Neoteric aspects, problems and prospects of development of medical tourism in Ukraine

The article focuses on the main issues of the current state of development of medical tourism in Ukraine. It also examines the experience of foreign countries in the field of medical tourism. One has conducted the SWOT analysis, identified the main factors determining the attractiveness of the Ukrainian medical tourism market. The article describes three main models of attracting foreign patients that are used in Ukraine. As well as determines the main aspects, problems, and potential for development. Medical tourism is another segment of the market of health tourism. Today, travel agencies indicate an increase in the number of orders for medical tourism. For a long time, this kind of tourism has been in demand among Americans and residents of Western Europe. According to Medical Insights International, since 2016, incomes from health tourism have been increasing every year by 20%, with annual market turnover reaching $40-60 billion. Europeans and Americans go abroad seeking cheap medical care (plastic operations, heart surgery, organ transplantation, and dental services are in demand). Such services are provided at the highest level not only by European clinics but also clinics in Asia, Australia, and Latin America. Given the increasing demand for passing medical examination abroad, budgets for diagnostic travel are increasing, depending on the cost of the program, which is calculated by the clinic (usually 2.5-5 thousand euros), the choice of place of residence (the diagnosis is usually outpatient), the presence of a medical interpreter, transfer, etc

Sleep disordered breathing in patients with heart failure

Sleep disordered breathing (SDB) is a common co-morbidity in patients with heart failure(HF). Both its forms — central and obstructive sleep apnea — are highly prevalent in thispopulation. SDB fragments sleep, impairs life quality, worsens exercise tolerance, worsens HFand is an independent predictor of poor prognosis. Still, SDB remains largely undiagnosed.Therefore, early detection of SDB seems to be of primary importance, especially in the presenceof new diagnostic and therapeutic methods. Treatment with continuous positive airwaypressure (CPAP) increases left ventricular ejection fraction and stroke volume in virtually allHF patients with obstructive and in 50% with central sleep apnea. For those in whom centralsleep apnea is not suppressed by CPAP, a trial of adaptive servoventilation is recommended.Although no randomized, controlled trials have shown improvement in mortality, several observationalstudies have shown that effective treatment of both forms of sleep apnea with variouspositive airway pressure devices improves survival of HF patients. Currently, 2 large trials withnewer masked based therapies with adaptive servoventilation are in progress. This article isa brief overview of present knowledge, the pathophysiology, diagnostic approach and therapy ofSDB

МОДЕЛЮВАННЯ ТА ПРОГНОЗУВАННЯ РЕЖИМУ ГРУНТОВИХ ВОД ДЛЯ РИСОВИХ СИСТЕМ, ЯК ОДНОГО З ГОЛОВНИХ ПОКАЗНИКІВ МЕЛІОРАТИВНОГО СТАНУ ТЕРИТОРІЇ

Relevance of research. An important factor of the formation of the soil state of modern rice irrigation systems is water-salt, nutrient and groundwater regimes. Ground water level is one of the indicators of the technical state of rice irrigation systems. Direct correlative dependence of rice yield on the ameliorative state of the field is proved by many researchers. Maintaining of soil fertility when growing rise at a constant level is ensured by sustentation of the ground water level not less than 1,5 m from the surface in the inter-vegetation period. Measures to combat flooding in the territory are developed based on monitoring dates. GIS technologies should be used to quickly perform the assessment of conditions when man-made factors change. Objective of research is to develop the forecast models of the mail indicators of the hydro-ameliorative state of rice irrigation systems, particularly for ground water levels, for saving their fertility and increasing their efficiency. Research methods. Mathematical-statistical, comparative and retrospective methods were used for analyzing the data base. The data from the Kakhovska hydrogeological and reclamation section of the Lower Dnieper BWMA as well as the data of own research over 28- year observations were used for model developing. The model of groundwater regime for the conditions of rice irrigation system was developed using the method of three-parameters smoothing, which takes into account seasonal fluctuations, in the program Statistica 10.0. The forecast was made for the period of 5 years for every month. The forecast models were developed for the experimental and production conditions. Results. The difference in groundwater level during a year at rice irrigation systems ranges from 0,5 to 1,0 m from the surface. Maximum actual value of ground water level in experimental conditions was 4,25 m from the surface, minimum actual value was 0,15 m from the surface during the research period and they did not differ much from the model values. The sampling interval was 4,19 m for the actual data and 3,88 m for the model. Close relation between the model of ground water regime for experimental conditions and the actual data is confirmed by the correlation coefficient 0,96. The forecast of ground water regime of rice irrigation system for the experimental conditions shows that the groundwater level will decrease in the period of 2019-2024 years and will vary in the range of 1,20-2,23 m from the surface. Maximum actual value of ground water level in the production conditions was 3,78 m from the surface, minimum one was 1,39 m from surface. Model data do not much differ from the actual values. The reliability of the developed model of ground water regime for the production conditions of rice irrigation systems is confirmed by the correlation coefficient 0,96. The forecast model of the groundwater regime developed for production conditions shows that the indicator will increase in the period of 2018-2023 years and will change in the range of 2,13-2,85 m from the surface. Conclusions. Forecast modeling of ground water regime of rice irrigation systems shows that ground water level will be deeper than 2,0 m from surface in inter-vegetation period in experimental and production conditions. The results of forecasting have proved that it is unlikely the occurrence of negative soil process due to ground water regime and a good hydrogeological-ameliorative state of experimental and production rice irrigation systems during the forecast period.Метою дослідження є побудова прогнозних моделей основних показників гідрогеолого-меліоративного стану рисових зрошувальних систем, на прикладі рівня підґрунтових вод, для збереження їх родючості та підвищення ефективності. Моделі розроблено для дослідних – рисова зрошувальна система Інституту рису НААН України, площею 190 га та виробничих умов – Тарасівська рисова зрошувальна система, площею 350 га. Обидві рисові зрошувальні системи експлуатуються понад 50 років. Ґрунтовий покрив представлений темно-каштановим солонцюватим, лучно-каштановим солонцюватим та солонцем лучним. На рисових зрошувальних системах використовується сівозміна з наповненістю рисом не більше 50 %. Прогнозні моделі побудовані за методом трипараметричного згладжування у програмі Statistica 10.0, із використання даних Гідрогеолого-меліоративної дільниці БУВР Нижнього Дніпра та власних досліджень, за період 28 років. Прогноз виконано на період 5 років, із визначенням досліджуваного параметра щомісячно. Прогноз, розроблений на основі побудованої моделі для дослідної рисової зрошувальної системи, показує, що рівень ґрунтових вод буде знижуватись за 2019-2024 рр. та варіюватиметься в межах 1,20-2,23 м. Прогнозна модель режиму ґрунтових вод, розроблена для виробничих умов, свідчить, що досліджуваний показник буде підвищуватись у період 2018-2023 рр. та змінюватиметься в межах 2,13-2,85 м. Аналіз результатів моделювання режиму ґрунтових вод рисових зрошувальних систем підтверджує, що, як на дослідній, так і на виробничій рисових зрошувальних системах, за прогнозований період, досліджуваний показник буде знижуватись у міжполивний період року, нижче 2,0 м. Моніторинг режиму ґрунтових вод на рисових зрошувальних системах є одним із найбільш ефективних методів формування якісних баз даних для створення прогнозів явища підтоплення та розробки ефективних заходів в боротьбі з його негативними наслідками

Intravenous iron supplementation improves energy metabolism of exercising skeletal muscles without effect on either oxidative stress or inflammation in male patients with heart failure with reduced ejection fraction

Background: Skeletal muscle dysfunction is a feature of heart failure (HF). Iron deficiency (ID) is prevalent in patients with HF associated with exercise intolerance and poor quality of life. Intravenous iron in iron deficient patients with HF has attenuated HF symptoms, however the pathomechanisms remain unclear. The aim of study was to assess whether intravenous iron supplementation as compared to placebo improves energy metabolism of skeletal muscles in patients with HF. Methods: Men with heart failure with reduced ejection fraction (HFrEF) and ID were randomised in 1:1 ratio to either intravenous ferric carboxymaltose (IV FCM) or placebo. In vivo reduction of lactates by exercising skeletal muscles of forearm was analyzed. A change in lactate production between week 0 and 24 was considered as a primary endpoint of the  study. Results: There were two study arms: the placebo and the IV FCM (12 and 11 male patients with HFrEF). At baseline, there were no differences between these two study arms. IV FCM therapy as compared to placebo reduced the exertional production of lactates in exercising skeletal muscles. These effects were accompanied by a significant increase in both serum ferritin and transferrin saturation in the IV FCM arm which was not demonstrated in the placebo arm. Conclusions: Intravenous iron supplementation in iron deficient men with HFrEF improves the functioning of skeletal muscles via an improvement in energy metabolism in exercising skeletal muscles, limiting the contribution of anaerobic reactions generating ATP as reflected by a lower in vivo lactate production in exercising muscles in patients with repleted iron stores

The +4G Site in Kozak Consensus Is Not Related to the Efficiency of Translation Initiation

The optimal context for translation initiation in mammalian species is GCCRCCaugG (where R = purine and “aug” is the initiation codon), with the -3R and +4G being particularly important. The presence of +4G has been interpreted as necessary for efficient translation initiation. Accumulated experimental and bioinformatic evidence has suggested an alternative explanation based on amino acid constraint on the second codon, i.e., amino acid Ala or Gly are needed as the second amino acid in the nascent peptide for the cleavage of the initiator Met, and the consequent overuse of Ala and Gly codons (GCN and GGN) leads to the +4G consensus. I performed a critical test of these alternative hypotheses on +4G based on 34169 human protein-coding genes and published gene expression data. The result shows that the prevalence of +4G is not related to translation initiation. Among the five G-starting codons, only alanine codons (GCN), and glycine codons (GGN) to a much smaller extent, are overrepresented at the second codon, whereas the other three codons are not overrepresented. While highly expressed genes have more +4G than lowly expressed genes, the difference is caused by GCN and GGN codons at the second codon. These results are inconsistent with +4G being needed for efficient translation initiation, but consistent with the proposal of amino acid constraint hypothesis

Experimental annotation of post-translational features and translated coding regions in the pathogen Salmonella Typhimurium

<p>Abstract</p> <p>Background</p> <p>Complete and accurate genome annotation is crucial for comprehensive and systematic studies of biological systems. However, determining protein-coding genes for most new genomes is almost completely performed by inference using computational predictions with significant documented error rates (> 15%). Furthermore, gene prediction programs provide no information on biologically important post-translational processing events critical for protein function.</p> <p>Results</p> <p>We experimentally annotated the bacterial pathogen <it>Salmonella </it>Typhimurium 14028, using "shotgun" proteomics to accurately uncover the translational landscape and post-translational features. The data provide protein-level experimental validation for approximately half of the predicted protein-coding genes in <it>Salmonella </it>and suggest revisions to several genes that appear to have incorrectly assigned translational start sites, including a potential novel alternate start codon. Additionally, we uncovered 12 non-annotated genes missed by gene prediction programs, as well as evidence suggesting a role for one of these novel ORFs in <it>Salmonella </it>pathogenesis. We also characterized post-translational features in the <it>Salmonella </it>genome, including chemical modifications and proteolytic cleavages. We find that bacteria have a much larger and more complex repertoire of chemical modifications than previously thought including several novel modifications. Our <it>in vivo </it>proteolysis data identified more than 130 signal peptide and N-terminal methionine cleavage events critical for protein function.</p> <p>Conclusion</p> <p>This work highlights several ways in which application of proteomics data can improve the quality of genome annotations to facilitate novel biological insights and provides a comprehensive proteome map of <it>Salmonella </it>as a resource for systems analysis.</p

A crowdsourced analysis to identify ab initio molecular signatures predictive of susceptibility to viral infection

The response to respiratory viruses varies substantially between individuals, and there are currently no known molecular predictors from the early stages of infection. Here we conduct a community-based analysis to determine whether pre- or early post-exposure molecular factors could predict physiologic responses to viral exposure. Using peripheral blood gene expression profiles collected from healthy subjects prior to exposure to one of four respiratory viruses (H1N1, H3N2, Rhinovirus, and RSV), as well as up to 24 h following exposure, we find that it is possible to construct models predictive of symptomatic response using profiles even prior to viral exposure. Analysis of predictive gene features reveal little overlap among models; however, in aggregate, these genes are enriched for common pathways. Heme metabolism, the most significantly enriched pathway, is associated with a higher risk of developing symptoms following viral exposure. This study demonstrates that pre-exposure molecular predictors can be identified and improves our understanding of the mechanisms of response to respiratory viruses

Fem lärares tolkning av begreppet lokalhistoria

I dagens läroplan Läroplan för grundskola, förskoleklassen och fritidshemmet 2011 (LGR 11) finns inget som tydligt pekar på att eleverna i årskurs 4-6 ska arbeta med lokalhistoria eller närområdesstudier som ämnet även kan benämnas. Däremot kan undervisning kring det lokala bidra så att elevernas historiemedvetande och identitet stärks. Studiens syfte är att belysa fem lärares tolkning av begreppet lokalhistoria samt hur de har använt lokalhistoria i deras undervisning. Studien är gjord med kvalitativa halvstrukturerade intervjuer. Studien bygger även på teoretiska utgångspunkter samt tidigare litteratur och forskning kring området. Datainsamlingen från de kvalitativa halvstrukturerade intervjuerna har sammanställts i ett resultat. Efter att resultatet har presenteras görs en analys av resultatet. Därefter diskuteras studiens metod och resultat. I resultatdiskussionen kopplas och jämförs studiens resultat i förhållande till tidigare forskning, litteratur och teoretiska utgångspunkter. Den här studien presenterar fem lärares tolkning av begreppet lokalhistoria och hur de har använt lokalhistoria i undervisningen i relation med tidigare forskning och teoretiska utgångspunkter.Historia</p