First trimester prenatal screening in multiple pregnancies. Part II: serum proteins PAPP-A and β-hCG as markers of adverse pregnancy outcomes

Aim: to evaluate the ability of serum biochemical markers in pregnant woman - PAPP-A (pregnancy-associated plasma protein-A) and β-hCG (the в-subunit of human chorionic gonadotropin) studied in the first trimester (11+0-13+6) during combined prenatal screening to predict adverse perinatal outcomes of multiple pregnancy that occurred spontaneously and as a result of in vitro fertilization (IVF).Materials and methods. The main group consisted from 65 women with pregnancy occurred as a result of IVF; comparison group included 56 women with spontaneous pregnancy. All pregnancies were multiple and their outcomes were known. Serum PAPP-A and β-hCG levels were measured in the first trimester. The results were expressed in absolute values and in MoM (multiples of median). Subgroups were compared with mono- and dichorionic pregnancies, complicated and uncomplicated pregnancies, distributed according to MoM index: within the reference values (0.5-2.0), below or above the reference values.Results. PAPP-A MoM values in the spontaneous pregnancy group were 1.12 [0.8; 1.57], in the IVF group - 1.35 [1.11; 1.72] (p = 0.01). In subgroup of low PAPP-A MoM antenatal fetal death occurred in 50 %, in subgroup of normal PAPP-A MoM - in 14.58 %, in subgroup of high PAPP-A MoM - in 5.88 % (p = 0.011). In addition, a positive correlation was found between serum PAPP-A level and time of fetal death (rs = 0.564; p = 0.036). Low PAPP-A MoM values were associated with 50 % fetal mortality, 75 % of them were attributable to pregnancy as a result of IVF.Conclusion. Identification of adverse outcomes in multiple pregnancies is still a difficult task, but evaluation of serum biochemical markers during the first trimester screening can help in early diagnosis of necessity and extent of timely prophylaxis

First trimester prenatal screening in multiple pregnancies. Part I: comparative analysis of serum proteins PAPP-A and p-hCG in pregnancies conceived spontaneously or by in vitro fertilization

Introduction. Serum proteins PAPP-A (pregnancy-associated plasma protein-A) and β-hCG (the в-subunit of human chorionic gonadotropin) levels are components of the 1st trimester combined screening aimed to detect fetal aneuploidies. In contrast to singleton pregnancies, where the values are well established, this is not the case in twins.Aim: a comparative analysis of serum proteins PAPP-A and β-hCG levels, as well as parameters PAPP-A MoM and β-hCG MoM in the first trimester during pregnancy with dichorionic diamniotic twins that occurred spontaneously or as a result of in vitro fertilization (IVF).Materials and methods. The study group included multiple pregnancies as a result of IVF procedure (n = 100) and spontaneous multiple pregnancies (n = 121) considered as controls. The levels of PAPP-A, β-hCG, PAPP-A MoM and β-hCG MoM were compared using nonparametric Mann-Whitney U test.Results. The PAPP-A MoM level resulted higher in the group of IVF twins (p = 0,007) compared to spontaneous twins: 1.28 [0.97; 1.89] vs. 1.12 [0.87; 1.40] (median [interquartile range]). There were no statistically significant differences in в-hCG levels between the groups of IVF twins and spontaneous twins.Conclusion. The results justify the need for further study of PAPP-A and β-hCG to establish their association with adverse outcomes in both groups of multiple pregnancies

The XXI Century Competencies Formation: the Methodology of Foresight, “Adornation” and Deconstruction

The methodology of foresight and “adornation” of competencies is analyzed. The concept of deconstruction of competencies is introduced. The article substantiates the necessity of foresight, adornment and deconstruction in the process of forming competencies of the future, the relationship of which can be represented both in the form of a cycle of successive technologies, and in the form of intertwining processes with one of the technologies dominating, depending on the specifics of the situation and the social context.Анализируются методологии форсайта и адорнации компетенций. Впервые вводится понятие деконструкции компетенций. Обосновывается одинаковая необходимость форсайта, адорнации и деконструкции в процессе формиро-вания компетенций будущего, взаимосвязь которых может быть представлена как в форме цикла сменяющих друг друга технологий, так и в форме взаимнопереплетающихся процессов с доминированием одной из технологий в зависимости от особенностей ситуации и социального контекста

Social and hygienic characteristics of gynаecologist, working in women`s consultations and hospitals of Saint-Petersburg

In the article data about pattern of gynаecologists, working in the health care facilities of Saint-Petersburg is presented. Sociological interview was the main method of research. Particularly, data about age-sex pattern of doctors, their qualification level, self-estimation of theirs health are described. Doctor's satisfaction of their job and reasons to be unpleased of it are also analyzed. Doctor's self-estimation of their knowledge level in different questions, concerning their profession is discussed in the article

Проблемы управления курсовым проектированием при формировании профессиональных компетенций IT-специалистов

The authors analyze the relevance of the object of research, which is dictated by the ever-increasing role of competence-based education both at the stage of training at a higher educational institution and in the learning process throughout the professional path of IT specialists. The article is devoted to the specifics of planning and managing the process of creating course projects by future IT specialists during their studies at a higher educational institution. The emphasis in the article is on the aspect that the process of managing the direction of course design is in many ways similar to the process of creating IT products, which undoubtedly needs to be taken into account when determining the difficulties and features of managing the direction of course design of IT specialists. During the research, the main objective and subjective causes of difficulties during the process of creating a course project for students of IT specialties were identified, and ways of leveling them were determined. As a result of the analysis of project management techniques and practices, the critical chain method is identified as an effective tool for managing the planning and implementation of tasks in project activities. The purpose of the study is to study methods and practices in project activities and adapt their features to the practice of developing future IT specialists course projects as mini IT projects with a minimum set of requirements and participants, which can undoubtedly be considered as a mini model of a real IT project. The article analyzes the factors influencing the unfavorable course of execution and completion of course projects, highlights the main artifacts of course design, determines the length of the project buffer by the critical chain method. Based on the results of the study, practical recommendations are given for the effective planning and management of course design of future IT specialists.Авторами анализируется актуальность объекта исследования, которая продиктована постоянно возрастающей ролью компетентностного образования как на этапе обучения в высшем учебном заведении, так и в процессе обучения на протяжении всего профессионального пути IT-специалистов. Статья посвящена особенностям планирования и управления процессом создания будущими IT-специалистами курсовых проектов в ходе обучения в высшем учебном заведении. Акцент в статье сделан на тот аспект, что процесс управления ходом курсового проектирования во многом схож с процессом создания IT-продуктов, что несомненно необходимо учитывать при определении трудностей и особенностей управления ходом курсового проектирования IT-специалистов. При проведении исследования были выявлены основные объективные и субъективные причины возникновения трудностей в ходе процесса создания курсового проекта у студентов IT-специальностей, определены способы их нивелирования. В результате проведенного анализа методик и практик управления проектами выделен метод критической цепи как эффективный инструмент управления планированием и реализацией задач в проектной деятельности. Целью исследования является изучение методов и практик в проектной деятельности и адаптации их особенностей на практику разработки будущими IT-специалистами курсовых проектов как мини IT-проектов с минимальным набором и требований, и участников, что несомненно может быть рассмотрено как мини-модель реального IT-проекта. В статье проанализированы факторы, влияющие на неблагополучный ход выполнения и завершения курсовых проектов, выделены основные артефакты курсового проектирования, определена протяженность буфера проекта по методу критической цепи. По результатам проведенного исследования даны практические рекомендации для эффективного планирования и управления курсовым проектированием будущих IT-специалистов

Reference of N.G. Petrova's е.а. article «about problems of standartization in public health services»

Article is devoted to the problems of providing qualified medical health care to population. By the author`s opinion, the solving of this problem is impossible without wide-spread introducing of system of standards in public health service. Standardizing must be spread in all quality components: structural, technological and resulting. Authors prove imperfections of existing technological standards on the example of gynaecological service. Other standards are too old, or are not still worked out until nowadays. Working out of standards - is a priority aim, which can increase public health services efficiency

Specialists training in big data using distributed architectural solutions services

Application integration and business process improvement connected with Distributed Computation Services and Predictive Analytics can bring new concurrent capabilities. This article considers organization of Big Data learning and Big Data experience exchange in Belarus. The experience of the organizing and the use of virtual distributed computing infrastructure for Big Data trainings in BSUIR is proposed

Antenatal fetal death in multiple pregnancy: is early prediction possible?

Introduction. Perinatal mortality in multiple pregnancies increases by 8–10 times compared to singletons. Stillbirth is a significant part of all complications of multiple pregnancies. Although the incidence of perinatal mortality in multiple pregnancies has decreased consistently compared to extremely high rates in the past, it remains relatively high, despite significant positive changes in the management of such pregnancies. Aim: to assess the diagnostic potential of the first trimester's biochemical screening in multiple pregnancies for predicting antenatal fetal death. Materials and Methods. As part of a retrospective study, a cohort of twin pregnancies after in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), or spontaneous conception underwent screening of the first trimester at 11+0–13+6 weeks of gestation as recommended by the Fetal Medicine Foundation. Determination of pregnancy-associated plasma protein-A (PAPP-A) in blood serum with subsequent calculation of the relative PAPP-A MoM (multiples of median) – a multiple of the median (an indicator of how much the individual test result deviates from the reference values) was performed. Results. Prenatal screening and outcomes of 302 multiple pregnancies showed that with PAPP-A MoM < 0.5, antenatal fetal death occurred with a frequency of 42.86 % (6/14), with PAPP-A MoM within the reference values – In 12.67 % (28/221), with PAPP-A MoM > 2.0 – in 6.7 % (2/30). Differences between patients with PAPP-A MoM < 0.5 and PAPP-A MoM within the reference values, as well as PAPP-A MoM < 0.5 and PAPP-A MoM > 2.0 were statistically significant (p = 0.002 and p = 0.004, respectively). No differences were detected between spontaneous and assisted reproductive technology (ART) pregnancies. Conclusion. In women with multiple pregnancies resulting from ART or spontaneous, PAPP-A MoM values below the reference interval (< 0.5) in the first trimester are associated with an increased risk of antenatal fetal death

The model of interaction of network educational client-server systems subjects

Рассматриваются вопросы создания автоматизированных образовательных систем на основе современных информационных технологий. Представлена модель асинхронного сетевого взаимодействия обучаемого и обучающего, выделены основные процессы, алгоритмы и информационные потоки. Приведен вариант архитектурного решения для разработки таких систем, определена концептуальная модель виртуального тьютора, модели представления и накопления знаний, рассмотрены методы реализации дидактических концепций в автоматизированных образовательных системах