed the compatibility of data for some water quality variables; 2) estimated the potential effects of the differences in sampling frequency; 3) provided a few regression models to calculate the missing data for months not sampled by the Russian side. Data of the concurrent Estonian and Russian sampling indicated a good compatibility. Estonian data analysis suggested that water quality assessment results are sensitive to sampling frequency. For example, total phosphorus (TP) in the largest basin showed a long-term decreasing trend in three month data that disappeared when data for other months were added. Disregarding some months may lead to under- or overestimation of certain factors with no consistency in the response of different basins. Hence, data of the whole ice-free period are recommended for an adequate water quality assessment. Furthermore, we demonstrated that monthly values of the water quality variables of the same year are autocorrelated. Based on this, we filled the gaps in the long-term data and compiled a dataset for the whole lake that enables its most comprehensive use in water quality assessment and management. Long-term data revealed no water quality improvement of Lake Peipsi. Further reduction of the external nutrient load is needed. Eutrophication is sustained by high internal phosphorus load.

Quantification of nitrogen and phosphorus inputs from farming activities into the water bodies in the Leningrad and Kaliningrad regions.

Agricultural intensification leads to higher diffuse environmental pollution. Successful pollution control requires the continuous monitoring of farming activities, reliable baseline data, and tested computational models for the quantitative assessment of diffuse loads. The study aimed to quantify the diffuse inputs of manure nitrogen (N) and phosphorus (P) to the marine environment from large livestock farms and to identify the lowering effect of the best available techniques of manure/organic fertiliser handling. The study area was the Leningrad and Kaliningrad regions, found in the Russian part of the Baltic Sea catchment area. The total diffuse load in 2017 was estimated by the Russian and Belarus methodologies based on the calculations of the livestock density and the total field application of nitrogen and phosphorus with organic fertilisers. In the Leningrad Region, it was 4571.53 t N year-1 and 280.01 t P year-1; in the Kaliningrad Region-6132.48 t N year-1 and 372.32 t P year-1. The introduction of relevant best available techniques and the supply of all farms with waterproof manure storages and pads could reduce the diffuse load on the catchment in the Leningrad region by 1078.07 t N year-1 and 55.5 t P year-1 and in the Kaliningrad Region-by 1060.43 t N year-1 and 40.5 t P year-1. Such a reduction would provide a marked contribution to fulfilling the nutrient input ceilings set for the Russian Federation under the Helsinki Commission (HELCOM) Baltic Sea Action Plan.

miR-21, miR-93, miR-191, miR-let-7b, and miR-499 Expression Level in Plasma and Cerebrospinal Fluid in Patients with Prolonged Disorders of Consciousness.

In recent decades, significant progress has been achieved in understanding the mechanisms of disturbance and restoration of consciousness in patients after severe brain damage resulting in prolonged disorders of consciousness (pDOC). MicroRNAs (miRs) may be potential candidates as possible biomarkers for the classification of disease subtypes, and prognosis in patients with pDOC. The aim of the study was to analyze miRs expression levels (hsa-miR-21-5p, hsa-miR-93-5p, hsa-miR-191-5p, mmu-miR-499-5p, hsa-let-7b-5p) by a real-time polymerase chain reaction in plasma and cerebrospinal fluid (CSF) from patients with pDOC and to identify a potential biomarker for dividing patients into groups according to disease severity. We analyzed the levels of investigated miRs in pDOC patients, divided by etiology, CRSI, and the total group compared with controls. Our results showed that dividing patients with pDOC into groups according to the etiology of the disease resulted in the most significant differences in the levels of miR-93, -21, and -191 in CSF and plasma samples between groups of patients. Among the analyzed miRs, we did not find a marker that would help to distinguish VS/UWS patient groups from MCS. Examining of miRs as possible prognostic markers in patients with pDOC, the starting point seems to be the cause that led to the development of the disease.

Prevalence of oral diseases and the assessment of t he simplified oral hygiene, decayed-missing-filling an d community periodontal indices among inmates of the russian federation / Prevalência de doenças bucais e a investigação dos índices de higiene oral simplificado, dentes cariados-peridos-restaurados e índice periodontal comunitário em detentos da federação russa

To investigate the prevalence of oral diseases and to assess the simplified oral hygiene (OHI-S) index, the decayed-missing-filled teeth (DMFT) index and the community periodontal index (CPI)among inmates incarcerated in the Russian Federation. The sample consisted of 175 male and 130 female inmates serving sentences at corrective colonies in the region of Kirov, Russia. Information about level of education, time of incarceration and general health status were collected via personal interviews. Additionally, the inmates underwent extra- and intraoral exams in the search for clinically detectable lesions and oral diseases. A quantitative analysis of the oral health was established through the assessment of OHI-S, DMFT and CPI indices. These indices were statistically tested for their association with inmates' time of incarceration and level of education. Complete dentition, partial tooth loss and edentulism were observed in 10.5%, 81.9% and 7.5% of the sample. Dental caries (92.4%), periodontal diseases (55.7% periodontitis and 33.1% gingivitis), diseases of pulp and periapical tissue (87.9%) were the most prevalent findings. The most prevalent disease in the oral mucosa was the cheilitis (64.9%) followed by glossitis (21.9%) and palatal nicotinic leukokeratosis (28.8%). OHI-S and DMFT indices showed strong positive association with time of incarceration and level of education. Higher index scores were observed in inmates in prison for a longer time and with a lower level of education (p=0.001). These outcomes highlight the need for promoting oral health care policies to inmates incarcerated in prisons of the Russian Federation.

Investigar a prevalência de doenças bucais e os índices de higiene oral simplificado (IHO-S), dentes cariados-perdidos-restaurados (CPO-D) e índice periodontal comunitário (CPI) em detentos daFederação Russa. A amostra consistiu de 175 homens e 130 mulheres encarceradas em colônias corretivas na região de Kirov, na Federação Russa. Informações relacionadas ao nível educacional, tempo de encarceramento e condição de saúde geral foram coletadas por meio de entrevistas. Adicionalmente, exames extra e intrabucais foram realizados com a finalidade de detectar possíveis doenças e lesões em dentes e tecidos moles. Análise quantitativa da saúde bucal foi conduzida por meio da investigação dos índices IHO-S, CPO-D e CPI. Estes índices foram testados estatisticamente em face de sua associação com o nível educacional e tempo de encarceramento dos detentos. Dentição completa, parcial e edentulismo foram observadas em 10.5%, 81.9% e 7.5% da amostra. Cárie (92.4%), doença periodontal (55.7% periodontite e 33.1% gengivite) e doenças pulpares (87.9%) foram as mais prevalentes. Queilite (64.9%), glossite (21.9%) e estomatite nicotínica no palato (28.8%) foram as lesões mais prevalentes em mucosa. Forte Associação positiva foi verificada entre os índices IHO-S e CPO-D e o nível educacional e tempo de encarceramento dos detentos. Quanto menor o nível educacional e maior o tempo de encarceramento, maiores foram os referidos índices (p=0.001). Conclusão:Estes resultados apontam para a necessidade de promoção de políticas direcionadas ao cuidado bucal em detentos encarcerados na Federação Russa.