ДОСВІД ФОРМУВАННЯ ЛІДЕРСЬКОЇ КОМПЕТЕНТНОСТІ ВИКЛАДАЧІВ ХАРКІВСЬКОЇ МЕДИЧНОЇ АКАДЕМІЇ ПІСЛЯДИПЛОМНОЇ ОСВІТИ

The scientific works on the study of leadership competence and professional level of teachers at higher medical schools are analyzed in the article; the experience of formation of  Kharkiv Medical Academy of Postgraduate Education teachers’ leadership skills is described. It is proved that in the conditions of intellectual competition the continuous-improvement, teaching search and use of innovative technologies are mandatory requirements that are made demands on teacher-leader. Different approaches using self-monitoring and self-evaluation of activities and encourage the development of leadership qualities of teacher’s personality are described.У даній статті проведено аналіз наукових праць щодо дослідження лідерської компетентності та професійного рівня викладачів вищих медичних  навчальних закладів і висвітлюється досвід формування лідерських здібностей викладачів Харківської медичної  академії післядипломної освіти. Доведено, що  в умовах інтелектуальної конкуренції безперервне самовдосконалення, педагогічний пошук і використання інноваційних технологій є обов’язковими вимогами, які пред’являються до викладача-лідера. Приведено опис різних підходів із використанням самоконтролю та самооцінки власної діяльності й стимулювання розвитку лідерських якостей особистості викладача

Ecosystem and human health assessment to define environmental management strategies: The case of long-term human impacts on an Arctic lake

Abstract There are rich deposits of mineral and fossil natural resources in the Arctic, which make this region very attractive for extracting industries. Their operations have immediate and vast consequences for ecological systems, which are particularly vulnerable in this region. We are developing a management strategy for Arctic watersheds impacted by industrial production. The case study is Lake Imandra watershed (Murmansk oblast, Russia) that has exceptionally high levels of economic development and large numbers of people living there. We track the impacts of toxic pollution on ecosystem health and then -human health. Three periods are identified: (a) natural, pre-industrial state; (b) disturbed, under rapid economic development; and (c) partial recovery, during recent economic meltdown. The ecosystem is shown to transform into a qualitatively new state, which is still different from the original natural state, even after toxic loadings have substantially decreased. Fish disease where analyzed to produce and integral evaluation of ecosystem health. Accumulation of heavy metals in fish is correlated with etiology of many diseases. Dose-effect relationships are between integral water quality indices and ecosystem health indicators clearly demonstrates that existing water quality standards adopted in Russia are inadequate for Arctic regions. Health was also poor for people drinking water from the Lake. Transport of heavy metals from drinking water, into human organs, and their effect on liver and kidney diseases shows the close connection between ecosystem and human health. A management system is outlined that is based on feedback from indices of ecosystem and human health and control over economic production and/or the amount of toxic loading produced. We argue that prospects for implementation of such a system are quite bleak at this time, and that more likely we will see a continued depopulation of these Northern regions

Удаление метастазов при метастатическом раке толстой кишки с мутацией в гене BRAF — результаты много‑ центрового ретроспективного исследования

Introduction: local treatment of metastases is an integral part of colon cancer treatment. However, there is not enough data on the efficacy of surgical resection of metastases in patients with a BRAF gene mutation to recom‑mend this approach in routine practice. We initiated a retrospective multicenter study to assess the incidence of BRAF gene mutations in patients with metastatic colon cancer and to study the efficacy of metastasectomy in this group of patients.Materials and methods: we selected all patients who underwent surgical resection of metastases in various sites from the database of patients with BRAF gene mutations created as a result of a multicenter retrospective study with participation of 7 clinics in the Russian Federation. All 57 patients with RAS gene mutations and 43 patients with wild‑type RAS and BRAF genes who also underwent surgical resection of metastases at any stage of treatment were selected from the register of the Chemotherapy Department No. 2 of the NMRC of Oncology named after N. N. Blokhin for comparative analysis. Disease‑free survival and overall survival were used as primary efficacy criteria.Results: we found 26 patients with BRAF gene mutations who underwent surgical resection of metastases. When comparing disease‑free survival, the worst median was achieved in the group of patients with BRAF gene mutations: 7 months versus 14 months in patients with RAS gene mutations (HR 0.4, 94 % CI 0.23–0.7, P = 0.006); median disease‑free survival was not achieved in the wild‑type RAS and BRAF group (HR 0.2, 95 % CI 0.11–0.45, P <0.001).The median overall survival in the BRAF gene mutation group was 26 months versus 38 months in the RAS gene mutations group (HR 0.8, 95 % CI 0.33–1.98, P = 0.6) and 49 months in the wtRAS/wtBRAF group (RR 0.46, 95 % CI 0.17–1.24, P = 0.1). Resection of recurrent tumors in patients with metastases in retroperitoneal lymph nodes was associated with extremely low disease‑free survival (2 months); at the same time, disease‑free survival was 7 months after resection of isolated metastases in the liver and 8 months for metastases in the peritoneum.Conclusion: prognosis of patients with a BRAF gene mutation after surgical resection of metastases is worse than in patients with a different mutation phenotype. Nevertheless, literature data, as well as the results of our study, confirm the possibility of performing metastasectomy with careful selection of patients.Цель: Локальные методы лечения метастазов являются неотъемлемой частью терапии больных раком толстой кишки. Однако данных по эффективности хирургического удаления метастазов при мутации в гене BRAF недостаточно, чтобы рекомендовать данный подход в рутинной практике. Нами инициировано ретроспективное многоцентровое исследование по оценки встречаемости мутаций в гене BRAF при метастатическом раке толстой кишки, в рамках которого изучена эффективность метастазэктомии в этой группе пациентов.Материалы и методы: Из базы данных пациентов с мутацией в гене BRAF, созданной в результате многоцентрового ретроспективного исследования с участием 7 клиник Российской Федерации, были отобраны все пациенты, которым проводилось хирургическое удаление метастазов различной локализации. С целью сравнительного анализа из регистра отделения химиотерапии № 2 НМИЦ онкологии им. Н. Н. Блохина были отобраны все 57 пациентов с мутацией в генах RAS и 43 пациента с диким типом генов RAS и BRAF, которым также проводилось хирургическое удаление метастазов на любом из этапов лечения. В качестве основных критериев эффективности рассматривались выживаемость без признаков болезни и общая выживаемость.Результаты: Было найдено 26 больных с мутацией в гене BRAF, которым выполнялось хирургическое удаление метастазов. При сравнении выживаемости без признаков болезни наихудший показатель медианы был достигнут в группе пациентов с мутацией в гене BRAF — 7 месяцев против 14 месяцев при мутации в генах RAS (ОР 0,4, 94% ДИ 0,23–0,7, р=0,006); медиана выживаемости без признаков болезни в группе с диким типом генов RAS и BRAF не была достигнута (ОР 0,2, 95 % ДИ 0,11–0,45, р<0,001). Медиана общей выживаемости в группе с мутацией в гене BRAF составила 26 месяцев против 38 месяцев в группе с мутацией в генах RAS (ОР 0,8, 95% ДИ 0,33–1,98, р=0,6) и 49 месяцев в группе wtRAS/wtBRAF (ОР 0,46, 95% ДИ 0,17–1,24, р=0,1). Удаление рецидивных опухолей и при поражении забрюшинных лимфоузлов метастазами было ассоциировано с крайне низкой выживаемостью без признаков болезни (2 месяца), тогда как при удалении изолированных метастазов в печени она составила 7 месяцев, в брюшине — 8 месяцев.Выводы: Прогноз больных с мутацией в гене BRAF после хирургического удаления метастазов хуже в сравнении с пациентами с другим мутационным фенотипом. Тем не менее, данные литературы, а также результаты нашего исследования подтверждают возможность выполнения метастазэктомии при тщательным отборе пациентов

Pasvik River Watercourse, Barents region: Pollution Impacts and Ecological Responses Investigation in 1993

For the Pasvik River watercourse two major ecological problems was encountered: 1) Effects of heavy metals. This process is observed especially in Keutsyarv and to a lesser extent in lower part of Pasvik River. This is caused by the Ni and Cu input with waste water from smelters and pits of the "Pechenhanickel" company. Very high content of heavy metals (especially Ni) in water, lake sediment, macrophytes and fish is documented in Kuetsyarv. Extensive toxic effects were documented on the fish-population in the lake. The toxic effects are less than expected from the concentrations of heavy metals. This is due to high calsiumcontent, organic matter and eutrophication. 2) Eutrophication. This process is caused by domestic sewage from the settlements and compostion of planctonic and benthic communities, Kuetsyarv is eutrophic and the Pasvik River is oligotrophic to oligo-mesotrophic.Norwegian Ministry of Environment Miljøverndepartementet (MD

Quasi-collinear and partially degenerate four-wave mixing: An alternative explanation of the phase-conjugation property of backward stimulated scattering

A quasi-collinear and partially degenerate four-wave mixing model is proposed to explain the optical phase-conjugation property of various types of stimulated backscattering. According to this model, after passing through a phase-disturbed medium or an aberration plate, the input pump beam can be resolved into two portions: a stronger undisturbed regular portion and a weaker phase-disturbed irregular portion. These two portions interfere with each other and create a volume holographic grating in the pumped region of the scattering medium. Only the stronger undisturbed portion of the pump field can excite an initial backward stimulated scattering beam with a regular wavefront. When the latter (as a reading beam) passes through the induced holographic grating, a diffracted wave will be created and then amplified together with the reading beam. A rigorous mathematical analysis shows that under certain conditions the combination of these two portions (the reading wave and the diffracted wave) of the backward stimulated scattering can be an approximate phase-conjugate field of the input pump field. The major theoretical conclusions are basically supported by the experimental results based on a specially designed two-beam interference setup.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45798/1/11447_2005_Article_570.pd