Kazakh National Medical University

Background/Objectives: Autoimmune hepatitis (AIH) is a chronic immune-mediated inflammatory liver disease that, if not diagnosed and treated promptly, leads to cirrhosis and liver failure. Data on AIH in Central Asia, including Kazakhstan, remain limited. The aim of this study was to characterize the clinical profile of AIH in a Kazakhstani patient cohort, determine the timeliness of diagnosis, and develop an interpretable machine learning model for detecting liver fibrosis based on routine clinical and laboratory parameters. Methods: A retrospective observational study of adult patients with a diagnosis of AIH between 2015 and 2025 was conducted. Demographic, laboratory, instrumental, and histological data of patients with AIH were extracted from medical records. All statistical analyses were performed using SPSS 22.0. Results: The study included 240 patients with a mean age of 49.3 ± 14.3 years; 87.1% of patients were women. The Random Forest model showed the best results: ROC-AUC of 0.803 ± 0.057, PR-AUC of 0.868 ± 0.044, Brier of 0.180 ± 0.017, sensitivity of 0.816, and specificity of 0.641. SHAP analysis confirmed that platelet count, age, INR, disease duration, and bilirubin and albumin levels made the greatest contribution to the prognosis. Conclusions: This retrospective observational study of AIH in Kazakhstan identified a patient population characterized by late diagnosis and advanced disease stages at presentation, a high frequency of overlapping autoimmune liver diseases, and a significant burden of metabolic and extrahepatic autoimmune comorbidities. The results demonstrate that an interpretable machine learning model based on routine biomarkers can effectively detect fibrosis and provide clinically interpretable risk factors.

This study focuses on the development and techno-functional evaluation of soft ice cream based on freeze-dried camel milk enriched with sea buckthorn concentrate. The aim was to substantiate the feasibility of using freeze-dried camel milk as a hypoallergenic raw material and to evaluate its influence on the technological (structural stability and melt resistance) and physicochemical properties of a low-temperature dessert. The research methodology included analysis of the fatty acid profile, determination of macro- and microelement composition, and assessment of vitamin content using instrumental physicochemical methods. The fatty acid profile analysis revealed a predominance of saturated fatty acids (78.6%), which contributes to improved structural stability and enhanced melt resistance. This effect compensates for the specific protein composition of camel milk, particularly the natural absence of β-lactoglobulin, a major allergen of cow’s milk. The developed product demonstrated high functional potential: its hypoallergenic properties were confirmed, and the vitamin C content reached 634 mg/100 g, exceeding conventional analogues by several orders of magnitude due to the synergistic interaction between camel milk and sea buckthorn. The scientific significance of the study lies in expanding current understanding of the technological potential of freeze-dried camel milk in frozen dessert systems. The practical relevance is associated with the applicability of the obtained results in the development of functional and specialized nutrition products. At the same time, a pronounced imbalance in macroelement composition was identified. Elevated levels of calcium (173.9 mg/100 g) and magnesium (88.0 mg/100 g) were accompanied by critically low contents of phosphorus (15.0 mg/100 g) and potassium (10.2 mg/100 g), as well as the absence of vitamin D₃. These factors reduce mineral bioavailability and overall physiological value. Therefore, mandatory formulation correction was proposed through the introduction of potassium phosphates to restore a physiologically optimal Ca:P ratio and fortification with vitamin D₃ to enhance mineral absorption. For the first time, a comprehensive techno-functional assessment of soft ice cream based on freeze-dried camel milk was conducted, integrating structural, nutritional, and functional indicators.

Artificial intelligence (AI) is transforming university career services, shifting from traditional predictive algorithms to interactive generative agents. This transition raises critical questions about student agency and the digital platformisation of career guidance. In this systematic review, we examined empirical evaluations and technical architectures of AI implementations in higher education career counselling from 2015 to 2025. Following PRISMA 2020 guidelines, we identified 43 studies across Web of Science, Scopus, and ERIC. Methodologically, we appraised study quality using the Mixed Methods Appraisal Tool (MMAT) and conducted a thematic narrative synthesis. We identified three main AI implementation typologies: (1) Generative Chatbots offering scalable 24/7 support, though limited by user trust barriers and a lack of perceived empathy; (2) Predictive Analytics forecasting employability, which require transparent, explainable models; and (3) Recommender Ecosystems that match students to personalized career pathways using institutional data. Interpreting these empirical findings through Career Construction Theory and Platformisation, we highlight a tension between technological efficiency and student agency. While AI expands information access, over-reliance on opaque algorithms introduces the risk of “automation bias,” where students passively accept recommendations rather than actively constructing their vocational identities. We conclude that AI should augment, rather than replace, human counsellors within a hybrid support model. Future research should prioritize longitudinal evaluations of AI interventions, algorithmic audits of recommender platforms, and the development of Explainable AI (XAI) to foster critical AI literacy.

A compelling body of evidence links pesticide exposure to human diseases. The liver plays a central role in the detoxification of pesticides, suggesting intense pesticide-liver cell interactions. A growing body of studies highlighted in this review supports the contribution of pesticides of various chemical classes to the development of non-alcoholic fatty liver disease (NAFLD), alcohol-associated liver disease (ALD), liver cirrhosis, viral hepatitis, hepatocellular carcinoma, etc., via disrupting lipid and carbohydrate metabolism and redox homeostasis, promoting endoplasmic reticulum stress and mitochondrial dysfunction, as well as stimulating apoptosis, fibrosis, and inflammation. In this review, we systematically illustrated an underappreciated mechanism of pesticide-induced overall and hepatic toxicity, i.e., the ability to induce non-apoptotic regulated cell death (RCD) pathways such as ferroptosis, necroptosis, and pyroptosis. Our analysis indicates that pesticides are implicated in driving liver diseases by inducing ferroptosis, necroptosis, and pyroptosis. Non-apoptotic RCDs mediate pesticide-induced liver steatosis and fibrosis. Furthermore, these cell death modalities fuel inflammation through the promotion of pro-inflammatory cytokine production and the generation of damage-associated molecular patterns. Understanding of deeper mechanisms of pesticide-induced effects on the non-apoptotic cell death machinery and subsequent immunogenic effects in liver pathology might help develop novel preventive strategies to reduce liver damage.

Microsurgical DREZotomy (MDT) involves lesioning the dorsal root entry zone at the cervical spinal level, carrying a potential risk of iatrogenic spinal cord injury. Misidentifying the C4 root can lead to impaired diaphragmatic contractions and respiratory compromise. This report is the first MDT procedure in our Central Asian region and introduces the simultaneous analysis of 3 ventilator waveforms-capnography, pressure time, and flow time-as a novel, rapid-response intraoperative neurophysiological monitoring for definitive C4 root identification. Traumatic brachial plexus avulsion is an upper limb injury resulting in severe complications such as paralysis and neuropathic pain. Patients with refractory, pharmaco-resistant pain may be candidates for cervical MDT. Intraoperative neurophysiological monitoring during MDT is beneficial because it allows for anatomical mapping from C4 to Th1 nerve roots. The C4 root should not be targeted during MDT because it is cardinal for diaphragmatic muscular activity. Three ventilation curves simultaneously displayed synchronous changes during C4 ventral root stimulation, indicative of phrenic excitation and the diaphragm's reaction against the anesthesia machine. The expected C4 ventral root responses completely aligned with the stimulation patterns observed across all 3 monitored parameters. The simplicity of this method and its high practical applicability make it valuable for identifying phrenic nerve fibers during various surgical procedures where nerve roots responsible for diaphragmatic muscle contraction may be at risk.

In recent years, Kazakhstan has undergone an active institutional transformation of the anti-corruption system, and the media is one of the important aspects in the formation of this culture.The purpose of the research is to analyze the influence of media on the formation of anti-corruption culture in Kazakhstan, where attention is paid to the consumption model, trust in sources of information, and how people interact with corruption-related content.The analysis is based on a population survey, covering all regions of Kazakhstan (N = 2685). Data was collected through a combination of face-to-face and online interviews. The survey assessed the frequency of consumption of media content, trust in public, independent, and digital media, views on media coverage of corruption, evaluative interaction with media, and anti-corruption policies. Descriptive statistics and correlation analysis were used to test the proposed theories. The results show that media content related to corruption is weakly and inconsistently linked to anti-corruption policies, indicating the limited influence of passive media consumption. The reliability of media sources has only a partial, context-dependent relationship with the perception of objectivity and effectiveness of the media. However, active interaction with media content through critical evaluation, checking information, and awareness of media influence is the strongest predictor of media effectiveness in shaping an anti-corruption culture. The results show that media influence manifests itself through reflexive and interpretative processes, rather than through simple familiarization or blind reliance on specific sources. The practical significance of the study is that anti-corruption reforms in Kazakhstan are focused on legal and institutional measures, and less attention is paid to the social and cultural impact of media on public opinion and ethical norms. This study fills in the gap, as well as examining how media use and audience engagement relate to perceptions of corruption and how effectively media promote anti-corruption values.

Background and Objectives: Chronic spontaneous urticaria (CSU) significantly affects patients' quality of life (QoL) and remains challenging to manage, particularly in under-researched regions. This study aimed to assess the clinical burden, disease control, and quality of life among patients with CSU in Kazakhstan and to identify predictors of severe disease activity. Materials and Methods: We conducted a cross-sectional study of 350 patients with CSU attending the Republican Allergy Center in Almaty between December 2024 and June 2025. Patients were classified based on the presence of co-existing chronic inducible urticaria (CIndU), angioedema, or both. Disease activity, control, and QoL were assessed using the Urticaria Activity Score over 7 days (UAS7), Urticaria Control Test (UCT), and Dermatology Life Quality Index (DLQI), respectively. Multivariable logistic regression and correlation analyses were used to identify predictors of severe disease and interrelationships among clinical measures. Results: Among 350 patients (mean age 43.5 ± 14.7 years; 78% female), 46.3% had CSU alone, while 53.7% had associated phenotypes. Severe urticaria (UAS7 ≥ 28) affected 30% of patients. Suboptimal disease control (UCT ≤ 11) was reported in 30%, and 30% experienced strong or very strong QoL impairment (DLQI > 10). Older disease onset (≥60 years; OR = 1.98; 95% CI: 1.02-3.81) and nighttime symptoms (OR = 1.67; 95% CI: 1.02-2.73) were independently associated with severe disease. A strong inverse correlation was observed between UAS7 and UCT (ρ = -0.71), and a positive correlation between UAS7 and DLQI (ρ = 0.66), highlighting the impact of disease activity on control and QoL. Conclusions: CSU imposes a substantial clinical and psychosocial burden in Kazakhstan. One-third of patients experience severe symptoms and impaired QoL despite ongoing treatment. Older age at disease onset and nighttime symptoms may serve as practical indicators of disease severity. These findings highlight the need for improved access to advanced therapies, systematic monitoring using validated tools, and multidisciplinary care strategies in resource-constrained settings.

A pharmaceutical development of an ointment based on a thick extract of Filipendula vulgaris M. obtained by ultrasonic extraction has been carried out. The use of ultrasonic treatment made it possible to increase the efficiency of extracting biologically active substances, reduce extraction time, and preserve thermolabile components of the plant material. The chemical composition of the thick extract was studied using gas chromatography–mass spectrometry (GC/MS). The analysis revealed the presence of a complex of phenolic compounds, flavonoids, organic acids, esters, and other secondary metabolites with pronounced antioxidant and antiinflammatory activity. The obtained data confirm the pharmacological significance of the extract and the feasibility of its use as an active ingredient in the development of soft dosage forms. Based on the studied extract, five model compositions of the ointment were developed, differing in the ratio of base components and the concentration of the active substance. Each model was evaluated for physicochemical, organoleptic, and rheological characteristics. Parameters such as consistency, resistance to delamination, pH, viscosity, and uniformity of extract distribution in the ointment mass were determined. According to the totality of the obtained data, the optimal composition was identified, providing structural stability and pharmaco-technological properties that meet the requirements for soft dosage forms. Toxicological studies and pharmacological tests of the developed samples were carried out. No signs of acute toxicity or irritating effects were observed during topical application. Experimental evaluation of anti-inflammatory activity demonstrated a significant reduction of inflammatory reactions, indicating a pronounced therapeutic potential of the developed ointment. Thus, the study results confirm that the thick extract of Filipendula vulgaris M. is a promising herbal source of biologically active substances for the development of soft dosage forms with antiinflammatory properties. The developed ointment composition is characterized by stability, safety, and pharmacological efficacy, making it a potential basis for further preclinical and technological studies aimed at pharmaceutical implementation.

Relevance: Enhanced Recovery After Surgery (ERAS) and the Fast-Track rehabilitation concept represent a modern multidisciplinary model of perioperative management aimed at reducing surgical stress, minimizing postoperative complications, and accelerating functional recovery. In thoracic surgery, the implementation of ERAS principles encompasses the entire perioperative pathway—from prehabilitation and minimally invasive techniques to multimodal analgesia, early mobilization, and nutritional optimization. Despite proven effectiveness, in Kazakhstan, individual elements of accelerated recovery are applied inconsistently, and the concept itself remains underrepresented in the professional community. Conducting a literature review on this topic is the first step toward forming the scientific and clinical foundation necessary for subsequent adaptation and implementa-tion of ERAS principles within the national healthcare system. The study aimed to provide an analytical review of current evidence on the concepts of Enhanced Recovery After Surgery (ERAS) and Fast-Track rehabilitation in the surgical treatment of non-small cell lung cancer. Methods: A literature search was conducted across international bibliographic data-bases, including PubMed, PubMed Central, Scopus, and Google Scholar, using combinations of keywords such as lung cancer, ERAS, Fast-Track, and lung resection. The initial search identified more than 300 publications. After removal of duplicates and exclusion of studies that did not meet the predefined inclusion criteria, 28 studies were included in the final analytical review. Results: The implementation of minimally invasive surgical approaches (VATS) in lung cancer is not associated with an increased rate of postoperative complications; however, the risk of pulmonary and cardiorespiratory adverse events remains. According to meta-analyses, the use of ERAS proto-cols is associated with a significant reduction in postoperative complications and a decrease in length of hospital stay by approximately 2–3 days, without an increase in mortality or readmission rates, particularly when high protocol compliance is achieved. Conclusion: ERAS protocols in thoracic surgery have demonstrated proven efficacy and safety, contributing to reduced postoperative complications, shorter hospital stay, and lower treatment costs without increasing mortality. Successful implementation requires standardization, multidisciplinary collaboration, and systematic monitoring. In Kazakhstan, the integration of ERAS remains limited, underscoring the need to adapt international recommendations and implement them in a stepwise manner within the national healthcare system.