Domain and user knowledge in a web-based courseware engineering course, knowlegde-based software engineering.

AIMS is a knowledge-based system for learning and teaching support within the context of distance education. It is aimed not only at enhancing learner's conceptual knowledge in a specific subject area but also at providing knowledge verification tools for the teacher. The system can be used to aid learning and teaching in different subject areas and to provide user-oriented support in searching courserelated information, concept teaching and learning, and conceptual and task-oriented domain structuring

Towards Implementing Gamification in MOOCs

Gamification is well known as a design strategy used to generate a change in users’ behaviour, such as motivation. However, while in recent years interest in it has been growing, empirical evidence on the effects that the application of game elements can generate on users’ behaviour is still lacking. We present the results of a study as a step towards designing gamification with better understanding of the possible effects that each game element could generate on end users. By involving three groups of experts: game designers, learning scientists and specialists in technology-enhanced learning (TEL), we assessed a selected number of 21 game design patterns in relation to the effects these could generate on learning performance, goal achievement and engagement of learners if implemented in a Massive Online Open Course (MOOC). Based on quantitative and qualitative data collected, 9 game elements have been selected to be further investigated

Zollinger–Ellison syndrome: modern aspects of diagnostics and treatment

The aim of review. To reflect modern concepts on clinic, diagnostics and treatment of Zollinger–Ellison syndrome (ZES).Key points. ZES is rare disease related to intragastric hyperacidity. Phenomenon of hyperacidity in ZES patients is caused by hypergastrinemia associated with ectopic gastrin production. Disease frequently develops in patients with multiple endocrine neoplasia syndrome of the 1-st type. Clinical presentation of ZES directly reflects hypersecretion of hydrochloric acid with development of erosive — ulcerative lesions of esophagus, stomach and duodenum, resistant to standard dozes of proton pump inhibitors (PPI). One of basic methods of ZES diagnostics is assessment of serum gastrin level and intragastric acid production. Conservative treatment includes prescription of high PPI dozes, and octreotide analogues.Conclusion. ZES is not a common disease, anyhow knowledge of its clinical course is important for duly recognition. ZES should be considered at differential diagnostics in patients with frequently relapsing upper gastro-intestinal erosive-ulcerative lesions and in patients resistant to standard dozes of PPI

Identifying Game Elements Suitable for MOOCs

Massive Online Open Courses (MOOCs) have increasingly become objects of research interest and studies in recent years. While MOOCs could be a means to address massive audiences, they suffer from high drop-out rates and low user engagement. Gamification is known as the application of game design elements in non-gaming scenarios to solve problems or to influence a user’s behaviour change. By applying gamification to MOOCs, we aim to enhance users’ engagement and goal achievement within a MOOC environment. To define our gamification strategy, we asked 42 experts in the fields of game design, learning science and technology-enhanced learning to rate 21 selected game design patterns according to their suitability within a MOOC environment application. The data collected allowed us to identify a set of nine game design patterns as promising candidates to be tested in MOOC environment

Difficulties of iron-deficiency anemia diagnostics

The aim of clinical case presentation. To illustrate difficulties of detection of sources of gastro-intestinal bleeding (GIB) at investigation of patient with severe chronic iron-deficiency anemia.Key points. At the moment of hospital admission in obvious cause of GIB has not been revealed. At complex investigation potential sources of blood loss were found out: hiatal hernia (HH) and diverticula of the large intestine. Pathology data in some cases are complicated both by overt clinical GIB, and microlosses. Presented case illustrates extremely high adaptive potential of female body to chronic blood loss - patient continued to work down to the moment of hospital admission. Definite feature of presented case is the dissociation between severity of anemia and absence of clinical symptoms of HH and diverticular disease.Conclusion. Presented case emphasizes exclusive importance of control of total blood count in women in postmenopausal period and necessity in prophylactic medical examination of patients

Klatskin tumor (<i>Review of literature</i>)

The aim of review. Article reviews of cumulated literature data on the rare form of cholangiocarcinoma in bifurcation of hepatic ducts and named after Gerald Klatskin.Key points. Obstructive jaundice at the absence of abdominal pain is leading clinical symptom of this disease. The histological pattern is represented by adenocarcinoma of acinar, tubular, trabecular, alveolar or papillary types. Bismuth-Corlette classification, that allows more precise differentiation of hepatic ducts lesion localization, is presented; diagnostic methods are discussed in details.Conclusion. Difficulties of diagnosis and verification of Klatskin tumor determine a broad field for differential diagnostics. By virtue of low frequency disease represents a serious problem in assessment of cholestatic syndrome origin

Evaluation of the efficacy and safety of the hybrid scheme for eradication therapy of Helicobacter pylori infection

The aim is to conduct a comprehensive comparative study of the efficacy and safety of the hybrid scheme of eradication therapy (ET) in patients with peptic ulcer of the stomach or duodenum associated with Helicobacter pylori. Materials and methods. In a prospective, randomized comparative study, 180 patients were divided into three equal groups of 60 people, depending on the prescribed 10-day ET regimen. Group 1 - the standard triple scheme (omeprazole, amoxicillin and clarithromycin); group 2 - four-component therapy with preparations of bismuth (omeprazole, tetracycline, metronidazole, bismuth tricalium dicitrate); group 3 - hybrid scheme (first 5 days: omeprazole and amoxicillin, the next 5 days: omeprazole, amoxicillin, clarithromycin, metronidazole). The effectiveness of ET was determined with the help of a breath test a month after the end of therapy. Adverse events were recorded by patients in specially developed diaries. Pharmacoeconomic analysis was carried out using the "cost-effectiveness" method with calculation of the CER coefficient. Results and discussion. The effectiveness of standard triple therapy was 73.3% (ITT), 75.9% (PP); four-component therapy with bismuth preparations - 78.3% (ITT), 82.4% (PP); hybrid scheme - 85% (ITT), 91% (PP). Hybrid therapy proved to be significantly more effective than standard triple therapy with a odds ratio (OR) of 3.25; 95% confidence interval (CI) 1.08-9.73 (p=0.043, χ2=4.75, p-level=0.029298). The incidence of adverse events with the use of triple, four-component and hybrid ET regimens was 15; 18.3 and 28.3% respectively. The OR of at least one adverse event in patients receiving a hybrid ET regimen compared with triple therapy was 2.24 (95% CI 0.91-5.53, p=0.0823, χ2=3.14, p-level=0.076394), and compared with the four-component therapy - 1.76 (95% CI 0.74-4.17, p=0.2804, χ2=1.68, p-level=0.194924). According to the results of the pharmacoeconomic analysis, the most profitable from an economic point of view was a hybrid ET scheme with a CER of 20.1. The conclusion. Hybrid therapy showed the greatest effectiveness in comparison with the triple and four-component ET regimens, however, the incidence of side effects in patients receiving the hybrid ET scheme was higher, although it remained within the acceptable level for use in clinical practice. Pharmacoeconomic analysis also showed the advisability of designating a hybrid ET scheme. The obtained data allow to draw a conclusion about the necessity of further study of the efficiency and safety of the hybrid ET scheme

Present-day pathophysiological concept of functional dyspepsia

The aim of review. To present modern data on the pathophysiological mechanisms causing functional dyspepsia (FD) syndrome.Key points. Nowadays FD is considered to be a complex multifactor process which cause and effect relationships are under continuous active study. Disorders of stomach motility (delay of evacuation, disorders of relaxation accommodation) and sensitivity (visceral hypersensitivity to distention) are considered to be the basic pathophysiological mechanisms of FD. These changes develop approximately in 40% of FD patients. Besides that, alteration of duodenal sensitivity to hydrochloric acid and lipids can play significant role in genesis of FD.Conclusion. Mechanisms of FD are based on multiple heterogenous disorders of motor and sensitive functions of the stomach and duodenum. Due to major role of stomach motility disorders prokinetics are the priority drugs for treatment of FD