Особливості хірургічного лікування вогнепальних поранень живота

Особливості хірургічного лікування вогнепальних поранень живот

Штучні нейронні мережі, їх використання у кіберзлочинності та боротьбі з нею

Казмірчук І. С. Штучні нейронні мережі, їх використання у кіберзлочинності та боротьбі з нею / І. С. Казмірчук, В. А. Євтушок // Протидія кіберзагрозам та торгівлі людьми: зб. матеріалів Міжнар. наук.-практ. конф. (м. Харків, 26 листоп. 2019 р.) / МВС України, Харків. нац. ун-т внутр. справ ; Координатор проектів ОБСЄ в Україні. – Харків : ХНУВС, 2019. – С. 243-244.Зазначається, що нейронна мережа - це математична програмна модель, побудована за принципом функціонування біологічних нейронних мереж – мереж нервових клітин живого організму. Головною особливістю таких мереж є те, що вони не програмуються в звичайному сенсі цього слова, а «навчаються» подібно до людського мозку. В процесі навчання нейронна мережа здатна виявляти складні залежності між вхідними даними й вихідними, а також здійснювати узагальнення.It is noted that a neural network is a mathematical software model built on the principle of functioning of biological neural networks - networks of nerve cells of a living organism. The main feature of such networks is that they are not programmed in the usual sense of the word, but are trained like the human brain. In the learning process, the neural network is able to detect complex relationships between input and output data, as well as perform generalization.Отмечается, что нейронная сеть – это математическая программная модель, построенная по принципу функционирования биологических нейронных сетей – сетей нервных клеток живого организма. Главной особенностью таких сетей является то, что они не программируются в обычном смысле этого слова, а обучаются подобно человеческому мозгу. В процессе обучения нейронная сеть способна обнаруживать сложные зависимости между входными и исходящими данными, а также осуществлять обобщение

Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: Results from the CREDENCE trial and meta-analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-Analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus. METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-Analysis. RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: Total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]). CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms

Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to 300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m 2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Methodological Foundations of Soft Skills of Musical Art Teachers in Pedagogical Institutions of Higher Education

Discussions about the exact sciences dominate education these days, with a lot of emphasis on teaching STEM disciplines. Because of this, teachers of other subjects, such as art or history, felt a little left out when talking about how to properly prepare students for future careers. However, there is even less attention is paid to the soft skills that students need to succeed after they graduate and work. The classes designed specifically for soft skills are the rare occurrence, but that does not mean these skills are not important. This determines the relevance of this paper. The purpose of the paper was to highlight the necessary soft skills for future specialists in musical or artistic disciplines, as well as to trace their differences with hard skills. The key research method was the analysis of theoretical materials and the development of general soft skills, which are necessary for the training of teachers of musical art, and the development of which is important for teachers to pay attention to. Teachers will not always have time to plan classes that perfectly combine hard and interpersonal skills.&nbsp