Luhansk State Medical University

Cerebellar-type multiple system atrophy (MSA-C) presents significant challenges for early diagnosis due to the absence of specific biomarkers and its clinical similarity to other forms of ataxia. The presented clinical case highlights the importance of dynamic monitoring of magnetic resonance imaging (MRI) changes for confirming the diagnosis of MSA-C and demonstrates the characteristic temporal evolution of key neuroimaging markers.A clinical observation of a 47‑year-old patient with progressive cerebellar ataxia and autonomic failure (orthostatic hypotension, urinary incontinence) consistent with established diagnostic criteria for MSA-C is presented. Brain MRI findings obtained in follow-up with a 7‑month interval are of particular value. First detection of the highly specific “hot cross bun” sign for MSA-C – a cross-shaped area of hyperintense signal in the central pons. Progressive thinning of the middle cerebellar peduncles (by 3 mm), cerebellar vermis atrophy (by 2 mm), and enlargement of the fourth ventricle and pontine cisterns were also documented. These changes objectively correlated with the progression of cerebellar clinical symptoms in the patient.The findings of this clinical case indicate that dynamic MRI evaluation is an indispensable method in the diagnosis of MSA-C. The appearance of the pathognomonic “hot cross bun” sign and quantitatively measurable progression of atrophy in specific posterior fossa structures (the cerebellum, middle cerebellar peduncles, and pons) over a short time interval represent highly specific radiological criteria that allow reliable differentiation of MSA-C from hereditary ataxias even in the absence of definitive biomarkers. Early and sequential MRI with assessment of imaging changes over time significantly improves the accuracy of antemortem diagnosis of this severe neurodegenerative disease.

The purpose of the study is to conduct a philosophical analysis of the mechanisms, forms, and consequences of cultural heritage updating to understand the direction of cultural space's evolution in the era of global civilizational transition. The scientific novelty lies in substantiating the concept of cultural heritage updating as a key, dialectical mechanism that not only determines a paradigmatic cultural shift in the context of contemporary transformations but also acts as a powerful counter-discursive tool against unification and instrumentalization, while ensuring cultural autonomy and personal development. The study revealed that a paradigmatic cultural shift in modern society is not destructive, but a complex adaptive process, the central catalyst of which is cultural heritage updating. Culture provides the opportunity for an active reinterpretation of the past, in the context of the transmission of cultural experience, imbuing it with existential and epistemological relevance.

The article presents a complex mathematical model of the surface hardening process of rotating parts in a plasma torch with a liquid electrode. The model takes into account key physical aspects, including electrical breakdown, plasma dynamics, heat transfer, phase transformations in the material and the effect of part rotation on the hardening uniformity. The proposed equations describe the conditions for the formation of an arc discharge, heat balance, plasma ionization, as well as the kinetics of heating and cooling. The results of modeling implemented in the Matlab environment confirm the possibility of achieving high surface hardness due to martensitic transformation at a cooling rate above 200°C/s. The model allows optimizing hardening parameters such as plasma torch power, rotation speed and exposure time, which helps to reduce the number of experiments and increase the efficiency of the technology.

Precancerous diseases of the cervix continue to remain an urgent medical and social problem of today and occupy one of the leading places in the structure of gynecological morbidity. A typical representative of precancerous diseases of the cervix is cervical intraepithelial neoplasia, which is closely associated with the human papillomavirus (HPV). Women under the age of 25 who have risk factors that may become an obstacle to self-elimination of the virus, as well as to reducing the viral load, deserve special attention.The objective: to evaluate the effectiveness of phytotherapy in the complex treatment of papilloma-associated cervical lesions in young women.Materials and methods. 236 women aged 18–25 years were examined. All women underwent vaginal biocenosis, as well as co-testing (according to the results obtained, 9 women (3.8%) were found to be HPV-negative, which served as the basis for their exclusion from the study), depending on the results of which, women were divided into groups I, II and III. Group I included 83 women with HPV and cytological result Negative for Intraepithelial Lesion or Malignancy. Group II included 77 women with HPV and cytological conclusion Atypical Squamous Cells of Undetermined Significance. Group III included 67 with HPV and cytological conclusion Low-grade Squamous Intraepithelial Lesion. Subsequently, depending on the therapy received, women in groups I, II and III were additionally divided into two subgroups. Subgroups IA, IIA and IIIA included women who received local anti-inflammatory therapy depending on the identified pathogen in combination with a phytotherapy based on an oil solution of a mixture of herbs of sodden pike, ground wormwood and oil extract of echinacea roots once a day in the form of oral capsules for 1 year. Women in subgroups IB, IIB and IIIB were offered only local anti-inflammatory therapy depending on the identified pathogen. Treatment results were monitored after 6 months by repeated quantitative HPV testing and liquid cytology. Vaginal biocenosis was monitored 4 months after the start of treatment.Results. According to the results of quantitative HPV testing, women in group I had a low viral load – 67 (80.7%); p < 0.05), moderate load – 16 (19.3%) cases, and the absence of cases of high viral load. 50 (64.9%) and 48 (62.3%), p > 0.05, women in groups II and III had a moderate viral load. The number of cases of high viral load was found to be significantly higher among women in group III – 22 (28.6%), group II – 13 (16.9%), p > 0.05. When assessing the vaginal biocenosis after 4 months, women in subgroup IIIA had significant improvements in the results of repeated bacteriological examination compared to women in subgroup IIIB and the results of the initial examination. It should be noted that in subgroup IIIA, according to the results of the determination of Enterococcus faecalis – 4 (12.1%) (subgroup IIA – 2 (5.6%)) and Candida albicans – 6 (18.2%) (subgroup IIA – 4 (11.1%)) showed a non-significant higher number of results containing diagnostically significant titers of pathogens.Conclusions. The inclusion of a phytotherapy based on an oil solution of a mixture of herbs of sodden pike, ground wormwood and oil extract of echinacea roots in the complex treatment of young women with papilloma-associated cervical lesions contributes to a decrease in viral load, the transition to a lower viral load which is reflected in significantly better results of cytological examination in women of subgroups A. The combined use of a phytotherapy with local anti-inflammatory therapy aimed at correcting the vaginal biocenosis is effective in the context of reducing the amount of opportunistic microflora in a diagnostically significant concentration.

Using an original methodology, we determined the area values of individual ear sectors in mesocephalic girls based on photographic images. A database was created and relationships were identified, which are necessary for subsequent comparative analysis based on gender and head shape.

Artikel ini membahas pola asuh yang diterapkan di Taman Pengasuhan Anak (TPA) Ar-Rahmah Nurul Jadid. Penelitian ini bertujuan untuk mengidentifikasi pola asuh yang efektif dalam mendukung perkembangan karakter dan emosional anak. Dengan pendekatan kualitatif, data dikumpulkan melalui wawancara dengan pengasuh dan orang tua, serta observasi langsung di TPA. Hasil penelitian menunjukkan bahwa pola asuh yang positif, berbasis nilai-nilai agama, dan melibatkan orang tua secara aktif berkontribusi besar terhadap perkembangan anak. Temuan ini diharapkan dapat menjadi referensi bagi pengasuh dan orang tua dalam menciptakan lingkungan yang mendukung pertumbuhan anak.

Background. The article is devoted to the study of the peculiarities of teaching foreign languages to schoolchildren in the inclusive post-conflict educational environment of Donbas. The subject of the study encompasses the methods and strategies for developing inclusive competence among teachers in the context of teaching foreign languages in the post-conflict inclusive environment of Donbas, as well as the adaptation of educational practices to the psycho-emotional and communicative characteristics of students with special educational needs. The aimof the study is to identify and substantiate the features of teaching foreign languages to schoolchildren in the post-conflict inclusive environment of Donbas and to determine ways of developing teachers’ professional and inclusive competence for effective teaching and support of children with special educational needs. Materials and methods.The methodological framework of the study is based on the analysis of domestic and foreign literature, the socio-ecological model, principles of trauma-informed pedagogy, and the theory of resilience. It examines the psycho-pedagogical characteristics of students in a post-conflict region, including heightened anxiety, emotional instability, difficulties in attention and learning, particularly when studying foreign languages. Special attention is given to developing teachers’ inclusive competence, enabling the adaptation of teaching methods to the needs of students with special educational needs and the creation of a safe, supportive learning environment. Results.The results of the study demonstrate the necessity of developing inclusive competence among foreign language teachers, creating a safe and supportive educational environment, applying adaptive teaching methods, and integrating linguistic, psychopedagogical, and inclusive components. Students with post-traumatic experience face specific challenges in foreign language learning, manifested in reduced motivation, increased fatigue, and a need for emotional support. The study highlights the importance of considering age-specific manifestations of trauma and adopting differentiated approaches for younger children and adolescents. The proposed methodological recommendations for foreign language teachers, aimed at implementing trauma-informed, inclusive, and discipline-oriented teaching strategies, include the use of storytelling, visualisation, group work, relaxation techniques, and the creation of a supportive classroom atmosphere. The findings of the study can be applied in the school education system of post-conflict regions to enhance the effectiveness of language learning and support students’ psychosocial rehabilitation.

Today, inclusive education improves the quality of social adaptation, but socio-pedagogical rehabilitation of children with physical conditions has a long history. This article describes the evolution of the social rehabilitation system, its pedagogical methods, and relevant social institutions across various historical contexts. The historical-pedagogical analysis of socio-pedagogical rehabilitation for children with special needs revealed some factors that influenced its evolution, pedagogical perspectives, modern trends, and international best practices. The research relied on the methods of historical and pedagogical analysis, a comparative approach, regulatory documents, and social practices. As charitable care gave way to structured and inclusive approaches, the socio-pedagogical rehabilitation of children with disabilities started to integrate education with social components. Today, its primary focus is on creating inclusive environment and interdisciplinary collaboration. However, the current rehabilitation methodologies require innovative technologies to make support for children with disabilities more efficient.

The article presents a theoretical justification and a conceptual model for developing the mechanism of psychological induction in medical students as an effective means of fostering professional identity, emotional competence, and ethical culture in future physicians. The relevance of the study is driven by the growing significance of affective and value-based components in medical education, as well as the insufficient theoretical and pedagogical exploration of the phenomenon of psychological induction. The article aims to design a conceptual model of psychological induction, define its structural components, identify pedagogical conditions for its implementation, and outline the expected outcomes. The research methodological framework is grounded in systemic, competency-based, and humanistic approaches, as well as concepts of social learning, reflective pedagogy, and narrative medicine. The proposed model integrates four interrelated components (cognitive, emotional, behavioral, and reflective), which enable profound value-emotional transformation during students’ professional formation. The article defines key pedagogical conditions that support the model's effectiveness: a safe educational environment, a person-centered and humanistic teaching style, emotionally rich instructional methods, development of reflexivity, and the creation of moral choice situations. Strategies for implementing the model into educational practice are proposed, including integration into academic disciplines and modules, redesigning pedagogical interactions, faculty training, and methodological support. Expected outcomes of the model’s application are outlined, and potential limitations are identified. Prospects for further research involve empirical validation of the model’s effectiveness and its adaptation to various educational contexts in medical training.

Background:Heart failure (HF) stands as one of the world’s major causes of morbidity and mortality, yet there is insufficient therapeutic choice, particularly for patients with heart failure with preserved ejection fraction (HFpEF) and mildly reduced ejection fraction (HFmrEF). Patients treated with SGLT2 inhibitors experience cardiovascular benefits as an additional effect beyond its glucose control capabilities. In this meta-analysis, the effectiveness and safety of SGLT2 inhibitors are assessed for patients with heart failure with reduced ejection fraction (HFrEF), HFpEF, and HFmrEF. Of particular interest is their effect on cardiovascular mortality, heart failure hospitalizations, and symptom burden.Methods:A systematic review and meta-analysis were conducted following PRISMA guidelines. Research performed on the Cochrane Library, PubMed, and Embase electronic databases retrieved randomized controlled trials (RCTs) and cohort studies that evaluated SGLT2 inhibitors treatment for patients with reduced (HFrEF), preserved (HFpEF), and mid-range (HFmrEF) ejection fraction levels. The study analyzed cardiovascular mortality together with heart failure hospitalizations and symptom improvement as well as renal function decline among heart failure patients. The analysis incorporated Hazard ratios (HRs) and 95% confidence intervals (CIs) using a random-effects model to pool the data. The assessment of heterogeneity used Cochran’s Q test alongside the I2 statistic, and publication bias was evaluated through funnel plots and Egger’s regression test.Results:The examined research included eight studies that utilized clinical trials combined with real-world data for analysis. Both patients with HFrEF (HR: 0.74, 95% CI: 0.65–0.85, P < 0.001) and HFpEF (HR: 0.82, 95% CI: 0.73–0.92, P = 0.0008) experienced significant decreases in cardiovascular death and HF progression through SGLT2 inhibitors treatment. Benefits in HFmrEF patients were similar to those in HFpEF, mainly based on subgroup analyses in the DELIVER trial. Patients treated with SGLT2 inhibitors experienced a 24% reduction in hospital admissions compared to a control group with rates confirmed through an analysis of HR: 0.76 (95% CI: 0.63–0.93, P = 0.01). Patients taking SGLT2 inhibitors showed a 39% decrease in kidney failure risk according to analysis (HR: 0.61, 95% CI: 0.51–0.72, P < 0.001). The treatment showed positive effects on symptoms through early NT-proBNP reduction and improved self-reported patient outcomes. The assessment of heterogeneity showed moderate levels through I2 = 52.7% while detecting no meaningful publication bias.Conclusion:With their ability to improve symptoms and lower cardiovascular mortality, hospitalizations, and renal decline, SGLT2 inhibitors offer substantial clinical benefits for all three types of heart failure: HFrEF, HFmrEF, and HFpEF. These results lend credence to their incorporation into medical therapy for heart failure that is guided by guidelines, irrespective of diabetes or ejection fraction.