Formation of risk-oriented thinking of training in the conditions of realization of gef and professional standards

The article points to the successful application of pedagogical technology for the formation of risk-oriented thinking of students, developed in accordance with modern requirements of vocational educationУказывается на успешное применение педагогической технологии формирования риск-ориентированного мышления обучающихся, разработанной в соответствии с современными требованиями профессионального образовани

Formation of risk-oriented thinking of students on the basis of acmeological approach

The article points to the successful application of the acmeological approach in the preparation of graduate students on the example of the discipline "Formation of riskoriented thinking of students"В статье указывается на успешное применение акмеологического подхода при подготовке аспирантов на примере дисциплины «Формирование риск-ориентированного мышления студентов

Risk-oriented thinking of students of technical university as a modern condition of vocational education

The article suggests the use of continuous advanced safety training, a special role in which is assigned to the formation of risk-based thinking based on modern pedagogical technologiesВ статье предлагается использование непрерывной опережающей подготовки по безопасности, особая роль в которой отводится формированию риск-ориентированного мышления на основе современных педагогических технологи

РОЛЬ ОСТЕОКАЛЬЦИНУ В РЕГУЛЯЦІЇ СЕКРЕЦІЇ ІНСУЛІНУ ТА ОСТЕОТРОПНИХ ЕФЕКТІВ РІЗНИХ КЛАСІВ ПРОТИДІАБЕТИЧНИХ ПРЕПАРАТІВ (огляд літератури і власні дослідження)

Background. Current data suggest that bone tissue produces hormonally active factors - modulators of metabolic processes throughout the body. The most significant osteoproteins is osteocalcin, the non-collagen structural protein of the bone matrix, which is synthesized by osteoblasts and enters the bloodstream during the resorption of bone tissue. Osteocalcin is involved in the regulation of energy balance, insulin secretion, peripheric insulin sensitivity, and adipocyte’s function, while being an important marker of bone remodeling. The aim of this study was to investigate the relationship between osteocalcin levels and metabolic parameters in 97 patients with type 2 diabetes over 50 years of age, in the course of pharmacotherapy using different classes of antidiabetic drugs, namely human insulin, glucagon-like peptide-1 agonists (aGLP), and sodium-glucose co-transporter 2 (SGLT2) inhibitors, depending on presence of obesity. Results. There was found the highest serum osteocalcin level in patients without obese who received a metabolically active therapy with insulin or aGLP-1, comparing to nonobese subjects of SGLT2 inhibitors therapy group. The lowest level of HbA1c and triglycerides observed in non-obese patients on the background of taking aGLP-1. Conclusion. It can be assumed that the factor determining the hypoglycemic efficacy of investigated drugs may be the pathogenesis of type 2 diabetes which depends on the degree of obesity, while the type of antidiabetic therapy has a corrective effect, probably mediated by changes in body weight and fat distribution.Background. Current data suggest that bone tissue produces hormonally active factors - modulators of metabolic processes throughout the body. The most significant osteoproteins is osteocalcin, the non-collagen structural protein of the bone matrix, which is synthesized by osteoblasts and enters the bloodstream during the resorption of bone tissue. Osteocalcin is involved in the regulation of energy balance, insulin secretion, peripheric insulin sensitivity, and adipocyte’s function, while being an important marker of bone remodeling. The aim of this study was to investigate the relationship between osteocalcin levels and metabolic parameters in 97 patients with type 2 diabetes over 50 years of age, in the course of pharmacotherapy using different classes of antidiabetic drugs, namely human insulin, glucagon-like peptide-1 agonists (aGLP), and sodium-glucose co-transporter 2 (SGLT2) inhibitors, depending on presence of obesity. Results. There was found the highest serum osteocalcin level in patients without obese who received a metabolically active therapy with insulin or aGLP-1, comparing to nonobese subjects of SGLT2 inhibitors therapy group. The lowest level of HbA1c and triglycerides observed in non-obese patients on the background of taking aGLP-1. Conclusion. It can be assumed that the factor determining the hypoglycemic efficacy of investigated drugs may be the pathogenesis of type 2 diabetes which depends on the degree of obesity, while the type of antidiabetic therapy has a corrective effect, probably mediated by changes in body weight and fat distribution

ВЗАЄМОЗВ’ЯЗКИ ОСТЕОКАЛЬЦИНУ З ГОРМОНАЛЬНО-МЕТАБОЛІЧНИМИ ПОРУШЕННЯМИ ЧОЛОВІКІВ З ЦУКРОВИМ ДІАБЕТОМ 2 ТИПУ З РІЗНИМ СТУПЕНЕМ ОЖИРІННЯ (огляд літератури і власні дослідження)

The bone hormone osteocalcin is formed by osteoblasts and is partially released into the bloodstream during bone resorption, being a biomarker of bone remodeling. Osteocalcin also plays an important role in the endocrine regulation of metabolic and energy processes in the body and in their coordination. Osteocalcin uses a feedback mechanism to regulate insulin secretion, insulin sensitivity of peripheral tissues, and adipokine levels. In general, the secretion of osteocalcin and insulin are important factors in the formation of hormonal-metabolic phenotype, body composition, determination of regional distribution and metabolic activity of both bone and adipose tissue.The aim of this study was to establish the relationship between osteocalcin concentration and hormonal changes in men with type 2 diabetes with and without obesity on the background of involutive changes. Results. 64 men with type 2 diabetes, older than 50 years, were divided into 2 groups by BMI: 1) non-obese, BMI <30 kg / m2 (n = 31); 2) -obese, BMI ≥ 30 kg / m2 (n = 33). Lower levels of insulin secretion (lower serum C-peptide and insulin levels) were observed in non-obese patients in the absence of a compensatory increase in proinsulin levels. It can be assumed that the increase in the concentration of osteocalcin in group 1 is compensatory, although it does not have a significant effect on blood glucose levels. However, it may have a protective effect on the severity of insulin resistance syndrome and related metabolic disorders. Lower levels of osteocalcin in the obese group were associated with a higher degree of insulin resistance and insulin secretion. There was no significant difference between the two groups in serum proinsulin levels, as well as in androgen supply, which was assessed by the levels of total testosterone, testosteronestradiol-binding globulin, and free testosterone index. Conclusion. Lower levels of osteocalcin may be a marker of an increased risk of adverse metabolic changes in obese patients with type 2 diabetes, followed by complications compared to non-overweight patientsThe bone hormone osteocalcin is formed by osteoblasts and is partially released into the bloodstream during bone resorption, being a biomarker of bone remodeling. Osteocalcin also plays an important role in the endocrine regulation of metabolic and energy processes in the body and in their coordination. Osteocalcin uses a feedback mechanism to regulate insulin secretion, insulin sensitivity of peripheral tissues, and adipokine levels. In general, the secretion of osteocalcin and insulin are important factors in the formation of hormonal-metabolic phenotype, body composition, determination of regional distribution and metabolic activity of both bone and adipose tissue.The aim of this study was to establish the relationship between osteocalcin concentration and hormonal changes in men with type 2 diabetes with and without obesity on the background of involutive changes. Results. 64 men with type 2 diabetes, older than 50 years, were divided into 2 groups by BMI: 1) non-obese, BMI <30 kg / m2 (n = 31); 2) -obese, BMI ≥ 30 kg / m2 (n = 33). Lower levels of insulin secretion (lower serum C-peptide and insulin levels) were observed in non-obese patients in the absence of a compensatory increase in proinsulin levels. It can be assumed that the increase in the concentration of osteocalcin in group 1 is compensatory, although it does not have a significant effect on blood glucose levels. However, it may have a protective effect on the severity of insulin resistance syndrome and related metabolic disorders. Lower levels of osteocalcin in the obese group were associated with a higher degree of insulin resistance and insulin secretion. There was no significant difference between the two groups in serum proinsulin levels, as well as in androgen supply, which was assessed by the levels of total testosterone, testosteronestradiol-binding globulin, and free testosterone index. Conclusion. Lower levels of osteocalcin may be a marker of an increased risk of adverse metabolic changes in obese patients with type 2 diabetes, followed by complications compared to non-overweight patient

ГЕМОРРАГИЧЕСКАЯ ЛИХОРАДКА С ПОЧЕЧНЫМ СИНДРОМОМ НА ЮГЕ ДАЛЬНЕГО ВОСТОКА РОССИИ: АКТУАЛЬНЫЕ ПРОБЛЕМЫ ДИАГНОСТИКИ И ТЕРАПИИ

Contemporary problems of hemorrhagic fever with renal syndrome (HFRS), being one of hantaviral infection nozoforms and wide-spread on Euro Asiatic continent are considered. Annual increase morbidity with of natural foci expansion, often severe course and a high mortality rate determine the importance of HFRS for health of many countries and in particular the Russia. This article presents of long standing results obtained during the study of epidemiologic, clinical and laboratory diagnostic, immunopathogenesis, treatment trials in Primorsky region of Russian Federation, being the endemic area of co-circulation of several pathogenic hantaviruses.Рассмотрены современные проблемы одной их нозоформ хантавирусной инфекции – геморрагической лихорадки с почечным синдромом (ГЛПС), широко распространенной на Евразийском континенте. Ежегодный прирост заболеваемости с расширением природных очагов инфекции, нередко тяжелое течение и высокий уровень летальности определяют большое значение ГЛПС для здравоохранения многих стран, в том числе и России. Статья представляет результаты многолетнего изучения эпидемиологии, ранней клинической и лабораторной диагностики, иммунопатогенеза и терапии ГЛПС в Приморском крае – эндемичном регионе циркуляции нескольких патогенных хантавирусов

Pastoralism and Emergent Complex Settlement in the Middle Bronze Age, Azerbaijan: Isotopic analyses of mobility strategies in transformation

Objectives. This article explores the scale and seasonal patterns of mobility at the complex settlement site of Qızqala during the Middle Bronze Age (2400–1,500 BCE). By integrating human bone, teeth, and environmental samples this research tests the hypothesis of the persistent importance of community-wide seasonal pastoral transhumance during the early formation of complex settlement systems of the South Caucasus. Methods. This research applies stable oxygen and radiogenic strontium isotope analyses on incremental samples of human tooth enamel, bulk tooth enamel, and bone to resolve mobility patterns. Sequential and bulk sampling techniques elucidate seasonal and residential mobility behaviors. Extensive environmental isotope samples of plant and water were collected through regional survey and establish local and regional isotopic baselines, which are compared to human isotope analysis results. Results. Qızqala individuals exhibit low isotopic variability compared to regional contemporaries. 87Sr/86Sr ratios from human remains indicate seasonal and residential isotopic variability within the baseline ranges of local landscapes. δ18O values display erratic patterns, but correspond to seasonal variability with fluctuations between highland and lowland altitudinal zone baseline values. Conclusions. Results suggest that isotopic analysis of multiple elements and sequential enamel samples offers finer resolution on the complexities of human mobility strategies and elucidate the daily lives of often overlooked mobile populations. Higher resolution of individual mobility reveals shared routine behaviors that underscore the importance of diverse social collaborations in forming complex polities in the South Caucasus

Механізми протидіабетичної дії агоніста дофамінових рецепторів бромокриптину і досвід його застосування у хворих на цукровий діабет 2-го типу

Hyperactivation of the sympathetic nervous system plays an important role in the pathogenesis of metabolic syndrome and type 2 diabetes mellitus (T2D), and therefore the use of sympatholytic drugs is a promising. Dopamine receptor agonist bromocriptine exerts a modulating effect on metabolic control through central and peripheral effects. Objective — to evaluate the effectiveness of bromocriptine as monotherapy or in combination with metformin in the treatment of patients with T2D. Materials and methods. Patients with deco­m­pensated T2D (men, age 49.2 ± 4.15 years) were prescribed bromocriptine in addition to metformin therapy (n = 16, group 1) or as monotherapy after discontinuation of sulfonylureas (n = 6, group 2). Anthropometric parameters, indicators of carbohyd­rate and lipid metabolism, levels of C-peptide, cortisol, DHEA-S were determined. Results and discussion. After 6 months of treat­ment, level of HbA1c decreased in all patients by 0.5 % compared to the baseline (p < 0.05), without changing the concentration of C-peptide. Unchanged level of total testosterone and corticosteroids balance prove the absence of an effect on the function of the gonads and adrenal cortex. During treatment, there was no cases of hypoglycemia or changes in anthropometric parameters. Conclusions. Treatment with bromocriptine in combination with metformin improved the glycemic control and lipid profile of the blood, without excessive secretion of insulin and effect on body weight. In patients who had previously taken sulfonylureas with hypoglycemic events,bromocriptine as monotherapy ensured proper control of glycemia and triglycerides, without changing insulin secretion and new episodes of hypoglycemia, andwith concomitant normalization of prolactin.В патогенезе метаболического синдрома и сахарного диабета (СД) 2-го типа важную роль играет гиперактивация симпатической нервной системы, в связи с чем перспективным направлением является применение препаратов группы симпатолитиков. Агонист рецепторов дофамина бромокриптин проявляет модулирующее действие на метаболический контроль посредством центральных и периферических эффектов. Цель работы — оценить эффективность бромокриптина в виде монотерапии или в комбинации с метформином в лечении больных СД 2-го типа. Материалы и методы. Пациентам с некомпенси­рован­ным гликемическим контролем (мужчины, возраст (49,2 ± 4,15) года) назначали бромокриптин дополнительно к терапии метформином (n = 16, группа 1) или в виде монотерапии после отмены препаратов сульфонилмочевины (ПСМ) (n = 6, 2-я группа). Определяли антропометрические пара­мет­ры, показатели углеводного, липидного обмена, уровни С-пептида, кортизола, ДГЭА-С. Результаты и обсуждение. У всех пациентов через 6 мес лечения отмечено достоверное снижение НbА1с на 0,5 % по сравнению с исходным уровнем (р < 0,05) без изменения концентрации С-пеп­тида. Отсутствие прямого влияния бромокриптина на функцию поло­­вых желез и коры надпочечников подтверждено неизменными показателями уровня общего тестостерона и кортикостероидов. В процессе лечения у пациентов не зарегистрировано случаев гипогликемии и изменения антропометрических параметров. Выводы. Назначение бромокриптина в комбинации с метформином позволяет улучшить показатели гликемического контроля и липидного спектра крови без избыточной секреции инсулина и негативного влияния на массу тела. Монотерапия бромокриптином у пациентов, принимавших ПСМ, с явлениями гипогликемии в анамнезе способствовала компенсации гликемии и уровня триглицеридов без изменения секреции инсулина и новых эпизодов гипогликемии с сопутствующим снижением содержания пролактина.У патогенезі метаболічного синдрому та цукрового діабету (ЦД) 2-го типу важливу роль відіграє гіпер­­активація симпатичної нервової системи, у зв’язку з чим перспективним напрямком є застосування препаратів групи симпатолітиків. Агоніст рецепторів дофаміну бромокриптин проявляє модулювальну дію на метаболічний контроль за допомогою центральних і периферичних ефектів. Мета роботи — оцінити ефективність бромокриптину у вигляді монотерапії або в комбінації з метформіном у лікуванні хворих із ЦД 2-го типу. Матеріали та методи. Пацієнтам з декомпенсованим ЦД 2-го типу (чоловіки, вік (49,2 ± 4,15) року) призначали бромокриптин додатково до терапії метформіном (n = 16, 1-ша група) або у вигляді монотерапії після відміни препаратів сульфонілсечовини (ПСС) (n = 6, 2-га група). Визначали антропометричні параметри, показники вуглеводного, ліпідного обміну, рівні С-пептиду, кортизолу, ДГЕА-С. Результати та обговорення. Після 6 міс лікування у всіх пацієнтів поліпшились показники глікемічного контролю і знизився рівень тригліцеридів (ТГ). Вміст HbA1c знизився на 0,5 % порівняно з вихідним (р < 0,05) без зміни концентрації С-пептиду. Незмінні показники загального тестостерону і балансу кортикостероїдів доводять відсутність впливу на функцію статевих залоз і кори надниркових залоз. У процесі лікування у пацієнтів не відзначено випадків гіпоглікемії і зміни антропометричних параметрів. Висновки. Призначення бромокриптину в комбінації з метформіном дало змогу поліпшити показники глікемічного контролю і ліпідного спектра крові без надмірної секреції інсуліну і впливу на масу тіла. Монотерапія бромокриптином у пацієнтів, які раніше приймали ПСС, з явищами гіпоглікемії в анамнезі забезпечила належний контроль глікемії і рівня ТГ без зміни секреції інсуліну і нових епізодів гіпоглікемії із супутньою нормалізацією вмісту пролактину

Osteocalcin Role In The Regulation Of Insulin Secretion And Osteotropic Effects Of Different Classes Of Anti-diabetic Drugs (Literature Review And Own Research)

Background. Current data suggest that bone tissue produces hormonally active factors - modulators of metabolic processes throughout the body. The most significant osteoproteins is osteocalcin, the non-collagen structural protein of the bone matrix, which is synthesized by osteoblasts and enters the bloodstream during the resorption of bone tissue. Osteocalcin is involved in the regulation of energy balance, insulin secretion, peripheric insulin sensitivity, and adipocyte's function, while being an important marker of bone remodeling. The aim of this study was to investigate the relationship between osteocalcin levels and metabolic parameters in 97 patients with type 2 diabetes over 50 years of age, in the course of pharmacotherapy using different classes of antidiabetic drugs, namely human insulin, glucagon-like peptide-1 agonists (aGLP), and sodium-glucose co-transporter 2 (SGLT2) inhibitors, depending on presence of obesity. Results. There was found the highest serum osteocalcin level in patients without obese who received a metabolically active therapy with insulin or aGLP-1, comparing to nonobese subjects of SGLT2 inhibitors therapy group. The lowest level of HbA1c and triglycerides observed in non-obese patients on the background of taking aGLP-1. Conclusion. It can be assumed that the factor determining the hypoglycemic efficacy of investigated drugs may be the pathogenesis of type 2 diabetes which depends on the degree of obesity, while the type of antidiabetic therapy has a corrective effect, probably mediated by changes in body weight and fat distribution