The role of students’ individual work in the formation of professional competences of future doctors.

Modern requirements for training of high-skilled specialists require the implementation of international medical and educational standards in the educational and integrative process. Formation of cognitive activity, pursuance of professional development, the necessity to correspond to world standards medical students’ of gained knowledge. Medical students’ individual work is very important for medical students’ education because it helps to systematize and use knowledge that was gained in practical classes. The aim of the work – to analyze the forms of students’ individual work, used at in the Department of Internal Medicine 2 and Phthisiology, in order to improve the educational process and to form the future doctor’s medical judgment, their ability to self-improvement and self-education. The recommended hours attempted for students’ individual work is 90 out of the total of 240 hours assigned to the discipline in teaching the module “internal diseases” for the 5th year students at the Depertment of Internal Medicine 2 and Phthisiology. In studying the discipline of "internal diseases" in the 5th year one of the main tasks of medical student’s occupation training is mastering ability of assimilation on his own, of knowledge and refresh it, and then to use knowledge effectively in the future career. The difference of the individual work lies in the fact that students can study individually choosing the necessary kind of extracurricular activity according to their interests. In addition, the lack of strict grading by the teacher has more advantages compared to practical classes. The curriculum, the teacher’s tasks and methodological materials determine the content of the individual work. The article presents the three main directions of students’ individual work in teaching discipline of "internal diseases" for students of the 5th year as: students’ individual work in classroom learning, students’ individual work individual work under the teacher’s supervision. When discussing the results of individual work, students learn to think critically, communicate with each other, and make their own well-thought-out (educated) decision. Well-structured process of the individual work encourages medical students to its qualitative fulfillment and it is a significant motivation for further professional growth. Significant reserves to increase its efficiency inherent in the use of modern computer technology. Medical students’ individual work should be considered as one of the necessary stages of a modern doctor training. The latest information technologies and individual scientific projects adoption into the educational process leads to efficiency improvement and it forms new future doctor’s professional competences

Enzyme-Directed Mutasynthesis: A Combined Experimental and Theoretical Approach to Substrate Recognition of a Polyketide Synthase

Acyltransferase domains control the extender unit recognition in Polyketide Synthases (PKS) and thereby the side-chain diversity of the resulting natural products. The enzyme engineering strategy presented here allows the alteration of the acyltransferase substrate profile to enable an engineered biosynthesis of natural product derivatives through the incorporation of a synthetic malonic acid thioester. Experimental sequence−function correlations combined with computational modeling revealed the origins of substrate recognition in these PKS domains and enabled a targeted mutagenesis. We show how a single point mutation was able to direct the incorporation of a malonic acid building block with a non-native functional group into erythromycin. This approach, introduced here as enzyme-directed mutasynthesis, opens a new field of possibilities beyond the state of the art for the combination of organic chemistry and biosynthesis toward natural product analogues

Student’s Learning Profile as a Tool of Personal Learning Logistics

Increase of complexity and uncertainty as well as demand for personalization (including in education) urges universities to pay attention to educational subjectivity and its development; to transfer towards individual / collective-individual educational navigation and flexible systems of educational programs management (including formation of temporary learning groups, supply of required educational resources in due time, protocols of appraisal and mutual offset of educational results), what determines the relevance of the research. Usage of logistic approach enables to distinguish the pedagogical and management objectives of educational activity organization as well as to facilitate personalization of education. The article considers an educational profile as an instrument of personal educational logistics in digital educational environment, presents the preliminary terms “digital track”, “portfolio”, “profile”. The authors also dwell on the requirements to educational profiles development and scenarios of handling them in digital educational environment taking into account domestic and global experience of educational profiles’ implementation

Galaxy Clusters as Reservoirs of Heavy Dark Matter and High-Energy Cosmic Rays: Constraints from Neutrino Observations

Galaxy Clusters (GCs) are the largest reservoirs of both dark matter and cosmic rays (CRs). Dark matter self-annihilation can lead to a high luminosity in gamma rays and neutrinos, enhanced by a strong degree of clustering in dark matter substructures. Hadronic CR interactions can also lead to a high luminosity in gamma rays and neutrinos, enhanced by the confinement of CRs from cluster accretion/merger shocks and active galactic nuclei. We show that IceCube/KM3Net observations of high-energy neutrinos can probe the nature of GCs and the separate dark matter and CR emission processes, taking into account how the results depend on the still-substantial uncertainties. Neutrino observations are relevant at high energies, especially at >10 TeV. Our results should be useful for improving experimental searches for high-energy neutrino emission. Neutrino telescopes are sensitive to extended sources formed by dark matter substructures and CRs distributed over large scales. Recent observations by Fermi and imaging atmospheric Cherenkov telescopes have placed interesting constraints on the gamma-ray emission from GCs. We also provide calculations of the gamma-ray fluxes, taking into account electromagnetic cascades inside GCs, which can be important for injections at sufficiently high energies. This also allows us to extend previous gamma-ray constraints to very high dark matter masses and significant CR injections at very high energies. Using both neutrinos and gamma rays, which can lead to comparable constraints, will allow more complete understandings of GCs. Neutrinos are essential for some dark matter annihilation channels, and for hadronic instead of electronic CRs. Our results suggest that the multi-messenger observations of GCs will be able to give useful constraints on specific models of dark matter and CRs. [Abstract abridged.]Comment: 31 pages, 20 figures, 1 table, accepted for publication in JCAP, references and discussions adde

Mesoscopic scattering of spin s particles

Quantum effects in weakly disordered systems are governed by the properties of the elementary interaction between propagating particles and impurities. Long range mesoscopic effects due to multiple scattering are derived by iterating the single scattering vertex, which has to be appropriately diagonalized. In the present contribution, we present a systematic and detailed diagonalisation of the diffuson and cooperon vertices responsible for weak localisation effects. We obtain general expressions for eigenvalues and projectors onto eigenmodes, for any spin and arbitrary elementary interaction with impurities. This description provides a common frame for a unified theory of mesoscopic spin physics for electrons, photons, and other quantum particles. We treat in detail the case of spin-flip scattering of electrons by freely orientable magnetic impurities and briefly review the case of photon scattering from degenerate dipole transitions in cold atomic gases.Comment: published version, with a new figure and new section

A comparison between endoscopic ultrasound-guided rendezvous and percutaneous biliary drainage after failed ERCP for malignant distal biliary obstruction

Background and study Aims: Selective biliary cannulation is unsuccessful in 5 % to 10 % of patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) for malignant distal biliary obstruction (MDBO). Percutaneous biliary drainage (PBD) has been the gold standard, but endoscopic ultrasound guided rendezvous (EUSr) have been increasingly used for biliary decompression in this patient population. Our aim was to compare the initial success rate, long-term efficacy, and safety of PBD and EUSr in relieving MDBO after failed ERC Patients and methods: A retrospective study involving 50 consecutive patients who had an initial failed ERCP for MDBO. Twenty-five patients undergoing EUSr between 2008 – 2014 were compared to 25 patients who underwent PBD immediately prior to the introduction of EUSr at our center (2002 – 2008). Comparisons were made between the two groups with regard to technical success, duration of hospital stay and adverse event rates after biliary decompression. Results: The mean age at presentation was 66.5 (± 12.6 years), 28 patients (54.9 %) were female. The etiology of MDBO was pancreaticobiliary malignancy in 44 (88 %) and metastatic disease in 6 (12 %) cases. Biliary drainage was technically successful by EUSr in 19 (76 %) cases and by PBD in 25 (100 %) (P = 0.002). Median length of hospital stay after initial drainage was 1 day in the EUSr group vs 5 days in PBD group (P = 0.02). Repeat biliary intervention was required for 4 patients in the EUSr group and 15 in the PBD group (P = 0.001). Conclusions: Initial technical success with EUSr was significantly lower than with PBD, however when EUSr was successful, patients had a significantly shorter post-procedure hospital stay and required fewer follow-up biliary interventions. Meeting presentations: Annual Digestive Diseases Week 201

Propagation of ultrahigh energy nuclei in clusters of galaxies: resulting composition and secondary emissions

We study the survival of ultrahigh energy nuclei injected in clusters of galaxies, as well as their secondary neutrino and photon emissions, using a complete numerical propagation method and a realistic modeling of the magnetic, baryonic and photonic backgrounds. It is found that the survival of heavy nuclei highly depends on the injection position and on the profile of the magnetic field. Taking into account the limited lifetime of the central source could also lead in some cases to the detection of a cosmic ray afterglow, temporally decorrelated from neutrino and gamma ray emissions. We calculate that the diffusive neutrino flux around 1 PeV coming from clusters of galaxies may have a chance to be detected by current instruments. The observation of single sources in neutrinos and in gamma rays produced by ultrahigh energy cosmic rays will be more difficult. Signals coming from lower energy cosmic rays (E < 1 PeV), if they exist, might however be detected by Fermi, for reasonable sets of parameters.Comment: 19 pages, 15 figures, version to appear in ApJ (minor changes

ЧУТЛИВІСТЬ МІКРООРГАНІЗМІВ, ВИДІЛЕНИХ З ПАТОЛОГІЧНОГО МАТЕРІАЛУ, ДО АНТИМІКРОБНИХ ПРЕПАРАТІВ

Excessive and uncontrolled use of antibiotics commonly results in the emergence of antimicrobial resistance (AMR). Therefore, the main aim of these studies was to determine the antibiotic susceptibility of microorganisms isolated from the pathological material. The article describes the susceptibility of isolated strains to the following antibiotics: ampicillin, amoxicillin, oxacillin, ofloxacin, streptomycin, cefazolin, gentamicin, amikacin, amoxiclav, erythromycin, enrofloxacin, lincomycin, tetracycline, doxycycline, vancomycin, rifampicin, ciprofloxacin, norfloxacin, tylosin, nitrofurantoin, polymyxin B. During the study of six Escherichia coli and three Salmonella enteritidis strains, it was ascertained that they demonstrated different susceptibility to the studied antibiotics, in particular, only two E. coli isolates, which is 33,3 %, were resistant to streptomycin, 50 % of the isolated strains were susceptible. When determining the susceptibility, it was established that all isolated E. coli isolates were resistant to cefazolin, vancomycin, oxacillin, and 83,3 % were resistant to amoxicillin, ampicillin, vancomycin, amoxiclav, rifampicin. 33,3 % of Salmonella enteritidis isolates were moderately susceptible to streptomycin, amoxicillin, and ampicillin, and 66,7 % were sensitive to ciprofloxacin, norfloxacin, and enrofloxacin. All isolated S. enteritidis strains were found to be resistant to cefazolin, tylosin, vancomycin, oxacillin, lincomycin, and erythromycin, 100 % susceptible to ciprofloxacin, amikacin, and ofloxacin and 68,7 % moderately susceptible to amoxicillin and gentamicin.Надмірне та безконтрольне використання антибіотиків часто приводить до виникнення антибіотикорезистентності. Тому основна мета цих досліджень полягала у визначенні чутливості до антибіотиків мікроорганізмів, виділених з патматеріалу. У статті наведене визначення чутливості виділених штамів до таких антибіотиків: ампіциліну, амоксициліну, оксациліну, офлоксацину, стрептоміцину, цефазоліну, гентаміцину, амікацину, амоксиклаву, еритроміцину, енрофлоксацину, лінкоміцину, тетрацикліну, доксицикліну, ванкоміцину, рифампіцину, ципрофлоксацину, норфлоксацину, тилозину, нітрофурантоїну, поліміксину В. При дослідженні шести щтамів ‒ Esсherichia coli та трьох Salmonella enteritidis, встановлено, що вони проявляли різну чутливість до досліджуваних антибіотиків, зокрема резистентними до стрептоміцину виявились лише два ізоляти E. coli, що складає 33,3 %, чутливими було 50 % виділених штамів. При визначенні чутливості встановлено, що всі виділені ізоляти E. coli були стійкими до цефазоліну, ванкоміцину, оксациліну, а 83,3 % стійкими до амоксациліну, ампіциліну, ванкоміцину, амоксиклаву, рифампіцину. 33,3 % виділених ізолятів S. enteritidis були помірно-чутливими до стрептоміцину, амоксациліну, ампіциліну, а 66,7 % ‒ чутливими до ципрофлоксацину, норфлоксацину та енрофлоксацину. Встановлено, що всі виділені штами S. enteritidis були стійкими до цефазоліну, тилозину, ванкоміцину, оксациліну, лінкоміцину та еритроміцину, 100 % чутливими до ципрофлоксацину, амікацину та офлоксацину та 68,7 % помірно-чутливими до амоксациліну та гентаміцину

Seasonal evolution of Aleutian low pressure systems: Implications for the North Pacific subpolar circulation

The seasonal change in the development of Aleutian low pressure systems from early fall to early winter is analyzed using a combination of meteorological reanalysis fields, satellite sea surface temperature (SST) data, and satellite wind data. The time period of the study is September–December 2002, although results are shown to be representative of the long-term climatology. Characteristics of the storms were documented as they progressed across the North Pacific, including their path, central pressure, deepening rate, and speed of translation. Clear patterns emerged. Storms tended to deepen in two distinct geographical locations—the Gulf of Alaska in early fall and the western North Pacific in late fall. In the Gulf of Alaska, a quasi-permanent “notch” in the SST distribution is argued to be of significance. The signature of the notch is imprinted in the atmosphere, resulting in a region of enhanced cyclonic potential vorticity in the lower troposphere that is conducive for storm development. Later in the season, as winter approaches and the Sea of Okhotsk becomes partially ice covered and cold, the air emanating from the Asian continent leads to enhanced baroclinicity in the region south of Kamchatka. This corresponds to enhanced storm cyclogenesis in that region. Consequently, there is a seasonal westward migration of the dominant lobe of the Aleutian low. The impact of the wind stress curl pattern resulting from these two regions of storm development on the oceanic circulation is investigated using historical hydrography. It is argued that the seasonal bimodal input of cyclonic vorticity from the wind may be partly responsible for the two distinct North Pacific subarctic gyres