Organizational-pedagogical conditions of building invariant competences in the process of Russian and foreign students common education

Organizational-pedagogical conditions of building invariant competences in the process of Russian and foreign students common education are considered in the articleРассматриваются организационно-педагогические условия формирования инвариантных компетенций в процессе совместного обучения российских и зарубежных студенто

Peculiarities of the “I-image” formation of the State Traffic Inspectorate employee of the Ministry of Internal Affairs of Russia under the influence of public opinion

The socio-psychological mechanisms of the influence of public opinion on the formation of the “I-image” of the State Traffic Inspectorate employee as a factor of regulation of official behavior have been investigated. The article considers the problem of forming a positive “I-image” of the State Traffic Inspectorate employee and the search for the optimal psychotechnology for its successful manifestation in the regulation of official behavior in relation to the fact that the decline in the authority of the above-mentioned service in the eyes of the public does not allow us to fully form a positive “I-image”. The psychodiagnostic methods used in the study and the empirical base have been described. The results of the study have been processed and interpreted using descriptive statistics, correlation and factor analysis. Purposeful psychological influence contributes to the formation of a positive “I-image” of the State Traffic Inspectorate employee, which has been proved by an empirical study

DEVELOPMENT OF RUSSIAN STUDENTS’ INVARIANT SKILLS IN PROCESS OF LEARNING WITH FOREIGNERS

В статье рассматриваются возможности совместного обучения российских и зарубежных студентов для формирования их инвариантных компетенцийThe article describes opportunities of common education of Russian and foreign students for their invariant skills developmen

Current approaches to risk assessment of chronic heart failure after myocardial infarction

In the last decade, there has been an increase in the number of survivors of myocardial infarction (MI). However, the risk of developing chronic heart failure (CHF) remains high in this category of patients. Population aging and comorbidity further contribute to adverse outcomes. Optimization of approaches to identify predictors of postinfarction CHF is an important clinical task of modern medicine. The aim of the investigation is to develop a method to assess the risk of CHF development after MI. Material and Methods. The present analysis included 186 patients who underwent MI from January 2019 to January 2020: 86 patients with signs of CHF above functional class (FC) 2 (NYHA) (mean age 64.3 years) and 100 patients without signs of CHF or with CHF 1 (NYHA) (mean age 62.6 years) by day 30 of MI. A mathematical model of CHF risk after MI was built by factor and correlation analysis methods. Results. A method for assessing CHF risk after a previous MI was developed. The proposed formula is programmed in Excel table processor and includes 5 indicators: presence of atrial fibrillation, Killip class of acute heart failure, triglycerides level, ST-segment elevation of electrocardiogram, left ventricular ejection fraction less than 45 %. The authors’ approach allows long-term personalized monitoring, taking into account the ranked contribution of each factor in a particular patient; it is characterized by high sensitivity, specificity, and accuracy. Conclusion. The present study investigated the factors of formation of postinfarct chronic heart failure syndrome. An original mathematical formula for CHF risk estimation, including routine indices of MI patients, has been proposed. The approach allows personalized management of selected cohorts of patients – with increased and standard risk of postinfarction CHF

Molecular genetic markers of myocardial infarction in combination with type 2 diabetes

Aim. To study associations of rs2464196 and rs11212617 polymorphisms with the development of myocardial infarction (MI) in combination with type 2 diabetes  (T2D).Material and methods. The study included two groups: main group (n=115) — patients with prior myocardial infarction and T2D, comparison  group (n=116) — patients with myocardial  infarction without T2D, hospitalized  from December 1, 2018 to December  31, 2019 at the Regional Vascular Center № 1 of the City Clinical Hospital № 1. Participants were comparable in sex and age. Patients underwent  clinical and instrumental investigations,  a genetic test for single nucleotide polymorphisms, which showed associations with the development  of MI and T2D according to genome-wide  association study (GWAS): rs2464196 of the HNF1A  gene, rs11212617 of the ATM gene.Results. Carriage of the AA genotype of the HNF1A  rs2464196 polymorphism was found to be associated MI in combination with T2D in the general group (odds  ratio (OR), 3,180, 95% confidence interval (CI), 1,206-8,387, p=0,015). After division of the group by sex, significant differences  remained only in women (OR=9,706, 95% CI, 1,188-79,325, p=0,011).Conclusion. The data obtained can make it possible to identify a priority group of patients for personalized prevention of cardiovascular diseases

ATRIUM-HOUSE – A TERRITORY OF COMFORT AND ADVANCED TECHNOLOGIES IN THE CONTEXT OF URBAN LANDSCAPE

The article discusses the issue of the role and the importance of a natural landscape in an industrial city, it reflects on the results of the analysis of a specific area with a view of potential low-rise residential estate as part of ‘Multi-Comfort House’ technology concept. It considers the feasibility and viability of using the typological structure of a ‘city villa’ to create a sustainable living environment in the context of urban development and landscape.В статье рассматривается вопрос о проблеме, роли и значении природного ландшафта в индустриальном городе, отражаются результаты анализа конкретной территории с целью возможного размещения на ней жилого малоэтажного комплекса в рамках технологии «мультикомфортный дом», возможность и целесообразность использования типологической структуры «городская вилла» для создания устойчивой жилой среды в контексте городской застройки и ландшафта.Сборник выпущен при поддержке Фонда содействия развитию УрФУ имени первого Президента России Б.Н. Ельцин

Study of the association of rs3746444 of the MIR499A gene and rs6922269 of the MTHFD1L gene with progressive atherosclerosis in patients with coronary heart disease

The aim of the study is to evaluate the association of some molecular genetic markers with progressive atherosclerosis. Material and methods. In total, the study included 202 patients (147 men and 55 women), who were divided into 2 groups. The 1st (main) group included patients with coronary artery disease (100 people) who had a combination of two or more cardiovascular events during the last 2 years before inclusion: myocardial infarction or unstable angina pectoris, arterial stenting for urgent indications (coronary and peripheral), stroke; acute ischemia, thrombosis or amputation of the lower extremities. The 2nd group (comparisons) included 102 patients with coronary artery disease who did not have any of the above cardiovascular events during the last 2 years before inclusion. DNA was isolated from peripheral blood samples by phenol-chloroform extraction. Results. In the group with progressive atherosclerosis at the age of 55 years and older, the AA rs3746444 genotype of the MIR499A gene was absent in both men and women, while in the control group its frequency reached 8.3 % (p = 0.044). The odds ratio of detecting the carriage of the heterozygous genotype AG of the rs6922269 polymorphism of the MTHFD1L gene in the group with progressive atherosclerosis is 0.5 times lower compared to the control group (95 % confidence interval 0.3–0.9; p = 0.034). Conclusions. Carrying the AA genotype rs3746444 of the MIR499A gene is a conditionally protective factor against the development of progressive atherosclerosis at the age of 55 years and older. Carrying the AG genotype of the rs6922269 polymorphism of the MTHFD1L gene is associated with a reduced likelihood of developing progressive atherosclerosis in patients with CAD

Pharmacoepidemiological analysis of routine management of heart failure patients in the Russian Federation. Part II

Aim. To assess the healthcare system costs for the management of patients with heart failure (HF) based on a retrospective analysis of primary medical documentation.Material and methods. We performed the analysis of outpatient records of 1000 patients, followed up for 1 year by a general practitioner or cardiologist in ambulatory clinic in 7 Russian regions. The assessment of the HF socioeconomic burden was carried out from the perspective of the state. A bottom-up approach was applied to the cost analysis. To calculate the average costs per patient per year, the costs for each patient were calculated, followed by estimation for the entire cohort. Direct costs (medical: outpatient care, inpatient care, drug therapy; nonmedical: disability pensions and temporary disability) and indirect costs (loss of gross domestic product) were estimated.Results. It was shown that the average cost of managing 1 HF patient is RUB 160338 per year. The cost of drug therapy varied significantly depending on the source of funding. So, the total therapy cost was about RUB 90000 per year, while within the drug assistance programs — about RUB 7000 per year. Thus, the proportion of drug therapy in cost pattern per patient from the state’s perspective was only 4,7%, while the maximum costs were for inpatient care (45,5%), stay in intensive care units (16,4%) and disability payments (21,6%). The direct costs for HF therapy, with the exception of drug therapy (examination, inpatient and outpatient treatment), averages RUB 108291 per year. The total direct nonmedical and indirect costs per HF patient per year were about RUB 44519 per year. It should be noted that the rehabilitation costs were not included in the calculation.Conclusion. Taking into account the significant burden of HF on the Russian healthcare system, the growing costs of healthcare and the increase in life expectancy, prevention and treatment of HF should be improved. The development of a HF centers’ network, creating a seamless system of HF care, as well as improving the availability of medication therapy and the inpatient management of patients can improve the healthcare quality for HF patients in Russia

КЛИНИЧЕСКАЯ ЭФФЕКТИВНОСТЬ ТАРГЕТНОЙ ТЕРАПИИ В ОТНОШЕНИИ МЕТАСТАТИЧЕСКОГО РАКА ЛЁГКОГО С РАЗЛИЧНЫМИ ТИПАМИ ТРАНСЛОКАЦИЙ ГЕНА ALK

Introduction. Translocations of ALK receptor tyrosine kinase occur in approximately 5–9 % of lung adenocarcinomas. The use of ALK inhibitors usually results in the reduction of tumor size. Nevertheless, the extent and duration of response can vary significantly. The aim of the study is to summarize the available information on the predictive role of various types of ALK translocations in response to ALK inhibitors. Material and methods. The review presents the data from relevant laboratory and clinical studies published in PubMed database, as well as the authors’ own results. Results. A number of experiments on cell cultures have demonstrated that the structure of ALK fusion affects the properties of the resulting chimeric protein, in particular its stability and sensitivity to crisotinib action. The few available clinical trials, evaluating the effect of ALK inhibitors depending on the type of translocation, showed heterogeneous results. While some of them detected associations between the so-called «short» variants of EML4-ALK rearrangements and worse survival when using crisotinib in comparison with the EML4-ALK type 1 variant, the others failed to confirm these observations. The study of 64 Russian patients receiving ALK inhibitors also did not support the effect of different ALK translocation variants on progression-free survival or objective response rate. Conclusions. There is a diversity of reported associations, with none of them characterized by sufficient reproducibility. Current evidences do not support the predictive role of ALK variants.Актуальность. Транслокации рецепторной тирозинкиназы ALK встречаются примерно в 5–9 % аденокарцином лёгкого. Применение ингибиторов данной киназы, как правило, сопровождается выраженным ответом опухоли на лечение. Тем не менее глубина и длительность эффекта таргетной терапии варьируют от пациента к пациенту. Цель исследования – обобщить имеющиеся сведения о причастности различных типов транслокаций ALK к формированию ответа на лечение ингибиторами ALK. Материал и методы. В обзоре представлены результаты опубликованных в базе данных PubMed лабораторных и клинических работ, посвященных указанной проблеме, а также собственных исследований. Результаты. Эксперименты на клеточных культурах продемонстрировали, что структура транслокации ALK влияет на свойства химерного белкового продукта, в частности на его стабильность и чувствительность к воздействию кризотинибом. Немногочисленные выполненные до сих пор клинические исследования, оценивающие эффект ингибиторов ALK в зависимости от типа перестройки, имели разнородные результаты. Если в части работ были обнаружены ассоциации между «короткими» вариантами транслокаций EML4-ALK и худшими показателями выживаемости при использовании кризотиниба в сравнении с вариантом EML4-ALK 1 типа, то другие авторы не наблюдали таких закономерностей. Анализ итогов лечения ингибиторами ALK 64 российских пациентов также не обнаружил влияния типа транслокации на длительность периода до прогрессирования заболевания или частоту объективных ответов. Заключение. В изученных выборках пациентов отмечались различные по своему характеру ассоциации, ни одна из которых не отличалась воспроизводимостью. Таким образом, варианты перестроек ALK нельзя рассматривать в качестве предиктивного фактора ответа на ALK-специфическую терапию

Evolution of chronic heart failure syndrome in a patient with myocardial infarction and complex rhythm disturbances

Abstract: today the problem of chronic heart failure as a complication of myocardial infarction and other cardiovascular diseases continues to be relevant, due to the increase in the prevalence of heart failure, especially the severe stage of heart disease and the main causes of deaths of this cohort of patients. The article presents a clinical case of chronic heart failure syndrome with complex rhythm disturbances in the patient against the background of the transferred transmural myocardial infarction and hypertension. The authors demonstrated that after a thorough assessment of the risk and benefit of various treatment methods, the therapeutic and surgical tactics of management of the patient in this clinical situation were correctly chosen, which allowed not only to prolong life, but also to improve the quality of life of the patient. Thus, in this clinical case, we show the importance of personalized therapy in the progression of chronic heart failure syndrome in patients with combined cardiovascular disease.На сегодняшний день проблема хронической сердечной недостаточности, как осложнение инфаркта миокарда и другой сердечно-сосудистой патологии продолжает оставаться актуальной, связно это с увеличением распространенности сердечной недостаточности, особенно тяжелой стадии поражения сердца и основными причинами летальных исходов данной когорты пациентов. В статье представлен клинический случай синдрома хронической сердечной недостаточности со сложными нарушениями ритма у пациента на фоне перенесенного трансмурального инфаркта миокарда и гипертонической болезни. Авторами продемонстрировано, как после тщательной оценки риска и пользы различных методов лечения была правильно подобрана терапевтическая и хирургическая тактика ведения больного в данной клинической ситуации, что позволило не только продлить жизнь, но и улучшить качество жизни пациента. Таким образом, данным клиническим случаем мы показываем важность персонифицированной терапии при прогрессировании синдрома хронической сердечной недостаточности у пациентов с сочетанной сердечно-сосудистой патологией