Initial Adjustment Research Articles

The influence of procedural volume on short-term outcomes for robotic pancreatoduodenectomy—a cohort study and a learning curve analysis

BackgroundAn increasing number of robotic pancreatoduodenectomies (RPD) are reported, however, questions remain on the number of procedures needed for gaining technical proficiency in RPD. Therefore, we aimed to assess the influence of procedure volume on short-term RPD outcomes and assess the learning curve effect.MethodsA retrospective review of consecutive RPD cases was undertaken. Non-adjusted cumulative sum (CUSUM) analysis was performed to identify the procedure volume threshold, following which before-threshold and after-threshold outcomes were compared.ResultsSince May 2017, 60 patients had undergone an RPD at our institution. The median operative time was 360 min (IQR 302.25–442 min). CUSUM analysis of operative time identified 21 cases as proficiency threshold, indicated by curve inflexion. Median operative time was significantly shorter after the threshold of 21 cases (470 vs 320 min, p < 0.001). No significant difference was found between before- and after-threshold groups in major Clavien-Dindo complications (23.8 vs 25.6%, p = 0.876).ConclusionsA decrease in operative time after 21 RPD cases suggests a threshold of technical proficiency potentially associated with an initial adjustment to new instrumentation, port placement and standardisation of operative step sequence. RPD can be safely performed by surgeons with prior laparoscopic surgery experience.

What Are the Psychotherapy Needs of Incarcerated Individuals?

What Are the Psychotherapy Needs of Incarcerated Individuals?

Endured and prevailed: a phenomenological study of doctors’ first year of clinical practice

ContextThe challenging nature of the transition from medical student to doctor is highlighted by the associated negative consequences to new doctors’ mental health and wellbeing. Enhanced understanding of the lived experience of recent medical graduates as they move through the stages of transition over the first year of practice can inform interventions to ease the difficulties encountered.MethodsUsing interpretative phenomenological analysis (IPA), a novel approach to this topic, we explored the lived experience of transition from student to doctor over the first year of practice after graduation. Twelve new graduates were purposively recruited. We conducted semi-structured interviews at the end of their first year of practice with respect to their experience over the first year.ResultsThe experience of transition was characterised by overlapping temporal stages. Participants’ initial adjustment period was characterised by shock, coping and stabilisation. A phase of development followed, with growth in confidence and a focus on self-care. Adversity was experienced in the form of interprofessional tensions, overwork, isolation and mistreatment. Finally, a period of reflection and rationalisation marked the end of the first year.DiscussionFollowing initial anxiety regarding competence and performance, participants’ experience of transition was predominantly influenced by cultural, relational and contextual aspects of clinical practice. Solutions to ease this challenging time include stage-specific transitional interventions, curricular change at both undergraduate and postgraduate levels and a re-evaluation of the clinical learning environment to mitigate the difficulties endured.

Large‐Eddy Simulation of Sea Spray Impacts on Fluxes in the High‐Wind Boundary Layer

AbstractThe exchange of enthalpy and momentum at the air‐sea interface is an important process in tropical cyclone (TC) development and intensification, and the effects of sea spray have long been uncertain, particularly at high wind speeds. Here we use a coupled large‐eddy simulation and Lagrangian cloud model to run high‐resolution simulations of an idealized, spray‐laden TC boundary layer. Simulations are performed with and without spray generation, using a realistic sea spray generation function over wind speeds relevant to TCs. We show that CD is not affected by spray droplets at 10‐m wind speeds up to 48 m s−1. CE and CH are modified during an initial transient adjustment stage, but quickly relax back to their unladen values due to surface layer saturation. This relaxation occurs faster for higher winds, because the increased spray concentration more rapidly saturates the surface layer.

Clinical discussion on methimazole in the treatment of hyperthyroidism

Methimazole is the most commonly used medication for hyperthyroidism with good effects and little adverse reactions. However, improper selection of initial dose will affect the efficacy, such as excessive dose is proven to various adverse reactions; insufficient dose can hardly achieve desired efficacy. Based on the literature and personal clinical experience, the author discusses the following clinical issues related to methimazole in the treatment of hyperthyroidism, including the selection of initial dose, dose adjustment and withdrawal of methimazole, drug therapy for patients with liver function injury, and management strategies for methimazole-related adverse reactions.

Spherical Formation Tracking Control of Non-Holonomic UAVs with State Constraints and Time Delays

This paper addresses a novel spherical formation tracking control problem of multiple UAVs with time-varying delays in the directed communication network, where the dynamics of each UAV is non-holonomic and in the presence of spatiotemporal flowfields. The state constraints (that is, position and velocity constraints) are derived from our previous differential geometry method and the F–S formulas. The state constraints and time delays in the directed communication network bring many difficulties to controller design. To this end, a virtual-structure-like design is given to achieve a formation with delayed information by using Lyapunov–Krasovskii functionals, and then proposing a barrier Lyapunov function for the satisfaction of state constraints to design a novel spherical formation tracking algorithm. The general assumption of the rate of change of time-varying delays, and a certain initial position and velocity adjustment range are given. Simulation results show the feasibility and effectiveness of the proposed algorithm.

REAL-TIME TOMATO LEAF DISEASE CLASSIFICATION USING CONVOLUTIONAL NEURAL NETWORK

Like most plant diseases, tomato leaf disease has physical symptoms. The currently accepted technique is for a trained plant pathologist to identify the condition through visual inspection of affected plant leaves and stems. But due to the manual process, the disease identification time and accuracy have always been questionable facts, making the problem a great application area for Computer-aided diagnostic techniques. Due to the durability and cutting-edge performance, the convolutional neural network (CNN) has been proposed in this study for the real-time classification of tomato leaf disease. The picture data used in this study for tomato leaves came from Plant Village databases. The models employed in this study were trained and tested using 16011 images from original and augmented datasets. The results are then applied to create a real-time system for mobile applications. The initial adjustment with the CNN architecture is proposed to get higher accuracy. A step-by-step systematic approach to parameter tuning is also proposed to improve the system’s performance. The proposed methods show maximum prediction accuracies of 98.00%, and 99.04% are achieved.

A Machine Learning-Based Initial Difficulty Level Adjustment Method for Balance Exercise on a Trunk Rehabilitation Robot.

Trunk rehabilitation exercises such as those for remediating core stability can help improve the seated balance of patients with weakness or loss of proprioception caused by diseases such as stroke, and aid the recovery of other functions such as gait. However, there has not yet been any reported method for automatically determining the parameters that define exercise difficulty on a trunk rehabilitation robot (TRR) based on data such as the patient's demographic information, balancing ability, and training sequence, etc. We have proposed a machine learning (ML)-based difficulty adjustment method to determine an appropriate virtual damping gain (Dvirtual) of the controller for the TRR's unstable training mode. Training data for the proposed system is obtained from 37 healthy young adults, and the trained ML model thus obtained is tested through experiments with a separate population of 25 healthy young adults. The leave-one-out cross validation results (37 subjects) from the training group for validation of the designed ML model showed 80.90% average accuracy (R2 score) for using the given information to predict the desired difficulty levels, which are represented by the level of balance performance quantified as Mean Velocity Displacement (MVD) of the center of pressure. Statistical analysis (Repeated measures analysis of variance) of subject performance also showed that ground truth difficulty levels from the training data and predicted difficulty levels did not differ significantly under any of the three exercise modes used in this study (Hard, Medium, and Easy), and the standard deviations were reduced by 16.39, 41.39, and 25.68%, respectively. Moreover, the Planar Deviation (PD) of the center of pressure, which was not the target parameter here, also showed results similar to the MVD, which indicates that the predicted Dvirtual affected the difficulty level of balance performance. Therefore, the proposed ML model-based difficulty adjustment method has potential for use with people who have varied balancing abilities.

633: LABORATORY MONITORING DURING THE FIRST 24 HOURS OF PEDIATRIC EXTRACORPOREAL MEMBRANE OXYGENATION

Introduction: Pediatric extracorporeal membrane oxygenation (ECMO) is a potentially lifesaving intervention for cardiopulmonary failure. Anticoagulation protocols are necessary to prevent complications. Limited data exist on how traditional coagulation tests correlate with early bleeding complications in this population. This study evaluates pre-and-post cannulation coagulation parameters during the first 24 hours of ECMO initiation in pediatric patients. Methods: This is an IRB approved retrospective cohort study. Included are 116 children that received ECMO at our academic institution from January 2017 to March 2022. Children with no hematologic events and acute bleeding events were compared. Routine pre-and-post-cannulation coagulation profiles in the initial 24-hours of ECMO were evaluated. Data was analyzed between groups using Mann Whitney U test with SPSS Statistics version 10.0. Results: Patients were grouped into “no event” (N=88) and “bleed event” (N=28). Average age was 43.3 months. Children with major bleeding events in the first 24 hours of ECMO had a longer time until target ACT was reached, 5 vs 3.5 hours (p=0.003). These patients also had more prolonged post-cannulation prothrombin time (PT), 19.2 vs 16.1 seconds (p=0.002), and international normalized ratio (INR), 1.9 vs 1.6 (p=0.002). Also, bleeding patients had lower pre-and-post-cannulation fibrinogen levels, 135 vs 229 (p=0.008) and 106.5 vs 181 (p=< 0.001), respectively, and lower post-cannulation platelet counts, 82.5 vs 109.5 (p=0.035). No differences were seen for the initial ACT, heparin dose, baseline platelet count, or pre-and-post hemoglobin and activated partial thromboplastin time. Conclusions: Major bleeding events occurred within 24 hours in approximately 24% of our cohort. Identifying risk factors for bleeding may aid in reducing morbidity and mortality. Our data shows that consideration of fibrinogen levels, platelet count, PT and ACT may help to identify pediatric patients at risk of early bleeding during ECMO. Attention to these baseline and immediate post-cannulation laboratory values may be important to determine initial bolus dosing and adjustment of anticoagulation in these patients. Continued multi-center collaboration and incorporation of other coagulation studies, like anti-FXa and thromboelastography, is needed.

The association between UGT1A1 polymorphisms and treatment toxicities of liposomal irinotecan

Initial dose adjustment is recommended for patients with known UGT1A1∗28 homozygosity for both conventional irinotecan and liposomal irinotecan (nal-IRI). A recent population pharmacokinetic (PK) study showed that Asian patients had a lower prevalence of UGT1A1∗28 homozygosity but a significantly higher maximum blood concentration of SN-38 (SN-38 Cmax) and a higher incidence of grade ≥3 neutropenia after nal-IRI administration than Caucasian patients. The current study investigated the association of UGT1A1 polymorphisms, including the Asian prevalent UGT1A1∗6, PK and toxicities of nal-IRI-based therapy in the Asian population. A total of 162 patients with nal-IRI-based therapy and available UGT1A1∗6 and UGT1A1∗28 genotyping were included, with 82 Asian patients from six previous phase I or II studies of nal-IRI (cohort 1) and another 80 patients with nal-IRI+ 5-fluorouracil/leucovorin every 2 weeks as real-world practice in a single institute in Taiwan (cohort 2). The frequency of UGT1A1∗6 or UGT1A1∗28 homozygosity/compound heterozygosity was 9.3%, with UGT1A1∗6/∗6 in 2.5%, UGT1A1∗28/∗28 in 1.9% and UGT1A1∗6/∗28 in 4.9%. Among the 53 patients in cohort 1 with available PK data, all 7 patients with homozygosity/compound heterozygosity harbored UGT1A1∗6 and had a significantly higher level of median dose-normalized area under the concentration-time curve (AUC) and Cmax of SN-38 than those with single heterozygosity/wild type. Of the entire study population, the incidence of grade ≥3 neutropenia and diarrhea was significantly higher in patients with homozygosity/compound heterozygosity than in those with single heterozygosity/wild type, 73.3% versus 38.1% (P= 0.012, Fisher's exact test) and 33.3% versus 9.5% (P= 0.018, Fisher's exact test), respectively. The results suggest that the recommendation of a lower starting dose of nal-IRI for patients with UGT1A1∗28 homozygosity should be extended to include patients with UGT1A1∗6 homozygosity/compound heterozygosity.

MINCE

Context. In recent years, Galactic archaeology has become a particularly vibrant field of astronomy, with its main focus set on the oldest stars of our Galaxy. In most cases, these stars have been identified as the most metal-poor. However, the struggle to find these ancient fossils has produced an important bias in the observations – in particular, the intermediate metal-poor stars (−2.5 &lt; [Fe/H] &lt; −1.5) have been frequently overlooked. The missing information has consequences for the precise study of the chemical enrichment of our Galaxy, in particular for what concerns neutron capture elements and it will be only partially covered by future multi object spectroscopic surveys such as WEAVE and 4MOST. Aims. Measuring at Intermediate Metallicity Neutron Capture Elements (MINCE) is gathering the first high-quality spectra (high signal-to-noise ratio, S/N, and high resolution) for several hundreds of bright and metal-poor stars, mainly located in our Galactic halo. Methods. We compiled our selection mainly on the basis of Gaia data and determined the stellar atmospheres of our sample and the chemical abundances of each star. Results. In this paper, we present the first sample of 59 spectra of 46 stars. We measured the radial velocities and computed the Galactic orbits for all stars. We found that 8 stars belong to the thin disc, 15 to disrupted satellites, and the remaining cannot be associated to the mentioned structures, and we call them halo stars. For 33 of these stars, we provide abundances for the elements up to zinc. We also show the chemical evolution results for eleven chemical elements, based on recent models. Conclusions. Our observational strategy of using multiple telescopes and spectrographs to acquire high S/N and high-resolution spectra for intermediate-metallicity stars has proven to be very efficient, since the present sample was acquired over only about one year of observations. Finally, our target selection strategy, after an initial adjustment, proved satisfactory for our purposes.

Development and evaluation of a psychological adjustment communication system for adolescents with polycystic ovary syndrome at a high risk of depression: A mixed-method study protocol.

Depression is a serious psychological disorder that causes substantial psychological and physical suffering in adolescents, contributes to over 50% of suicide attempts, and affects the health status and psychosocial functioning of 25% of the adult population. The prevalence of polycystic ovary syndrome (PCOS) in adolescents is 5.6∼11.04%, and the prevalence of depression in adolescents with PCOS is as high as 50-60%. Depression seriously affects the rehabilitation and quality of life of adolescents with PCOS. In this study, we present a protocol for a mixed-method study to develop and evaluate the effectiveness of a psychological adjustment communication system for reducing the prevalence of depression among adolescents with PCOS who are at a high risk of depression in China. This study utilizes social support theory to develop a mobile phone-based intervention for adolescents with PCOS at a high risk of depression. This sequential exploratory mixed-method study consists of four consecutive phases. In the first phase, we will review the literature to understand the disease experience and needs of adolescents with PCOS to construct an initial psychological adjustment communication system. In the second phase, researchers will interview patients and their parents using purposeful sampling methods and semi-structured interviews to appropriately modify the psychological adjustment communication system. In the third phase, the Delphi method will be used to improve the psychological adjustment communication system. The fourth phase will employ a quantitative approach using a before-and-after design to measure the effectiveness of the system. The results of this study will indicate the effectiveness of the psychological adjustment communication system in adolescents with PCOS who are at a high risk of depression. ChiCTR2100050123.

ODP193 Endocrinologists’ Experiences with Telehealth: Organizational and Logistical Issues with Implementation

Abstract Objective Telehealth use rapidly increased during the COVID-19 public health emergency. While this preserved safe access to care, there was insufficient time to optimize telehealth implementation for its clinical users. We sought to understand endocrinologists’ experiences with synchronous telehealth to identify factors that influence successful implementation and can promote sustained use. Methods We conducted semi-structured qualitative interviews with a purposive sample of 26 US endocrinologists. We asked about their experiences with telehealth, administrative and organizational factors, and technology-related issues. We also asked for recommendations for supporting clinicians’ continued telehealth use post-pandemic. We used a directed content analysis and rapid coding approach to identify factors affecting telehealth experiences. We noticed close alignment with and mapped findings to the human-organization-technology fit (HOT-fit) framework, which recognizes human, organizational, and technological factors as common elements influencing health information system implementation. Results We identified the following clinician, organizational, and technology factors from the HOT-fit framework that influenced successful use of telehealth.1) Clinician Factors: Negative attitudes towards telehealth, including resistance towards the technology or concerns that older patients struggle with it, were initial barriers to uptake. However, attitudes were malleable over time. After initial adjustment and training, most clinicians reported enjoying and seeing value in telehealth, and planned to continue using a combination of in-person and telehealth. Although many clinicians voiced fears of missing clinical issues, none reported overlooking findings that would change treatment plans. Clinicians found both benefits and burdens associated with telehealth; flexible scheduling improved work-life balance but some also noted increasing workload.2) Organizational Factors: Clinicians felt most supported in organizations that provided training and technology support for both patients and themselves, attending to technical, logistical, and clinical needs. Telehealth was less stressful when support staff were reallocated to streamline workflow with ancillary tasks. Scheduling practices affected clinician experience: mixed clinics with in-person and telehealth visits combined with overbooking often exacerbated workflow challenges. Payment policies and parity of telehealth and in-person visits were key factors encouraging clinicians’ continued telehealth use.3) Technology factors. Almost all clinicians preferred video visits over those by phone. However, clinicians sought improvements in usability and reliability of platforms for video visits and data sharing. Robust IT support in real time reduced the burden associated with using visit time to perform tech support. Conclusions Favorable clinician perceptions of telehealth are critical for sustained use. Clinicians initially approached telehealth at varied stages of acceptance and comfort. Perceptions of telehealth can improve with personal experience and organizational efforts that address individual training needs, adequate support staffing, tech support, and efficient workflow. Further telehealth implementation strategies by policymakers and health care leaders in endocrinology should address these aspects affecting clinician experience to maximize future success in telehealth adoption and use post-pandemic. Presentation: No date and time listed

Sensitive response mechanism of ARGs and MGEs to initial designed temperature during swine manure and food waste co-composting

The rapid aerobic composting process has been used to reduce organic wastes, but the associated risks of antibiotic resistance genes (ARGs) need to evaluate in an efficient way. The primary objective of this work was to explore the underlying mechanism of initial adjustment in composting temperature on the variation of ARGs, mobile genetic elements (MGEs), and microbial composition during co-composting. The co-composting was initially externally heated (T2) for 5 days. The results showed that ARGs abundance in conventional composting (T1) was reduced by 49.36%, while multidrug was enriched by 86.16% after a period of 30 days. While in T2 ARGs were removed by 79.46% particularly the fraction of sulfonamide, multidrug, and vancomycin resistance genes were >90% without rebounding of any ARGs. Whereas, MGEs were reduced by 68.12% and 93.62% in T1 and T2, while the half-lives of ARGs and MGEs were lower in T2 compared to T1 (86.3%,86.7%). T2 also affected the metabolism function by regulating carbohydrate metabolism (9.62–10.39%) and amino acid metabolism (9.92–10.93%). Apart from this, the potential human pathogenic bacteria Pseudomonas was reduced by 90.6% in T2 and only 32.9% in T1 respectively. Network analysis showed that Ureibacillus, Weissella, Corynebacterium, Escherichia-Shigella, Acinetobacter were the main host of multiple genes. Structural equation models exhibited that bacterial communities were mainly responsible for the enrichment of ARGs in T1, whereas, it was directly affected by MGEs in T2. Similarly, ARGs variation was directly related to composting temperature. With this simple strategy, ARGs associated risk can be significantly reduced in composting.

Parental Preferences Surrounding Timing and Content of Consent Conversations for Clinical Germline Genetic Testing Following a Child's New Cancer Diagnosis.

Clinical genomic testing is increasingly being used to direct pediatric cancer care. Many centers are interested in offering testing of tumors and paired germline tissues at or near the time of cancer diagnosis. We conducted this study to better understand parent preferences surrounding timing and content of consent conversations for clinical germline genetic testing of their children with cancer as a part of real-time cancer care. A seven-question survey developed by the Division of Cancer Predisposition and collaborators at St Jude Children's Research Hospital (St Jude) was distributed to members of the St Jude Patient Family Advisory Council, which included parents of childhood cancer survivors and bereaved parents whose children with cancer had died. Parents were asked to provide free text comments after each question. Qualitative methods were used to derive codes from parent comments, and survey results were depicted using descriptive statistics. The survey was completed by 172 parents. Ninety-three (54%) endorsed an approach for consent conversations ≥ 1 month after cancer diagnosis, whereas 58 (34%) endorsed an approach at 1-2 weeks and 21 (12%) at 1-2 days. Needing time to adjust to a new or relapsed cancer diagnosis and feeling overwhelmed were frequent themes; however, parents acknowledged the urgency and importance of testing. Parents desired testing of as many cancer-related genes as possible, with clinical utility the most important factor for proceeding with testing. Most parents (75%) desired germline results to be disclosed in person, preferably by a genetic counselor. Parents described urgency and benefits associated with germline testing, but desired flexibility in timing to allow for initial adjustment after their child's cancer diagnosis.

The implications of borderline personality features for jail inmates' institutional misconduct and treatment-seeking.

Borderline personality disorder (BPD) is common in jails and prisons. In a sample of 506 jail inmates (30% female), we examined whether BPD symptoms assessed upon incarceration predict subsequent institutional misconduct and treatment-seeking. BPD features modestly predicted occurrence (vs. nonoccurrence) of institutional misconduct. Importantly, BPD did not predict the number of institutional misconduct incidents. That is, BPD was not associated with frequent, repeated difficulties in institutional adjustment. Consistent with previous research showing a relationship between BPD and past treatment-seeking in clinical and community samples, jail inmates' BPD features significantly predicted subsequent requests for treatment. Regarding specific types of treatment, the relationship held for substance abuse programs and forensic mental health services but not for psychoeducational services or support groups. There were very few moderators of the link between BPD and subsequent institutional misconduct and treatment-seeking. Most of the observed relationships held across sex, race, and age. Findings of the study indicate that jail staff and clinicians must learn to distinguish between initial adjustment problems and frequent misconduct among inmates high in BPD to facilitate their adjustment. The study further highlights the need for BPD-relevant treatments and services in jails. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Role of hazard information in the adoption of seismic hazard adjustments: Information treatment experiment in Beijing

Knowledge of local earthquake hazards is essential to encourage earthquake preparedness. However, within communities lacking hazard information and social norms that encourage earthquake preparedness, convincing individuals to embark on earthquake preparedness is a great challenge. This study aims to examine the role of hazard information in the adoption of hazard adjustment for an earthquake disaster. An information experiment was conducted on 273 residents in a community of the Haidian District in Beijing. The respondents were questioned about their knowledge and adopted hazard adjustments for earthquakes, and the source of information they received about Beijing seismic hazard. Next, the respondents were given an information treatment by presenting an information card describing the seismic hazard in Beijing, and then assessing their intention to further hazard adjustment adoption after reading the information. Results showed that respondents with prior knowledge of the seismic hazard in Beijing presented a significantly higher initial adjustment adoption; however, this difference narrows significantly after the information treatment as the respondents without previous knowledge increased their intention for hazard adjustment adoption. This change in hazard adjustment adoption intention was also attributed to coping appraisal and social influence. These findings suggest that effective and affordable coping measures, and social information about others’ decision-making, should be communicated in hazard information, to improve earthquake preparedness. Although the generalisability issues need to be noted, this study provides a basis for evaluating and improving of earthquake preparedness in similar communities in the Haidian District of Beijing and inspires future exploration amongst larger population demographics.

RoCS: Robotic Curriculum for young Surgeons

Robotic-assisted procedures gain increasing acceptance for daily surgical routine. However, structured training programs are designed for surgeons with high expertise. Hence, a comprehensive training curriculum was established to ensure a basic competence in robotic abdominal surgery for young surgeons during their residency. The aim of the current work is to propose a feasible and effective training concept. The development process of this training curriculum is based on a comprehensive literature review which led to the concept of “robotic curriculum for young surgeons” (RoCS). It was implemented in the daily routine of a German university hospital starting in 2020. The robotic assessment questionnaire (RAQ) was used for electronic data collection. After the initial phase adjustments, it led to an improvement of the initial version of the curriculum. RoCS is a multimodal training program containing basic training through assistance at the operation table during robotic-assisted operations and basic console training. Key elements are the robotic team time-out (rTTO), perioperative process standardization including feasible personnel scheduling and useful procedure clustering into organ systems, procedural steps and procedural step complexity. Evaluation of standardized communication, performance assessment, patient factors and individual overall workload using NASA Task Load Index is realizable. Flexibility and adaptability to internal organization processes of surgical departments are the main advantages of the concept. RoCS is a strong training tool to meet the specific needs of young surgeons and evaluate their learning success of robotic procedural training. Furthermore, comparison within the different robotic systems should be considered. Further studies are needed to validate a multicenter concept design.

Assessment of the Quality of Drug Therapy in Patients with Stable Coronary Artery Disease in the Second Stage of the ALIGN Study

Aim. To assess adjusted pharmacotherapy for prescribing drugs of the main classes, according to clinical guidelines, and achieving target levels of lowdensity lipoprotein cholesterol (LDL-C) in patients with stable coronary heart disease (CHD).Material and methods. Of the 73 patients included in the ALIGN study, 64 patients (53 males and 11 females; mean age 68,2±9,4 years) with stable coronary artery disease attended a second visit (3 months after the initial treatment adjustment). Prescribed drug therapy, its compliance with clinical guidelines, achievement of lipid profile and blood pressure (BP) targets were studied in all patients.Results. An increase in the frequency of taking beta-blockers (p=0.002), lipid-lowering drugs (p=0.008) by patients was found during the second visit. The proportion of patients taking all 4 groups of drugs according to clinical guidelines (statins, antiplatelet agents, beta-blockers, angiotensinconverting enzyme inhibitors / angiotensin II receptor blockers) increased from 44% to 65.5% (p&lt;0.001) after correction of therapy, as well as an increase in the proportion of patients taking 1 antianginal drug in the presence of exertional angina from 75% to 89% (p&lt;0.001) was found. About 90% of hypertensive patients achieved the target level of systolic blood pressure (p&lt;0.001). Achievement of the target level of cholesterol low density lipoprotein (&lt;1.8 mmol/l) during the second visit was found in half of the patients (p=0.004).Conclusion. Despite the initial correction of drug therapy by the staff of the cardiology department, the prescribed treatment for patients with stable coronary artery disease did not in all cases comply with clinical guidelines due to insufficient adherence of doctors and insufficient adherence of patients to prescribed medical recommendations.Working group of the register PROFILE: Voronina V. P., Dmitrieva N. A., Komkova N. A., Zagrebelny A.V., Kutishenko N.P., Lerman O.V., Lukina Yu. V., Tolpygina S.N., Martsevich S.Yu.

Enhanced compatibility of teaching programs in pedagogical sectors with the new general education program

To meet the requirements of the new general education program, the Ministry of Education and Training as well as schools and educational institution has taken many measures to improve the adaptive capacity of teachers. As one of the universities offering pedagogical training - additional human resources for the new General Education Program - Tay Nguyen University has taken many measures to improve the quality of training in various fields of Pedagogy. In general, the pedagogical training programs of the University have made initial adjustments to meet the requirements of educational innovation. However, there are still shortcomings that need improving the compatibility of the training program with the new General Education Program.