Vol 22, No 4 (2025)

The implementation of a set of rehabilitation measures in accordance with the individual rehabilitation and habilitation program (IRHP) is one of the key tasks of medical institutions and social service organizations. The effectiveness of the rehabilitation can be judged both by the results of repeated examinations and by the subjective assessment of the quality of life by the disabled in dynamics. The purpose of the work – сomparison of indicators of subjective assessment of the health of disabled people depending on the duration of disability, prescribed and received rehabilitation measures in accordance with the IHRP. Materials and methods: From January to March 2025, a retrospective analytical descriptive study was conducted. The inclusion group consisted of 324 disabled people and disabled children with socially significant diseases, who had previously taken part in a survey on satisfaction with rehabilitation measures and subjective assessment of their health and quality of life. In the framework of this study, the respondents' information on the group and terms of disability establishment, as well as the assignment of rehabilitation services based on the results of medical and social examination were analyzed by extracting from the AIS "Electronic Social Register of the Population of St. Petersburg". Results and discussion: The analysis revealed a number of indicators influencing the self-assessment of the health of people with disabilities: life expectancy with disability and refusal of preferential drug provision during the development of the IPRA. The hypotheses about the presence of an association between the patient's subjective assessment of their health and the life expectancy with disability, as well as the association between the patient's subjective assessment of their health using the visual analogue scale (EQ-VAS) and consent to receive preferential provision in the form of medications were statistically confirmed. Conclusion: It is necessary to develop organizational and managerial solutions for working with long-term disabled persons in order to prevent deterioration of the patient's condition, focusing on the need to receive and take medications for prevention further unjustified requests, prevent disability and improve the quality of life of persons with disabilities.

Depression is a common and significant mental disorder. Previously, among the C(4)-derivatives of pyroglutamic acid synthesized by us, low-toxic compounds with psychotropic activity in vivo were identified. The purpose of the work: To screen new pyroglutamic acid derivatives for antidepressant activity and to study the effect of potential antidepressants in a reserpine-induced depression model. Materials and methods: The study was performed on adult male white mice weighing 25–35 g. The 17 test compounds, reference drugs (fluoxetine and amitriptyline), or a vehicle solution were administered intragastrically to mice of the corresponding groups 1 hour before the experimental sessions. For screening in the tail suspension test (TST), the test compounds were administered at a dose of 1/10 Mr/kg; then, effective doses for the active compounds were determined. To model depression, reserpine was administered to mice intraperitoneally at a dose of 1 mg/kg 20 h before, and the compounds selected in the screening and amitriptyline were administered 1 h before the beginning of the experimental session with the TST, Porsolt forced swimming test and sucrose anhedonia test. Results and discussion: A decrease in immobility in the TST screening was observed under the action of fluoxetine and compounds VAY1376, VAY1392, IAN1512, which it was decided to study further at a dose of 1/10 Mr/kg. In the depression model, reserpinized animals, compared with intact ones, showed less preference for sucrose and activity in the TST and forced swimming test. Compounds VAY1392 and IAN1512, comparable to amitriptyline, reduced the severity of all these manifestations of depression; VAY1376 was able to alleviate only the decrease in sucrose preference and active swimming time, but not immobilization. Conclusion: In a screening of antidepressant activity by the TST, compounds VAY1376, IAN1512, and VAY1392 were selected from 17 pyroglutamic acid derivatives at an effective dose of 1/10 Mr/kg. In a model of reserpine-induced depression, IAN1512 and VAY1392 neutralized depressive-like behavior comparable to amitriptyline; however, VAY1376 showed conflicting results, which may indicate heterogeneity or a different mechanism of action.

The use of modern or improved diagnostic methods in the treatment of patients with vertical occlusion abnormalities is still an urgent task. The possibility of using photostatic imaging has also been considered. The purpose of the work: To conduct a comparative analysis of photostatic images of patients with vertical occlusion abnormalities before and after orthodontic treatment. Material and methods:. The study involved 23 individuals with physiological occlusion, who formed the comparison group. In the first main group, the results of treatment of 11 patients with vertical incisor malocclusion were analyzed, and in the second group, 16 patients with deep incisor occlusion/malocclusion were analyzed. The angle of the nasal and gnatic parts of the face was analyzed in the profile photographs of the patients. From the point of the upper recess of the tragus, lines were drawn in a diagonal direction to the skin point "nasion" to the subnasal point "subnasale", and to the supramental point of the chin "supramentale". The study was approved by the Local Ethics Committee. During the statistical analysis, the average value of the indicator and its error (M ± m) were determined, and the significance of the indicator was analyzed using the Student's t-test. Results and discussion: When analyzing profile images of people with physiological occlusion, it was found that the average value of the angle of the nasal part of the face was (29.92 ± 0.83)°, which corresponded to the optimal height of the analyzed section. The angle of the gnathic part of the face was (19.97 ± 0.43)°, which corresponded to the optimal height of the bite. When treating patients with vertical incisor disocclusion, the gnathic angle decreased from (25.49 ± 1.22)° to the optimal parameters. Patients with deep incisor occlusion/disocclusion showed an increase in the gnathic angle from 16.71 to 20°. Conclusion: Thus, the indicators of the angles of the gnathic part of the face can be used in clinical practice when determining the height of the bite, and as a criterion for the effectiveness of treatment of patients with abnormalities of occlusion in the vertical direction.

Machine learning methods are widely used today in the search for biologically active substances. Moreover, chemical and biological data have a highly specific structure, and all medicinal substances act simultaneously on several biotargets. Given this, the development of new methods for constructing deep-learning convolutional neural networks to analyze the relationships between multi-target biological activity and the structure of chemical compounds is a relevant and scientifically important task. Purpose of the work: To create a methodology for building multi-target convolutional neural networks of deep learning based on the correlation convolution of multiple docking energies into relevant biotargets. Materials and methods: Ensemble multiple docking of 537 compounds with anxiolytic activity and 234 compounds with antimicrobial activity against S.aureus into 22 and 10 relevant biotargets respectively, and the subsequent generation of their multiple docking energy spectra were performed using the original MSite program and AutoDock Vina program. Using the original FCCorNet program, correlation convolution of the energy spectra of multiple docking was performed and the energies of fully-connected convolutional neural networks were calculated for the specified compounds. The original computer DeepNets program for constructing deep-learning neural networks was developed in Python using the PyTorch library. Multi-target convolutional neural networks of deep learning were trained on two datasets, including the levels of anxiolytic activity and antimicrobial activity against S. aureus of known compounds and the energies of fully-connected convolutional correlation neural networks, and their accuracy was estimated. Results and discussion: The accuracy of the constructed neural network model for anxiolytic activity was Acc = 68.3 %, with a statistical significance of p = 1.1 × 10^-9. The accuracy of the constructed neural network model for antimicrobial activity against S. aureus was Acc = 90.5 %, with a statistical significance of p < 1 × 10^-15. The accuracy of predicting antimicrobial activity for S. aureus exceeds that of predicting anxiolytic activity, possibly due to the more complex systemic multi-target mechanism underlying psychotropic effects, compared to the antibacterial action of chemical compounds. The results demonstrate the high validity of a new deep-learning convolutional neural network architecture for in silico searches for biologically active substances. Conclusions: A new multi-target deep-learning convolutional neural network architecture based on correlation convolution of energy spectra of multiple docking into a set of relevant biotargets has been developed. The developed methodology can be used for in silico searches for new high active compounds with various types of multi-target pharmacological activity.

The relevance of this research is driven by the need to improve the training of healthcare professionals who can effectively interact with patients and the general public under modern conditions of functioning health systems. The purpose of the work: To assess and investigate the dynamics of empathic abilities among medical students depending on their year of study. Material and methods: This study was conducted through surveys among dental faculty students and clinical interns at a medical university. In total, 859 respondents participated in the survey, including first-, third-, and fifth-year undergraduate students, as well as first- and second-year clinical interns. To evaluate the level of empathy, an adapted version of the “Emotional Response Scale” methodology was used, which allows determining participants' overall tendency towards experiencing others’ emotions and reacting to surrounding feelings. Surveys were carried out via an online platform that provided convenient access for participants and data collection. Results and discussion: A very high level of empathy (82 to 90 points based on survey results) was found among first-year students (1.9 %) and second-year residents (3.3 %). Fifth-year students have this indicator less frequently (1 %), while third-year students show no cases of extremely developed empathy et al. High levels of empathy (63 to 81 points) were most common among first-year students (14.1 %) and first-year residents (24.4 %). Fifth-year students are less likely to exhibit a high level of empathy (only 4.6 %), and third-year students do not appear in this category at all. The average level of empathy (37 to 62 points) varies slightly, with the highest frequency equally represented among first-year students and first-year residents (both 5.8 %). However, fifth-year students rarely fall into this category (just 1.9 %). Low levels of empathy (36 to 12 points) were observed exclusively among third-year students (4.6 %). Gender differences: Empathy develops differently between men and women during their education process. Men more often possess an average level of empathy initially (first year – 4.1 %; first two years of residency – 2.7 % and 2.9 %). Their higher empathy gradually increases, peaking in the second year of residency (10.5 %). Women demonstrate greater inclination towards high-level empathy from the start (9.3 % in the first year), which further rises by the second year of residency to 13.9 %. Very high empathy rates differ significantly: among women they increase from 1.4 to 3.1 %, whereas for men it remains stable around 1.7–1.9 %. Notably, second-year resident women show substantially higher empathy levels (3.1 %) compared to men (1.9 %). Conclusion: The study revealed uneven development of empathy among medical students of different ages and genders. Higher levels of empathy are characteristic of younger undergraduate students and second-year residents. Gender differences are evident: female students show greater growth in empathy throughout their training period, while changes in male students occur slower and are less pronounced. These findings suggest that individual characteristics should be taken into account when designing educational programs and methods aimed at developing professional qualities of healthcare professionals. The research outcomes can be utilized to optimize the educational process and create effective mechanisms for managing the quality of medical care delivery.

The introduction of outpatient glycemic monitoring into everyday practice significantly increased the ability to detect various forms of dysglycemia in patients with diabetes mellitus (DM) and prediabetes, and also contributed to improving the effectiveness of glycemic control. The purpose of the work: To study the frequency, nature and duration of dysglycemia episodes in patients with prediabetes and DM type 2, to reflect the impact of the results of outpatient glycemia monitoring on the choice of therapeutic strategy using the example of clinical observations. Materials and methods: The study included 59 patients, of which 48 were diagnosed with type 2 DM and 11 with prediabetes in the form of impaired glucose tolerance and impaired fasting glycemia. The average age of patients was, from and to years. Among the observed patients, there were 37 (62.7 %) men and 22 (37.2 %) women aged 30 to 76 years, with a mean age of (56.06 ± 11.44) years. All patients were on outpatient treatment, glycemic control was carried out through flash monitoring using the Freestyle libre 2 system. Assessment of disorders of the glycemic profile included studying the time in the target range, indicators of the average level and variability of glycemia, the frequency and duration of various episodes of dysglycemia: early postprandial hyperglycemia, hyperglycemic plateaus, episodes of latent hypoglycemia. The objective of the study was to demonstrate the clinical decision-making process in the management of patients with prediabetes and DM type 2 based on outpatient glucose monitoring data. Results and discussion: Different variants of dysglycemia were detected in all patients during monitoring, regardless of the time spent within the target glucose range. Clinical observations have shown that a change in therapeutic strategy based on data obtained during outpatient glucose monitoring leads to essential improvement in glycemic control. Conclusion: Outpatient glycemia monitoring is not only an opportunity for early detection of clinically significant carbohydrate metabolism disorders, but also an effective glycemia management tool in patients with prediabetes and type 2 DM.