Advanced Training Research Articles

Use of a handheld system for interventional ultrasound with puncture and biopsy in an in vitro liver model.

Ultrasound-guided interventions (such as biopsies) of unclear lesions are indicated if microcirculatory changes indicate possible malignant lesions. These place high demands on the ultrasound device used. In order to potentially reduce the often associated high technical effort, the wireless ultrasound device Vscan AirTM was examined as a possible ultrasound device for the intervention biopsy. As part of an advanced training course on Computertomographie- and ultrasound-guided biopsy and ablation procedures, participants were asked about the image quality of the handheld device used by means of questionnaires. Various lesions were evaluated at a depth of 1.0 to 5.0 cm in an in vitro liver model. The image quality was evaluated independently before, during and after the intervention. The rating scale contained values from 0 (no assessment possible) to 5 (maximum high image quality). A high-end device was used as a reference. A total of 11 participants took part in the study (n = 4 male [36.4%], n = 7 female [63.6%]). A total of five tumor like lesions at different depths (1 cm, 2 cm, 3 cm, 4 cm, >4 cm) were assessed separately. In all cases, an adequate biopsy of the target lesion (1 cm in length, core filling 5 mm) was successful. From a depth of 3 cm, the image quality of the mobile device increasingly decreased, but the image quality of the high-end system was still not impaired. Compared to the high-end device, there was a highly significant difference in image quality from a depth of 3 cm (p < 0.01). Assessment by inexperienced examiners using a handheld device was adequately possible. Mobile interventional ultrasound represents a potential alternative for the biopsy of unclear tumorous lesions with microcirculatory disorders with limited depth localization.

IMRA/SRS Delphi consensus on international standards for common core components of robotic surgical training design

Robotic surgery has expanded internationally at pace. There are multiple local robotic training pathways but there is inconsistency in standardisation of core common components for curricula internationally. A framework is required to define key objectives that can be implemented across robotic training ecosystems. This Delphi consensus aimed to provide recommendations for core considerations in robotic training design across diverse training environments internationally. A literature search was performed and an international steering committee (AG, KL, JW, HM, TC) proposed key components for contemporary robotic training design and a modified Delphi approach was used to gather stakeholder opinion. The outcomes were then discussed at a face-to-face international expert consensus at the IMRA educational session at the Society of Robotic Surgery (SRS) meeting and final voting was conducted on outstanding items. Stakeholders included robotic surgeons, proctors, trainees and robotic surgical training providers. There was consensus achieved in 139 statements organised into 15 themes. There was 100% agreement that standardised themes in robotic curricula may improve patient safety. Key take-home messages include—training curricula should be multiplatform, non-technical skills are an important component of a robotic curriculum as well as console and bedside skills, clinically relevant performance metrics should be used for assessment where available, the reliance on cadaveric and live animal models should be reduced as high-fidelity synthetic models emerge, and stepwise component training is useful for advanced procedural training. These consensus recommendations are intended to guide design of fit for purpose contemporary robotic surgical curricula. Integration of these components into robotic training pathways internationally is recommended.

Legal education and artificial intelligence: vectors of interaction

Objective: to develop proposals for the introduction of artificial intelligence (AI) in legal education. Methods: dialectical methods (analysis and synthesis, induction and deduction, systematization, comparison, classification, forecasting), statistical, formal-legal and comparative-legal methods. Used in combination, these methods allow comprehensive analysis of the relationship between AI and legal education. Results: the article reveals the main directions to improve legal education in the conditions of AI development: integration of information and communication technologies and training of specialists able to work effectively at the intersection of law and technology. The advantages and disadvantages of using AI in legal education are identified. Ethical aspects of AI application are outlined, as well as the need to manage the development of technologies based on the principles of fairness, transparency and consideration of human interests. The author states the importance of developing not only specialized knowledge, but also universal competencies that will help students to adapt successfully to the dynamically changing conditions of professional activity. Scientific novelty: a comprehensive analysis of the interaction between legal education and AI was carried out, including the identification of specific opportunities for the AI application in legal education, as well as related risks and problems. The author proposes a systematic approach to improving legal education in the context of AI development, focusing on theneed to revise educational programs in legal areas in terms of integrating information and communication technologies; developing universal competencies in students to adapt to a dynamically changing professional environment; introducing mandatory advanced training for judges, legal practitioners to develop skills for using AI systems. Practical significance: the study results can be used to optimize and adapt the educational programs of law schools to the digital era requirements and to develop effective approaches to the AI application in legal practice and education, taking into account ethical aspects and potential risks.

Examining flight time, cognitive reflection, workload, stress and metacognition on decision making performance for pilots during flight simulation

Despite technological advancements, human decision errors still contribute to civil aviation accidents. This study investigated whether flight time, cognitive reflection, task-load, metacognition, and perceived stress predicted decision-making (DM) performance during two in-flight training simulations with 104 commercial pilots at Bogota International Airport. Hierarchical regression analysis revealed that the predictors accounted for 56% of the variance. Cognitive reflection, flight time and performance task load emerged as significant positive predictors. Cognitive reflection significantly moderated the relationship between flight time and DM performance, with pilots scoring lower on cognitive reflection showing improved DM with increased flight time, while controlling for performance task load. The study did not find significant relationships between stress metacognition and DM performance. The study emphasises the significance of advanced training methods in improving pilots’ DM, especially for those with low cognitive reflection. Future research should expand to multiple airlines, address gender balance, and incorporate direct measures of metacognitive monitoring.

ИСПРАВЛЕНИЕ И РЕСОЦИАЛИЗАЦИЯ: К ВОПРОСУ О КОНЦЕПТУАЛЬНОЙ ЯСНОСТИ

The article analyzes the problems of correction and re-socialization of convicts and former convicts. According to the author, many issues of correction and re-socialization remain open, there is a lack of conceptual clarity in understanding these processes. The conclusion is proposed for discussion that in the process of re-socialization of convicts and former convicts, two stages can be distinguished – social readaptation and internalization. It is proved that social readaptation as an adaptation of convicts and persons who have served their sentences to new or restored norms and values, social roles can be expressed in obtaining general or additional education, vocational training, advanced training, involvement in paid work, development of mutual assistance among convicts, restoration and (or) development of ties with relatives, friends, colleagues, etc. It is noted that at the second independent stage of re-socialization, the acquired experience, values are reinteriorized with the help of other people, social institutions: they are assimilated, incorporated into the inner world of individuals, turning into a kind of reflex. The article substantiates the position that the process of re-socialization should be implemented through individual social rehabilitation programs and act in accordance with international acts as a way to achieve the main goal – the reintegration of convicts into society. It is concluded that the focus of penal enforcement policy should not be on absolute theories with ideas of retribution, which represent «the criminal as a rational agent weighing the costs and benefits of crime,» but on correctional concepts that see the criminal as a person amenable to correction and in need of support and treatment.

Research on Practice Teaching Mode of Electrical Engineering based on Innovative Talent Cultivation

With the rapid development of science and technology, the electrical engineering field has an increasingly urgent need for high-quality talents with innovative spirit. In order to comply with this trend, it is particularly important to build a practical teaching mode of electrical engineering with innovative talent cultivation as the core. The purpose of this paper is to discuss the strategies of improving the innovation ability and practical ability of electrical engineering students by clarifying the teaching objectives, strengthening the combination of theory and practice, innovating the teaching mode, constructing advanced experimental and practical training platforms, deepening the cooperation between schools and enterprises, perfecting the ability assessment and feedback mechanism, constructing a diversified cultivation system, and establishing an effective incentive mechanism.

In Silico Insights: QSAR Modeling of TBK1 Kinase Inhibitors for Enhanced Drug Discovery.

TBK1, or TANK-binding kinase 1, is an enzyme that functions as a serine/threonine protein kinase. It plays a crucial role in various cellular processes, including the innate immune response to viruses, cell proliferation, apoptosis, autophagy, and antitumor immunity. Dysregulation of TBK1 activity can lead to autoimmune diseases, neurodegenerative disorders, and cancer. Due to its central role in these critical pathways, TBK1 is a significant focus of research for therapeutic drug development. In this paper, we explore data from the CAS Content Collection regarding TBK1 and its implication in a large assortment of diseases and disorders. With the demand for developing efficient TBK1 inhibitors being outlined, we focus on utilizing a machine learning approach for developing predictive models for TBK1 inhibition, derived from the fragment-functional analysis descriptors. Using the extensive CAS Content Collection, we assembled a training set of TBK1 inhibitors with experimentally measured IC50 values. We explored several machine learning techniques combined with various molecular descriptors to derive and select the best TBK1 inhibitor QSAR models. Certain significant structural alerts that potentially contribute to inhibition of TBK1 are outlined and discussed. The merit of the article stems from identifying the most adequate TBK1 QSAR models and subsequent successful development of advanced positive training data to facilitate and enhance drug discovery for an important therapeutic target such as TBK1 inhibitors, based on an extensive, wide-ranging set of scientific information provided by the CAS Content Collection.

The Two Word Test as a semantic benchmark for large language models

Large language models (LLMs) have shown remarkable abilities recently, including passing advanced professional exams and demanding benchmark tests. This performance has led many to suggest that they are close to achieving humanlike or “true” understanding of language, and even artificial general intelligence (AGI). Here, we provide a new open-source benchmark, the Two Word Test (TWT), that can assess semantic abilities of LLMs using two-word phrases in a task that can be performed relatively easily by humans without advanced training. Combining multiple words into a single concept is a fundamental linguistic and conceptual operation routinely performed by people. The test requires meaningfulness judgments of 1768 noun-noun combinations that have been rated as meaningful (e.g., baby boy) or as having low meaningfulness (e.g., goat sky) by human raters. This novel test differs from existing benchmarks that rely on logical reasoning, inference, puzzle-solving, or domain expertise. We provide versions of the task that probe meaningfulness ratings on a 0–4 scale as well as binary judgments. With both versions, we conducted a series of experiments using the TWT on GPT-4, GPT-3.5, Claude-3-Optus, and Gemini-1-Pro-001. Results demonstrated that, compared to humans, all models performed relatively poorly at rating meaningfulness of these phrases. GPT-3.5-turbo, Gemini-1.0-Pro-001 and GPT-4-turbo were also unable to make binary discriminations between sensible and nonsense phrases, with these models consistently judging nonsensical phrases as making sense. Claude-3-Opus made a substantial improvement in binary discrimination of combinatorial phrases but was still significantly worse than human performance. The TWT can be used to understand and assess the limitations of current LLMs, and potentially improve them. The test also reminds us that caution is warranted in attributing “true” or human-level understanding to LLMs based only on tests that are challenging for humans.

Increasing the theoretical and practical capacity of the Eastern Operating Domain by means of advanced train separation systems

Aim. Currently, the mainline railway network does not fully meet the market’s needs in terms of capacity, which is why every day JSC RZD is forced to reject 2 to 4% of applications for the transportation of goods across routes passing through limited-capacity railway infrastructure facilities. Increasing the practical capacity of railway lines by building additional tracks at stations and on open lines is unacceptably long and requires massive capital investments. Methods. It is proposed to solve the above problem by increasing the utilization of railway infrastructure by reducing the succession times and station operation times in the traffic schedule by deploying moving block and virtual coupling. This approach allows reducing capital investments up to 32 times and the duration of project implementation up to 8 times with a comparable capacity increase. The paper details the functionality of train separation technology and its technical parameters. Conclusion. The train separation technology has been deployed and is in operation on the Far Eastern, Trans-Baikal, East Siberian, and Krasnoyarsk Railways, branches of JSC RZD, that are part of the Eastern Operating Domain of JSC RZD network. By the end of 2023, the total length of track covered by the train separation solution was 5,734 km. Conclusion. In 2023, the lines of the Eastern Operating Domain handled almost 36 thousand pairs of trains with reduced spacing. The train separation technology also allows improving the safety and the level of digitalisation of the transportation process.

Application of a Standard Simulation Module as a Tool for Professional Development of Higher Education Teachers

The cycle of advanced training of the faculty on the basis of the Federal Accreditation Center of Perm State Medical University was created to form the professional competencies of students and the work functions of teachers. To introduce practical classes into the programs of clinical disciplines, a standard simulation module (SIM) was used, which is becoming a mandatory basis for the educational process at the University. The analysis of 106 SIM showed the use of simulation equipment and identified problems that are the basis for further development of the course.

Seaport infrastructure risk assessment for hazardous cargo operations using Bayesian networks

Seaport infrastructure requires considerable resources and time for a full recovery from accidents caused by hazardous cargo. Despite their severity, the risk to seaport infrastructure from hazardous cargo operations has been insufficiently explored. This study aims to fill that gap by examining the risks to seaport infrastructure from the complex effects of hazardous cargo operations. It draws on literature, incident reports, and expert consultations to identify comprehensive risk factors and their interconnections. The study employs expert judgments alongside logistic regression to develop Conditional Probability Tables (CPTs) and conducts a risk analysis using Bayesian networks (BN). Our findings indicate that, under typical operating conditions, fire and explosion, corrosion, and improper handling are the most significant contributors to seaport infrastructure risk with probabilities of 8.73 %, 5.88 %, and 5.61 % respectively. Inverse propagation indicates that the contribution of improper handling and corrosion is enhanced by 153 % and 96 % respectively towards the increased risk. A sensitivity analysis was carried out to pinpoint critical risk factors. Based on these insights, the study suggests practical measures like the use of tracking and monitoring systems along with third-party audits for effective handling, augmented and virtual reality for advanced training, and automation technology for reduced human roles to subside risks to seaport infrastructure and promote uninterrupted operations.

Assuring reclaimed water quality using a multi-barrier treatment train according to the new EU non-potable water reuse regulation

In this study, we evaluated the ability of various pilot-scale treatment train combinations to meet the microbial requirements of the new European non-potable water reuse regulation 2020/741. The study utilized non-disinfected secondary effluent from the wastewater treatment plant in Schweinfurt, Germany, as feedwater for two pilot-scale treatment trains. The first, a reference treatment train (Train A), consisted of filtration and UV disinfection as specified for reclaimed water class A in the EU regulation. The second, an advanced treatment train (Train B), included ceramic ultrafiltration (UF), ozonation, biological activated carbon filtration (BAC), and final UV disinfection. Based on a Monte Carlo simulation for Train A, the EU requirements for pathogen removal were not met when an average UV dose of 400-600 J m−2 was applied. This shortcoming was likely due to a moderate transmittance range (50–65 %), resulting in decreased UV fluence. These findings suggest that operational conditions for disinfection should be more clearly specified to ensure consistent pathogen inactivation both during validation and regular operation. In contrast, treatment train B successfully met the requirements of the EU regulations by reducing pathogens to below the detection limit. The UF membrane demonstrated a positive effect on the overall log reduction values (LRVs) throughout the water reclamation system. It also enhanced the efficiency of downstream processes, such as ozonation and UV disinfection, by lowering total suspended solids and turbidity. However, even without the UF membrane, treatment train B was still able to meet the pathogenic EU requirements for non-potable reuse applications. Furthermore, the study observed that the inclusion of biologically activated carbon (BAC) filtration requires a final disinfection step (e.g., UV disinfection) to prevent the potential occurrence of heterotrophic bacteria that proliferate in the BAC filter. For process validation it is recommended to use at least two different virus surrogates (MS2 and PhiX174), rather than just one or total coliphage as required in the EU regulation.

Personalized Support for Participants of the Educational Space in the Resource Model of Supporting Family of an Early Age Child

Introduction.The aim of the work was the theoretical and methodological substantiation, development and implementation of the resource model of early support to the family of a child with disorders in the education system. Methodology. The article presents the results of a long-term empirical study of families raising early aged children with disorders, describes the author’s resource approach to their psychological and pedagogical support. The importance of a personalized approach in the interaction of all participants in the educational space (support specialists, children and their parents) in the triad is emphasized. Results. The resource field of the family, including internal and external resources, is designated. A resource model of early assistance to a child with disabilities and his family is presented. Variable strategies of such a model have been developed and tested depending on the request and resource capabilities of parents: patronage, accompanying, advisory. The events and areas of activity that were part of the personalized support process are listed. Conclusions. The importance of training and advanced training of personnel for the implementation of early support associated with professional theoretical and practical deficiencies is emphasized.

WP6.9 - Essential Surgery Skills Course: A One Week Training Program to Prepare Surgeons for Humanitarian Deployment

Abstract Background Medical students, surgical trainees, and surgical faculty are increasingly interested in incorporating global surgery into their clinical practices and professional careers. However, many concerns remain about the preparation of surgeons for operating in resource-limited settings and their exposure to critical procedures such as cesarean sections, hysterectomies, or fracture reductions. In an attempt to address these concerns, academic institutions have developed advanced professional training programs for the global surgeon. Methods A six-day essential surgery skills conference was created at a large academic institution that provides trainees and surgeons with an overview of common surgical scenarios across orthopedics, urology, obstetrics, gynecology, general surgery, anesthesia and ultrasound in the form of didactics, simulations, and wet labs. Results 11 surgical trainees from four large academic institutions attended the essential surgery skills conference. Trainees attended sessions on point of care ultrasound, regional anesthesia, general anesthesia, hysterectomies, cesarean sections, post-partum hemorrhage, fracture reduction and fixation, ureteral injuries, and humanitarian deployment. A pre and post-test was administered. Improvement was noted in the trainees scores on the post-test in their knowledge of surgical subspecialty care. Trainees also reported feeling better prepared for humanitarian deployment. Conclusion Global surgery conferences can be designed to provide a networking and collaboration forum for improving access to surgical services worldwide. One-week predeparture conferences that discuss essential technical skills and relevant global surgery knowledge may better prepare surgeons to operate in resource-limited settings.

ASSESSMENT OF THE COMPETENCE APPROACH OF DENTISTS OF VARIOUS SPECIALTIES IN PROVIDING MEDICAL CARE TO PATIENTS WITH INCREASED TOOTH ABRASION

BACKGROUND. This study examines the main aspects of the competence-based approach of dentists in the treatment of patients with increased tooth erasure (TSL). TSL is a serious problem that can lead to various diseases of the oral cavity, as well as tooth loss. The competence-based approach of dentists in the treatment of patients with TSL plays a key role in the prevention and treatment of this disease. A study examining the knowledge of dentists in providing care to patients with TSL will reveal the level of training of specialists in this field. This will allow us to assess the need for additional training and advanced training of dentists for the effective treatment of patients with TSL. The results of the study can be used to improve the work of dental institutions and educational programs for dentists. This will improve the quality of dental care, improve the prognosis of the disease in patients with TSL and reduce the risk of complications. AIM. To evaluate the knowledge of dental care for patients with increased tooth abrasion among dentists of different specialties. MATERIALS AND METHODS: The research is based on the results of a sociological survey using the questionnaire method of 175 dentists of different specialties. The survey of doctors was conducted according to the questionnaire developed by the authors "Assessment of professional competence in the tactics of managing patients with TSL by dentists of different profiles." The questionnaire included general information about the respondent (age, specialty), questions related to TSL (concept, complaints, symptoms, prevention of TSL, treatment), assessment of the questionnaire procedure. RESULTS. The study demonstrated a relatively low competence approach of dentists of various specialties in the prevention and treatment of patients with TSL. CONCLUSION: Dentists have demonstrated a low competence approach to the prevention and treatment of TSL. The lack of interaction between dentists in the treatment of TSL was determined. The results of the conducted sociological study, along with the high prevalence of TSL, determined the need to develop clinical recommendations for the prevention and treatment of TSL.

Teamwork Training: Practicing Skills of Primary Resuscitation and Stabilization of a Newborn in the Delivery Room

The quality and safety of medical care in modern medicine are determined by the level of formation of team competence of clinical specialists. The article describes 8 years of experience in the formation of good practice and interaction of an educational institution for advanced training of medical workers with city medical institutions of the obstetric profile and obstetric departments that are part of the FAP and the Central District Hospital of the Omsk Region using the example of simulation trainings of team interaction in primary resuscitation of a newborn in the delivery room.

Optimization of the Use of the Educational Platform "Dimedus" in the Work of the Simulation Center

The paper presents the results of using the digital educational platform "Dimedus" in the process of teaching students of the medical institute in professional retraining and advanced training programs for doctors and nurses. Proposals have been formulated for various options for the Dimedus configuration.

Enfermería en práctica avanzada a la vanguardia de la atención sanitaria

Advanced practice nursing (APN) is a category of nursing characterized by advanced training and autonomous clinical practice. Advanced practice nurses have a wide range of competencies, including diagnosing and treating diseases, prescribing medications, and case management. The objective: Analyze Advanced Practice Nursing at the forefront of health care. Material and method: A documentary investigation was carried out, through a systematic review in a first phase, analysis of the state of the art and then systematization according to descriptors, leaving a total of 35 articles for analysis, of which 6 come from Scopus and web of Science. Conclusions As a result of the review and analysis, three thematic areas emerged, which allowed the development of the work: Thematic area 1 (AT1): Nursing: Thematic area 2 (AT2): Advanced Practice Nursing and evolution. Thematic area 3 (AT3): Well-being and the health system. The research allowed the appreciation of the progress of Advanced Practice Nursing, as well as its challenges for its implementation in health systems, with the purpose of providing quality services to users of the health system.

Evaluation of the Effectiveness of Training Using Simulation Equipment and Simulators for Midwives of Maternity Hospitals

For the purpose of professional growth and assignment of qualification categories in the profile "Obstetrics" additional professional education (advanced training programs and professional retraining programs) and training in simulation centers are included. The results of the effectiveness of the training of midwives of maternity hospitals in the specialty "Obstetrics" on the topic "Development of practical skills of the algorithm of actions in the diagnosis of moderate and severe preeclampsia in a pregnant woman and a woman in labor in a maternity hospital" in the federal accreditation center of the Far Eastern State Medical University are presented.

Enhancing Human Resources Competency in a Defense University: Strategies and Best Practices

This systematic literature review examines strategies and best practices for enhancing human resources (HR) competencies within defense university environments, focusing on studies published between 2010 and 2023. Recognizing the distinct challenges faced by military educational institutions, the review identifies key themes and methodologies that contribute to effective HR development, including competency alignment with military culture, the integration of advanced training technologies, and leadership development frameworks. A total of 43 articles were analyzed from reputable databases, including Google Scholar, PubMed, Scopus, and Web of Science, with a particular emphasis on research addressing competency frameworks, leadership training programs, and performance evaluation in military contexts. The findings underscore the importance of tailored competency models that adhere to military standards, the adoption of cutting-edge training technologies, and the promotion of continuous professional development. Furthermore, the review highlights successful case studies that demonstrate significant improvements in HR competencies within defense universities. These insights provide a valuable guide for institutions seeking to enhance their HR capabilities. The study concludes by offering recommendations for future research, particularly in exploring innovative competency models, the advancement of training technologies, and leadership development strategies that meet the evolving needs of military organizations.