International Specialists Research Articles

Development of an automated process for monitoring of amiodarone treatment

Abstract Background Amiodarone treatment requires repeated laboratory evaluations of thyroid and liver function due to risk of side effects during long-term administration. Robotic process automation (RPA) represents the use of software robots to automate repetitive and routine tasks typically performed by humans. Purpose We aimed to develop an RPA using a diagnostic classification algorithm and clinical support system for follow-up of amiodarone treatment. Methods Based on international guidelines and clinical specialist advisory we constructed an RPA which was studied in a test environment in parallel with routine amiodarone treatment. Expert advice was integrated through a series of collaborative workshops, ensuring alignment of the algorithm with current best practices in thyroid and liver disease management. The RPA provided recommendations on the time interval to next laboratory testing and suggestions for patient management to the physician, who was serving as a human-in-the-loop responsible for clinical decisions. Results After iterative improvements the RPA was evaluated against physician orders (n=390 paired orders) without technical failures. The recommended time interval to next follow-up was (mean ± SD) 4.5 ± 2.4 vs. 3.1 ± 1.4 months for RPA vs. physician (p<0.0001). While normal laboratory findings resulted in recommended follow-up in 6 months by the RPA (72.2%) this was only ordered in 9.9% by the physician (Figure). Physicians’ orders clustered between 3-4 months (58.5%). All patients diagnosed with new side effects (n=12) were detected and communicated correctly by the RPA, whereas only 8 were correctly detected and responded to by the physician (Table). Conclusions An automated process constitutes a reliable alternative to the current fully manual management of amiodarone follow-up. It may reduce manual labour, frequency of laboratory testing and detect side effects with increased precision, thereby reducing costs and enhancing patient value. While the RPA shows promise, further research is needed to explore its adaptability to other treatment scenarios.

Sustainability-national and international initiatives in intensive care and emergency medicine

Climate change with global warming, natural disasters, species extinction and soil erosion is doubly relevant for medicine: On the one hand, heat waves, floods and other natural disasters lead to new disease patterns to which healthcare systems must adapt. On the other hand, the global healthcare system itself contributes to these effects, as it is estimated that the CO2 footprint of all healthcare facilities accounts for around 5% of global greenhouse gas emissions. National and international initiatives to promote sustainability concepts in intensive care and emergency medicine. Research on homepages of national and international (specialist) societies dealing with intensive and emergency care medicine and corresponding PubMed search (sustainability and climate change and emergency or intensive care medicine). Six of the 12national specialist societies surveyed have taken initiatives on sustainability, notable among them the initiative of Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) for anew registration of the S1guideline "Sustainability in intensive care and emergency medicine". On the international scene, the activities of the Australian and New Zealand Intensive Care Society (ANZICS) with numerous publications on the topic of sustainability in intensive care medicine and the practical guide "Abeginners guide to sustainability in intensive care medicine" as well as the European Society of Anaesthesiology and Intensive Care (ESAIC) with aconsensus paper on sustainability should be highlighted. At the national level, initiatives on sustainability (guidelines, working groups, forums) are emerging and are attracting increasing attention and activity. The umbrella organization of German Intensive Care Medicine, the Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), has so far shown no (discernible) activity; there is an urgent need for action here, and health policy and the German Medical Association should also become (even) more involved in reducing the CO2 footprint in the healthcare sector. Internationally, there are anumber of societies and institutions that are promoting the topic of "sustainability", although astronger focus on the area of intensive care and emergency medicine would also be desirable here.

Are Small Molecules Effective in Treating Inflammatory Pouch Disorders Following Ileal Pouch-Anal Anastomosis for Ulcerative Colitis? Here Is Where We Stand.

Ulcerative colitis (UC) management encompasses conventional and advanced treatments, including biological therapy and small molecules. Surgery, particularly in the form of ileal pouch-anal anastomosis (IPAA), is indicated in cases of refractory/severe disease. IPAA can lead to acute complications (e.g., acute pouchitis) as well as late complications, including chronic inflammatory disorders of the pouch. Chronic pouchitis, including the antibiotic-dependent (CADP) and antibiotic-refractory (CARP) forms, represents a significant and current therapeutic challenge due to the substantial need for evidence regarding viable treatment options. Biological therapies have shown promising results, with infliximab, adalimumab, ustekinumab, and vedolizumab demonstrating some efficacy in chronic pouchitis; however, robust randomized clinical trials are only available for vedolizumab. This narrative review focuses on the evidence concerning small molecules in chronic pouchitis, specifically Janus kinase (JAK) inhibitors and sphingosine-1-phosphate receptor (S1P-R) modulators. According to the preliminary studies and reports, Tofacitinib shows a potential effectiveness in CARP. Upadacitinib presents variable outcomes from the case series, necessitating further evaluation. Filgotinib and ozanimod demonstrate anecdotal efficacy. This review underscores the need for high-quality studies and real-world registries to develop robust guidelines for advanced therapies in post-IPAA inflammatory disorders, supported by vigilant clinical monitoring and ongoing education from international IBD specialist societies.

Development of Extemporaneous Compounding as an Initiating Factor in the Transformation of Pharmaceutical Education: International Experience and Current Trends

INTRODUCTION. Currently, stakeholders across the Russian medical and pharmaceutical community are focusing on the restoration of national pharmaceutical compounding. The Russian pharmaceutical compounding market, with its great potential for growth, requires highly qualified professionals able to ensure the operation of compounding pharmacies and the proper quality of extemporaneous medicinal products. The effectiveness of training for such specialists can be improved by analysing the experience of educational institutions in countries with developed pharmaceutical compounding systems.AIM. This study aimed to analyse the distinguishing features of training for pharmaceutical compounding specialists, as well as determine the main trends in pharmaceutical compounding education in leading international academic institutions.MATERIALS AND METHODS. The study used methods of logical, comparative, structural, and content analysis. The analysis covered 106 pharmacy and pharmacology curricula of the top-25 higher education providers from the QS World University Rankings by Quacquarelli Symonds. The curricula were analysed using open data published online, particularly, on the official websites of the selected universities.RESULTS. The article presents the distinguishing features of pharmaceutical compounding education at different academic qualification levels; these features include the requirements for applicants, time to degree, competence standards, structure of exams, and specifics of students’ professional engagement, with consideration of the national context. The key trends in the education of specialists in pharmaceutical compounding include a decrease in training time for mid-level specialists; a tendency towards concentrating on clinical disciplines due to the expansion of the roles of pharmacy professionals; a growing focus on specialisation in the areas of paediatric, dental, sterile, veterinary, radiopharmaceutical, and orphan drug compounding; increasing use of simulated practice experiences and online learning technologies; and the development of continuing professional education systems.CONCLUSIONS. Pharmaceutical education programmes of leading international educational organisations include disciplines related to extemporaneous compounding. Current international trends—pharmaceutical education with further specialisation in extemporaneous compounding, integration of simulation technologies and online learning into the educational process, and development of continuing professional education—coincide with the development directions of pharmaceutical education in the Russian Federation. Whereas international pharmacy specialists complete additional professional education programmes to gain an additional specialisation in the extemporaneous preparation of paediatric medicinal products, sterile dosage forms, chemotherapy products, radiopharmaceuticals, veterinary products, and dental products, Russian specialists can acquire these additional competencies through further education programmes at the levels of advanced training and residency.

INTENSITY OF GREENHOUSE GAS FORMATION DUE TO LIVESTOCK FARMING ACTIVITIES – AS AN ENVIRONMENTAL FACTOR

According to numerous expert assessments by international organizations and specialists, animal husbandry makes a significant negative contribution to global climate change due to the emission of greenhouse gases (GHG), which are formed at different stages of livestock production as a result of various chemical and biological processes in the body of animals and in livestock waste. The domestic animal husbandry is developing mainly due to the intensification of production in the industry, but traditional farming methods as well as small-scale production in the individual sector also take place. Since the use of various technologies in animal husbandry has different effects on the level of environmental pollution and GHG emissions, the aim of the research was to study the differences in the intensity of GHG gas formation by one animal reared with individual features of animal rearing technologies and business activities. The intensity of gas formation and emission of CH4 and N2O in typical farms for pork production and milk production by one animal reared was determined, analyzed and substantiated. A significant variation in this indicator was found depending on the individual economic and technological features of the studied farms. The average weighted annual intensity of CH4 emission from animal manure in pig farms varied within the range of 0.95–25.71, in cattle farm – 2.74; CH4 from intestinal fermentation of dairy cows – 110.8–148.4; N2O (direct) in pig farms – 0.0–0.106, in cattle farm – 0.229; N2O (indirect) in pig farms – 0.071–0.097, in cattle farm – 0.174. The emission intensity is characterized separately in each age and sex group of animals in the herd structure of farms and the average weighted emission intensity in pork producing farms depending on the season. Based on the research results, it is proposed to use the generalized average annual indicator of greenhouse gas emissions per one average weighted animal reared (kg/head/year) as an indicator of the environmental load of livestock farms on the environment, which will allow planning production volumes with minimal environmental risks in the context of climate change.

International Classification System for Ocular Complications of Anti-VEGF Agents in Clinical Trials

Complications associated with intravitreal anti-VEGF therapies are reported inconsistently in the literature, thus limiting an accurate evaluation and comparison of safety between studies. This study aimed to develop a standardized classification system for anti-VEGF ocular complications using the Delphi consensus process. Systematic review and Delphi consensus process. Twenty-five international retinal specialists participated in the Delphi consensus survey. A systematic literature search was conducted to identify complications of intravitreal anti-VEGF agent administration based on randomized controlled trials (RCTs) of anti-VEGF therapy. A comprehensive list of complications was derived from these studies, and this list was subjected to iterative Delphi consensus surveys involving international retinal specialists who voted on inclusion, exclusion, rephrasing, and addition of complications. Furthermore, surveys determined specifiers for the selected complications. This iterative process helped to refine the final classification system. The proportion of retinal specialists who choose to include or exclude complications associated with anti-VEGF administration. After screening 18 229 articles, 130 complications were categorized from 145 included RCTs. Participant consensus via the Delphi method resulted in the inclusion of 91 complications (70%) after 3 rounds. After incorporating further modifications made based on participant suggestions, such as rewording certain phrases and combining similar terms, 24 redundant complications were removed, leaving a total of 67 complications (52%) in the final list. A total of 14 complications (11%) met exclusion thresholds and were eliminated by participants across both rounds. All other remaining complications not meeting inclusion or exclusion thresholds also were excluded from the final classification system after the Delphi process terminated. In addition, 47 of 75 proposed complication specifiers (63%) were included based on participant agreement. Using the Delphi consensus process, a comprehensive, standardized classification system consisting of 67 ocular complications and 47 unique specifiers was established for intravitreal anti-VEGF agents in clinical trials. The adoption of this system in future trials could improve consistency and quality of adverse event reporting, potentially facilitating more accurate risk-benefit analyses. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Artificial Intelligence-Based Disease Activity Monitoring to Personalized Neovascular Age-Related Macular Degeneration Treatment: A Feasibility Study

PurposeTo evaluate the performance of a disease activity (DA) model developed to detect DA in participants with neovascular age-related macular degeneration (nAMD). DesignPost-hoc analysis. ParticipantsPatient dataset from the phase III HAWK and HARRIER (H&H) studies. MethodsAn artificial intelligence (AI)-based DA model was developed to generate a DA score based on measurements of optical coherence tomography (OCT) images and other parameters collected from H&H study participants. DA assessments were classified into three categories based on the extent of agreement between the DA model’s scores and the H&H investigators’ decisions: agreement (“easy”), disagreement (“noisy”), and close to the decision boundary (“difficult”). Then, a panel of 10 international retina specialists (“panelists”) reviewed a sample of DA assessments of these three categories that contributed to the training of the final DA model. A panelists’ majority vote on the reviewed cases was used to evaluate the accuracy, sensitivity, and specificity of the DA model. Main Outcome MeasureThe DA model’s performance in detecting DA compared with the DA assessments made by the investigators and panelists’ majority vote. ResultsA total of 4472 OCT DA assessments were used to develop the model; of these, panelists reviewed 425, categorized as “easy” (17.2%), “noisy” (20.5%), and “difficult” (62.4%). False-positive and false-negative rates of the DA model’s assessments decreased after changing the assessment in some cases reviewed by the panelists and retraining the DA model. Overall, the DA model achieved 80% accuracy. For “easy” cases, the DA model reached 96% accuracy and performed as well as the investigators (96% accuracy) and panelists (90% accuracy). For “noisy” cases, the DA model performed similarly to panelists and outperformed the investigators (84%, 86%, and 16% accuracies, respectively). The DA model also outperformed the investigators for “difficult” cases (74% and 53% accuracies, respectively), but underperformed the panelists (86% accuracy) owing to lower specificity. Subretinal and intraretinal fluids were the main clinical parameters driving the DA assessments made by the panelists. ConclusionsThese results demonstrate the potential of using an AI-based DA model to optimize treatment decisions in the clinical setting and in detecting and monitoring DA in nAMD patients.

AI-assisted clinical summary and treatment planning for cancer care: A comparative study of human vs. AI-based approaches.

1523 Background: Understanding a patient's clinical narrative, timeline, and history is critical for accurate treatment decision-making. However, reviewing and summarizing complex records is time-consuming and error-prone. Recent advancements in artificial intelligence (AI), specifically large language models (LLM), offer paths to improve quality and efficiency. Methods: A study was conducted on 50 breast cancer cases from an academic medical institution, utilizing all medical records—clinic, pathology, and radiology reports—up until the point of the initial treatment decision. All cases were processed using three different approaches: AI-assisted; full-AI; and human-only. In the AI-assisted method, two oncology physician assistants (PAs) revised AI-generated summaries to create clinical summaries. The full-AI method had AI independently produce clinical summaries, while the human-only method had the PAs compile summaries without AI. Eight board-certified international oncology specialists blindly evaluated summaries for faithfulness, completeness, and succinctness using a 3-point scale, ranked their preferences, and tried to predict which summaries were full-AI. Rankings were assessed using a Friedman test followed by a Wilcoxon signed-rank test, and full-AI prediction was assessed using a two-sided one-sample binomial test. After summarization, a distinct AI system with access to clinical guidelines provided treatment plans. These plans were then evaluated by a board-certified oncologist with access to the original treatment decision. Results: The study found specialists favored AI-assisted, followed by full-AI, and then human-only summaries, with average ranks of 1.73, 1.93, 2.34 respectively (lower is better, p<0.001). The difference between full-AI and AI-assisted was not significant (p=0.11). Evaluation scores (mean±95%CI, higher is better) showed AI-assisted, full-AI, and human-only scored 2.35±0.13, 2.14±0.14, 2.17±0.14 for faithfulness; 2.28±0.12, 2.01±0.12, 1.93±0.14 for completeness; and 2.33±0.12, 2.21±0.12, 1.99±0.13 for succinctness. The average summarization time was 19.71, 1.17, 26.03 minutes. Full-AI identification accuracy was 0.28 (not different from chance 0.33, p=0.46). With AI-assisted summaries, the treatment plans were accurate in 45 cases (90%) and partially accurate in 5 cases (10%). In the 5 partially accurate cases, the system was accurate with the provided input data, but there were inaccuracies with the input data, including incorrect formats or missing data. Conclusions: Incorporating LLMs into the creation of medical summaries has shown improvements in both quality and efficiency, achieving up to 22.2x speed up with full-AI, indicating that AI-assisted summarization tools can potentially enhance care quality. AI-assisted summaries yield accurate treatment plans when the input data is accurate.

Achieving a textbook outcome in patients undergoing gastric resections in a low incidence, high-volume Australian Upper GI unit

BackgroundTextbook outcome (TBO) has been proposed as a composite measure of quality in esophagogastric surgery, and achieving a TBO has been associated with improved overall survival (OS). The Dutch Upper Gastrointestinal Cancer Audit group determined their TBO rate for gastrectomy to be 32.1%, using 10 parameters. Our study aimed to assess the TBO rate in patients who had a gastrectomy for cancer in an Australian Upper GI unit, allowing for comparisons with international specialist centers. MethodsRetrospective analysis of a prospectively maintained database of patients who had a gastrectomy for cancer performed by the surgeons in a single Australian center between 2013 and 2018. Postoperative complications were analyzed using Clavien-Dindo (CD) ≥2 and CD ≥3 definitions. Baseline factors and their association with TBO were analyzed using multivariable logistical regression. The association between TBO and survival rates was determined by Cox proportional hazards regression analysis. ResultsIn 136 patients, 84 (62%) achieved a TBO when complications were graded as CD ≥2. Greatest negative impact on TBO was the complication rate, lymph node yield, and length of stay. Patients more likely to achieve a TBO were younger, with an increased body mass index and absence of underlying respiratory disease. A nonsignificant trend toward improved OS was seen when TBO was achieved. ConclusionOur TBO rate compares favorably with published data from high-volume centers. Assessment of a unit’s TBO may provide a stronger evaluation of quality when assessing where complex surgery should be performed within Australia.

Delphi Consensus on Diagnostic Criteria for LUMBAR Syndrome

To develop consensus on diagnostic criteria for LUMBAR syndrome, the association of segmental infantile hemangiomas that affect the Lower body with Urogenital anomalies, Ulceration, spinal cord Malformations, Bony defects, Anorectal malformations, Arterial anomalies and/or Renal anomalies. These diagnostic criteria were developed by an expert multidisciplinary and multi-institutional team based on analysis of peer-reviewed data, followed by electronic-Delphi consensus of a panel of 61 international pediatric specialists. After two Delphi rounds, a 92% or higher level of agreement was reached for each Delphi statement. 98% of panelists agreed with the diagnostic criteria, and 100% agreed the criteria would be useful in clinical practice. The diagnosis of LUMBAR requires the presence of a segmental, or patterned, infantile hemangioma of the lumbosacral, sacrococcygeal, or pelvic cutaneous regions plus one additional criterion of the urogenital, spinal, bony, anorectal, arterial, or renal organ systems. These diagnostic criteria will enhance clinical care by improving screening, detection, and overall awareness of this poorly understood neurocutaneous disorder. The criteria can be utilized by a wide variety of pediatric subspecialists. In addition, formal criteria will improve phenotypic uniformity among LUMBAR syndrome cohorts and a patient registry, allowing investigators to assess clinical features, long-term outcomes, and results of genetic sequencing in a standardized manner. Finally, these criteria will serve as a starting point for prospective studies to establish formal screening and management guidelines.

Research on the transformation of news media industries in China and Russia in the era of intelligent media

The subject of this study is the era of smart media, which will have a significant impact on the news media ecosystem. It will lead to another industrial transformation and change in the news industry. The convergence of traditional and new media is made possible by 5G technology, cloud computing and big data technologies. The COVID-19 pandemic has accelerated the pace of media analytics, digitisation and platformisation. In addition, recent years have seen a surge in the development of artificial intelligence, which has been applied to various fields such as military, healthcare, retirement, etc. The development of ChatGPT has been an important signal of intelligent change in the media industry. The news media industry is undergoing a transformation that is already well underway. The research methodology is comprehensive and includes: descriptive method, comparative data analysis, statistical analysis and content analysis. The novelty of the research is the analysis of intellectual media paradigms in China and Russia. The nature of media interaction between the two countries, as well as the trajectory of global innovative technologies are investigated. Trends related to the development of digitalisation and AI in the following areas are described in detail: digitalisation of operations, news production, development of media platforms and AI technologies, and media content digitalisation processes. A prospective analysis is made of the need for international specialists with both humanitarian and technical competences. The digital and intellectual transformation of news media can take the cooperation between the two countries to a new historical level. In addition, media cooperation between China and Russia can help stabilise the world situation and provide a favourable ecological environment for international media.

Service system and care pathway of forensic psychiatry patients-international research project 2023-2026

IntroductionThe Finnish forensic psychiatric service system lacks the standards and criteria guiding the quality and contents of patient care. Ensuring best recovery-oriented practices in forensic psychiatric services need to be developed at several levels.ObjectivesThe purpose of this research project is to develop safe, high-quality psychiatric care. The outcome of this project is the production of quality criteria for the forensic psychiatric care and service system.MethodsThe study will be executed at the Department of Nursing Science of the University of Turku during 2023-2026. The research methods include a literature review, a survey based on validated measurement questionnaires (Downes Survey, QPC-FIP, QPC-FIPS), individual and group interviews as well as the Delphi method. The research will cover the multidisciplinary employees at adult psychiatric wards in Finland’s larger hospital districts, employees of forensic psychiatric hospitals, and patients of forensic psychiatric hospitals. International specialists and specialists within Finland from various fields (nursing, medicine, psychology) will be invited to partake in the expert panel.ResultsThe research results will allow the development of the service system for forensic psychiatric patients in such a way that the identification of so-called risk patients can be improved already at the early stages of treatment, at the general psychiatric level. Moreover, the substance of care and participation during care can be created and the care following inpatient care and the patient’s transfer out of forensic psychiatric care can be developed. The research may promote the effectiveness of treatment by highlighting areas in the care chains that, when reinforced, will allow patients to receive the right kind of treatment at the right time. A proposal of standardized operating methods and quality criteria will be created for the Finnish forensic psychiatric treatment system. The research project will also reveal previously unresearched information that can be utilized in national health policy.ConclusionsThe project will promote equal prospects for wellbeing and a participatory society for citizens by exploring the views of forensic psychiatric patients and thus developing forensic psychiatric services. The project will promote sustainable employment by exploring the views of psychiatric personnel and increasing the quality and safety of psychiatric services.Disclosure of InterestNone Declared

Teaching international relations students intercultural commentary

Importance. The problem of mastering the skills of conducting intercultural commentary for international relations students is important and relevant. The purpose of the work is to show how, based on the study of fables from Russian and French literature, it is possible to develop the skills of intercultural analysis and intercultural commentary on the sociocultural characteristics of the country and peoples of their native and foreign languages.Research Methods. Based on a theoretical analysis of scientific literature, a refined concept of “intercultural commentary” is presented as a necessary skill for the professional activities of international relations students. The study proved that a prerequisite for the formation of intercultural communicative competence of future political scientists is familiarity with the national specifics of the culture, traditions and mentality of the people of the country of the language being studied.Comparative analysis of fables by I.A. Krylov and Lafontaine, questioning, and diagnostics made it possible to develop a step-by-step algorithm for training future political scientists and international law specialists in intercultural commentary.Results and Discussion. It is revealed and substantiated that through folklore and fables one can learn to recognize the typical characteristics and features of the Russian and French peoples, which arouses great interest in the didactic possibilities of its use in the system of intercultural teaching of the French language.Conclusion. The application of the research results can contribute to the development of new directions in linguodidactics and the design of an effective linguistic educational intercultural environment.

Problems of moral and patriotic education of youth in Kazakhstan

Relevance. The relevance of the study is due to the fact that moral and patriotic education is one of the elements of the formation of self-awareness in young people, as well as one of the directions of modern education. For education, the key task is to select and find a quality curriculum for the education of a harmonious personality. In this regard, this article aims to reveal topical issues related to the implementation of methods of moral and patriotic education in the educational sector of Kazakhstan. Purpose. The purpose of the study is to identify the key concept of moral and patriotic education, to analyze its impact on the education of the modern young generation of Kazakhstan. Methodology. The main directions of research are predetermined by the lack of theoretical and methodological development of this issue, its increasing practical relevance. The leading method for the study of this problem is to analyze the approaches of moral and patriotic education in the context of globalization, determining the need for their synthesis in the formation of a highly developed personality. Results. Based on the publications of other scientists in the field, formed their own conclusions, modeled the ways of further development of the educational sector. Materials of international specialists were studied, allowing a complex review of the importance of moral and patriotic education in modern conditions. As a result of the study the main methods of moral and patriotic education based on current trends in this area, scientific materials of popular specialists were highlighted. Conclusions. Materials of the article have practical value and can be used in the development of modern, improved methods of education and education of young people in Kazakhstan.

Ocular Surface Squamous Neoplasia: Changes in the Standard of Care 2003 to 2022.

The aim of this review was to elucidate treatment preferences for ocular surface squamous neoplasia and to examine the changes in treatment modalities over the past 2 decades. An electronic survey was distributed to members of The Cornea Society, Ocular Microbiology and Immunology Group, and 4 international corneal specialist listservs. Questions examined medical and surgical treatment preferences, and results were compared with surveys administered in 2003 and 2012. A total of 285 individuals responded to the survey; 90% of respondents were self-classified as corneal specialists. Seventy-three percent reported using primary topical monotherapy to treat ocular surface squamous neoplasia as compared with 58% in 2012 ( P = 0.008). Compared with 2003, the percentage use of topical interferon significantly increased ( P < 0.0001) from 14% to 55%, 5-fluorouracil increased ( P < 0.0001) from 5% to 23%, and mitomycin C decreased ( P < 0.0001) from 76% to 19% as a primary monotherapy. The frequency of performing excision without the use of postoperative adjunctive medical therapy decreased significantly ( P < 0.0001), from 66% to 26% for lesions <2 mm, 64% to 12% for lesions between 2 and 8 mm, and 47% to 5% for lesions >8 mm from 2003 to 2022. More clinicians initiated topical immuno/chemotherapy without performing a biopsy as compared to 2003 (31% vs. 11%, P < 0.0001). These results demonstrate a paradigm shift in the management of ocular surface squamous neoplasia. The use of primary medical therapy as a first approach has significantly increased, with a reduction in the frequency of performing surgical excision alone.

Patient reported outcomes in brachial plexus birth injury: results from the iPLUTO world‐wide consensus survey

Purpose Brachial plexus birth injuries (BPBI) can have lifelong effects on the development and functional use of the upper extremity. Currently there is no agreement with regards to what patient-reported outcome (PRO) measures should be used. Therefore, the ability to compare the effects of treatment between individuals and institutions is challenging. This study aimed to achieve consensus among clinicians on the use of PRO measures within this patient group to allow for improved comparison of treatments and outcomes in the future. Materials and Methods Online, a 3 round Delphi survey was completed by 35 international multi-disciplinary specialist centers. Results All respondents (100%) agreed that PRO measures are useful for clinical evaluation and patient treatment. None of the outcome measures scored >75% agreement for ability to assess responsiveness and current state in children with BPBI as most outcome measures were judged as not specific for BPBI. Additionally, participant centers were asked their perspective on the best available PRO option for each of the 3 categories: functional use of the upper limb, quality of life and pain. This resulted in endorsement by the participant centers of the Brachial Plexus Outcome Measure – Self-Evaluation, the Pediatric Quality of Life Inventory, and Visual Analogue Scale/Brief Pain Inventory respectively. Conclusion International specialists in BPBI agree that PRO measures are important to use both clinically and in research in children aged 5 years and above.

DIPLOMATIC PROCESSES IN THE DIGITAL AGE: «NET-DIPLOMACY» AND KAZAKHSTAN’S IMAGE

This article examines the problem of public diplomacy and the new “network diplomacy”, which is a current subject of research in the field of international journalism. Meanwhile, due to global “digitalization”, the concept of new forms of diplomacy in modern science is blurred. The authors of the article compare the term “net-diplomacy” with “twi-diplomacy” (X-diplomacy), “public diplomacy”, “digital diplomacy”, “mediated public diplomacy”, which allows to comprehend and evaluate its potential; the authors also pays special attention to the importance of building a positive image. Observation, comparison and mixed methods of the research were used. The authors used «qualitative analysis» also, thereby comparing new forms of diplomacy developing in domestic discourse with the method of US public diplomacy. The authors come to the conclusion that “network diplomacy” is a form of public diplomacy, a means of developing the national interests of the state and raising its image in the international arena. The practical significance of the article lies in introducing a new type of traditional diplomacy and its implementation, proper use of the new forms of diplomacy. The authors of the study prove that traditional diplomacy has undergone major changes in accordance with modern requirements. This article will be relevant and useful not only for political scientists and international relations specialists, but also for specialists in the field of journalism, communication and PR.

Value orientations of future international relations specialists in conditions of cultural transformation of society

Value orientations of future international relations specialists in conditions of cultural transformation of society

A Rhetorical Content Analysis of Moroccan Regional Agronomic Abstracts: Textual Practices of Plurilingual Science Communication

In order to contribute to a more nuanced understanding of the varied ways multiple language competencies are invoked in scientific communication and publication, this study features a content analysis of a collection of English, French, and Arabic abstracts from 14 articles of Al-Awamia, a Moroccan agronomic journal. Mapping rhetorically significant differences across abstracts in different languages suggests that EN/FR abstracts are tailored to an international specialist audience and Arabic abstracts favor a domestic policymaker audience in several key ways. The textual moves made to address these different audiences are typical of those studied by scholars of science communication, and accordingly this study indicates that plurilingual textual practices in scientific writing are associated with differences in audience and stakeholders. These findings carry implications for trans/pluri/multilingually oriented scholars of scientific communication, as well as for those who prepare future researchers for the demands of publication, suggesting that the flexible use of diverse linguistic resources is important to scientific practice in a globalized world.

FORMATION OF PROFESSIONAL COMPETENCES OF INTERNATIONAL-RELATIONS STUDENTS BY USING DIGITAL TECHNOLOGIES IN AUTONOMOUS WORK

Purpose. The article is devoted to the analysis of the specifics of the process of forming professionally significant competencies in the training of future international affairs specialists and to the analysis of how the resource of digital technologies used in the process of independent work influences the formation of professional and personal competencies. This problem is revealed using the example of the Chinese language.&#x0D; Methodology. Fundamental to the research is a systematic approach; main theoretical research methods are analysis, synthesis, deduction&#x0D; Results. The article substantiates the role of independent work in the formation of professional competencies. The study allows us to draw conclusions about the need to use digital technologies in the process of independent work in order to develop the professional competencies of students. The author offers a number of educational resources that allow you to effectively integrate digital technologies into the independent work of international relations students, taking into account the specifics of Chinese language.&#x0D; Practical implications. The results can be used in the practice of teaching international specialists, especially studying Chinese.