Application of interactive forms of professional self-determination: experience «Nizhniy Tagil State Professional College»

The article discusses the interactive forms of professional selfdetermination, used by the GAPOU SO N. A. Demidov ": professional tests, excursions to the sites of the Regional Championship “Young Professionals” (WorldSkills Russia), Laboratory of professions "Old sable", interactive platform "PROFnavigator"В статье рассматриваются интерактивные формы профессионального самоопределения, применяемые ГАПОУ СО «НТГПК им. Н. А. Демидова»: профессиональные пробы, экскурсии на площадки проведения Регионального чемпионата «Молодые профессионалы» (WorldSkills Russia), лаборатория профессий «Старый соболь», интерактивная площадка «ПРОФнавигатор

Velocity Structure Diagnostics of Simulated Galaxy Clusters

Gas motions in the hot intracluster medium of galaxy clusters have an important effect on the mass determination of the clusters through X-ray observations. The corresponding dynamical pressure has to be accounted for in addition to the hydrostatic pressure support to achieve a precise mass measurement. An analysis of the velocity structure of the ICM for simulated cluster-size haloes, especially focusing on rotational patterns, has been performed, demonstrating them to be an intermittent phenomenon, strongly related to the internal dynamics of substructures. We find that the expected build-up of rotation due to mass assembly gets easily destroyed by passages of gas-rich substructures close to the central region. Though, if a typical rotation pattern is established, the corresponding mass contribution is estimated to be up to ~17% of the total mass in the innermost region, and one has to account for it. Extending the analysis to a larger sample of simulated haloes we statistically observe that (i) the distribution of the rotational component of the gas velocity in the innermost region has typical values of ~200-300 km/s; (ii) except for few outliers, there is no monotonic increase of the rotational velocity with decreasing redshift, as we would expect from approaching a relaxed configuration. Therefore, the hypothesis that the build-up of rotation is strongly influenced by internal dynamics is confirmed, and minor events like gas-rich substructures passing close to the equatorial plane can easily destroy any ordered rotational pattern.Comment: 13 pages, 10 figures; Accepted for publication in MNRA

Assessment of Safety Signals for Aztreonam in Different Age Groups: National and International Drug Safety Monitoring

Aztreonam is the only approved monocyclic β-lactam antibiotic for human use that is active against Gram-negative aerobes, primarily Pseudomonas аeruginosa. Aztreonam has been used for more than 35 years, and aztreonam lysine has been on the market for 15 years. Although the medicinal products show clinical and microbiological efficacy in severe infections and are significant for cystic fibrosis patients, little information is published on their safety. In the meantime, new data have accumulated.The aim of the study was to analyse the data on adverse reactions in patients of different age groups receiving aztreonam, collected in the safety monitoring databases VigiBase and Pharmacovigilance.Materials and methods: the data on adverse reactions associated with aztreonam, in any dosage form, from the individual case reports submitted to VigiBase (the database of the Uppsala Monitoring Centre) before 15.09.2021 and to Pharmacovigilance (the database for spontaneous reports in the Automated Information System of the Federal Service for Surveillance in Healthcare of the Russian Federation) before 05.10.2021.Results: the analysis of adverse reactions during the use of aztreonam for approved indications showed differences in frequency, types and severity of the adverse reactions amongst the age groups. The most common adverse reaction with aztreonam was cystic fibrosis referred to in 1828 reports (12.0%). It was recorded more often in patients aged 18–44 years (39.2%).Conclusions: the data obtained allowed the authors to identify a new safety signal for aztreonam, namely an increased risk of inefficacy or insufficient efficacy in cystic fibrosis considered an adverse reaction in the individual reports from the databases of spontaneous reports. Confirmation of the signal requires further monitoring

Evaluation of the effect of the use of the drug ticagrelor in patients with acute coronary syndrome on achieving the target indicator “reduction of mortality from diseases of the circulatory system” in 2022-2024

Aim. To evaluate the effect of the use of the double antiplatelet therapy (DAT) with ticagrelor compared to DAT with clopidogrel and antithrombotic therapy with acetyl salicylic acid (ASA) in patients with acute coronary syndrome and patients with high coronary risk on the target indicator (CP) of the state program (GP) “Development of Healthcare” and the federal project “Fight against cardiovascular diseases” — reducing mortality from diseases of the circulatory system (BSC).Material and methods. All adult Russian patients with a diagnosis of ACS eligible for DAT were considered as the target population; in the second and third years, only patients with high coronary risk continued treatment. The calculation of the number of deaths that can be prevented using DAT ticagrelor 90 mg + ASA vs DAT of clopidogrel + ASA within 1st year from the date of diagnosis was based on the clinical efficacy data of the PLATO study. The number of deaths that can be prevented with the use of DAT ticagrelor 60 mg + ASA — instead of ASA monotherapy patients with a history of myocardial infarction was made based in the clinical efficacy results of the PEGASUS study. It was calculated what proportion of the target indicators could be achieved in 2022-24 years by using DAT with ticagrelor instead of clopidogrel or ASA monotherapy.Results. The use of DAT with ticagrelor vs DAT with clopidogrel or ASA for the treatment of patients with ACS will prevent additional 5389, 5704 and 6012 deaths in 2022-2024, that will ensure the implementation of the CP “reduction of mortality from BSC” GP “Development of healthcare” in the Russian Federation by 36,9%, 26,0% and 20,6% respectively.Conclusion. The use of DAT with ticagrelor for the treatment of patients with acute coronary syndrome ensure the implementation of the CP “reduction of mortality from BSC” GP “Development of healthcare” in the Russian Federation in 2024 by 20,6%

Analysis of the Causes for Renal Dysfunction during Antibiotic Therapy in a Patient with Lyme Disease

Adverse drug reactions (ADRs) are recorded throughout the lifecycle of a medicinal product. In the post-marketing period, new ADRs are primarily identified via drug safety signals. In order to assess a signal and establish causality between an adverse drug reaction and a suspected medicinal product, it is necessary to evaluate the signal strength and quality.The aim of the study was to analyse the information submitted to Russian regulatory authorities by a patient and check it for a potential causal association of acute tubulointerstitial nephritis (ATIN) with the use of ceftriaxone and with the patient’s principal diagnosis, Lyme disease.Materials and methods: the authors analysed the patient’s submission received by the Ministry of Health of the Russian Federation in 2022 with a complaint that the treatment of Lyme disease with ceftriaxone had caused ATIN. The probability of a causal relationship between the medicinal product and the ADR was evaluated using the Naranjo algorithm.Results: according to the review of literature and the spontaneous reports collected in Pharmacovigilance 2.0, the database in the Automated Information System of the Russian Federal Service for Surveillance in Healthcare, both ceftriaxone and the underlying condition (Lyme disease) may cause renal abnormalities. Ceftriaxone is potentially nephrotoxic; it mainly affects the tubular system of the kidneys. Borreliosis may cause kidney damage as well; such damage manifests clinically as rapidly progressing and fatal damage to the glomeruli.Conclusions: the probability of a causal relationship between the development of ATIN in the complainant and the use of ceftriaxone was categorised as “possible”. However, the information available did not allow for establishing a definite relationship between kidney damage and the use of the medicinal product. Further monitoring of similar cases is necessary to minimise the risks of developing this pathology during treatment with ceftriaxone

Polarization of X-ray lines from galaxy clusters and elliptical galaxies - a way to measure tangential component of gas velocity

We study the impact of gas motions on the polarization of bright X-ray emission lines from the hot intercluster medium (ICM). The polarization naturally arises from resonant scattering of emission lines owing to a quadrupole component in the radiation field produced by a centrally peaked gas density distribution. If differential gas motions are present then a photon emitted in one region of the cluster will be scattered in another region only if their relative velocities are small enough and the Doppler shift of the photon energy does not exceed the line width. This affects both the degree and the direction of polarization. The changes in the polarization signal are in particular sensitive to the gas motions perpendicular to the line of sight. We calculate the expected degree of polarization for several patterns of gas motions, including a slow inflow expected in a simple cooling flow model and a fast outflow in an expanding spherical shock wave. In both cases, the effect of non-zero gas velocities is found to be minor. We also calculate the polarization signal for a set of clusters, taken from large-scale structure simulations and evaluate the impact of the gas bulk motions on the polarization signal. We argue that the expected degree of polarization is within reach of the next generation of space X-ray polarimeters.Comment: 25 pages, 18 figures, accepted to MNRA

X-ray line formation in the spectrum of SS 433

The mechanisms for the formation of X-ray lines in the spectrum of SS 433 are investigated by taking into account the radiative transfer inside the jets. The results of Monte Carlo numerical simulations are presented. The effect of a decrease in line intensity due to scattering inside the jet turns out to be pronounced, but it does not exceed 60% in magnitude on the entire grid of parameters. The line broadening due to scattering, nutational motion, and the contribution of satellites can lead to overestimates of the jet opening angle $\Theta$ from the line widths in Chandra X-ray observations. The fine structure of the lines turns out to be very sensitive to the scattering effects. This makes its investigation by planned X-ray observatories equipped with high-resolution spectrometers (primarily Astro-H) a powerful tool for diagnosing the parameters of the jets in SS 433.Comment: 23 pages, 14 figures, to be published in Astronomy Letters, v. 38, n. 7, p. 443 (2012

Phenotypic Manifestation of Homozygous Partial Deletion of the Chromosome 1 Segment Spanning Cfhr3 Region

This article presents two clinical cases of patients with a homozygous deletion of segment of chromosome 1, which covers regions of genes associated with complement factor H, in particular CFHR3. Patients underwent in-depth clinical studies, heredity assessment, laboratory, instrumental and genetic diagnostics. The first clinical case describes a clinical case with deleted chromosome 1 segment in a 9-year-old girl who was diagnosed with atypical hemolytic-uremic syndrome. This is a complement-dependent disease that affects both adults and children. It is known that a defect in any proteins included in the alternative complement activation pathway can lead to atypical hemolytic-uremic syndrome. However, this syndrome is most often caused by defects in chromosome 1 region, including gene sequences associated with complement factor H-CFHR1 and CFHR3. Modern treatment of atypical hemolytic uremic syndrome involves targeted pathogenetic treatment, therefore, the genetic diagnosis seems to be a necessary step for differential diagnosis and confirmation. The patient had fairly typical clinical symptoms, including signs of thrombotic microangiopathy, thrombocytopenia, hemolytic anemia and increasing renal failure. It is also known that her mother had congenital hydronephrosis, and the pregnancy proceeded against a background of ureaplasma, mycoplasma, cytomegalovirus infection, chronic pyelonephritis, and preeclampsia. The second clinical case of a deleted chromosome 1 region, involving the CFHR3 gene, is a description of the disease in a boy of 8 years old, while the disease manifested with alopecia at the age of 4. Intermittent alopecia was the main symptom, while there were no signs of renal failure, thrombocytopenic purpura, and other symptoms characteristic of atypical hemolytic-uremic syndrome. The boy also revealed some congenital defects of the urinary system: Bladder diverticulum, unilateral ureterohydronephrosis, and bilateral dilatation of the pyelocaliceal system. The detected genetic defect is usually associated with atypical hemolytic uremic syndrome. However, the phenotype, i.e., clinical manifestations, determined a completely different diagnosis-primary immunodeficiency, a group of complement defects, and a deficiency of complement factor H-related protein. After analyzing the given clinical cases, we can conclude that clinical manifestations may vary significantly in carriers of same gene mutations. This suggests that there are additional factors (genetic or environmental) that can influence the formation of various phenotypic manifestations of this pathology. © 2020 Russian Association of Allergologists and Clinical Immunologists, St. Petersburg Regional Branch (SPb RAACI). All rights reserved

External and internal culture of students of the Ural state medical university

The article analyzes the data of an anonymous survey among students of the Ural State Medical University (UGMU) to determine the level of external and internal culture of students. It is determined that the level of students' culture is at the middle level, students have a correct understanding of the external and internal culture of behavior, but in practice they are always guided by their convictions. The best level of understanding of the culture among respondents show students of the dental faculty.В статье проанализированы данные анонимного анкетирования студентов Уральского Государственного Медицинского Университета (УГМУ) для определения уровня внешней и внутренней культуры обучающихся. Определено, что уровень культуры студентов находится на среднем уровне, обучающиеся имеют правильное представление о внешней и внутренней культуре поведения, но на практике всегда руководствуются своими убеждениями. Наилучший уровень представления о культуре по опросам показали студенты стоматологического факультет