Individual Manifestations Research Articles

Neuroendocrine tumors and survival rates in MEN-1 patients: impact of gender difference.

Among 100 MEN-1patients enrolled, 59 (59%) were female and 41 (41%) male, mean age at diagnosis was 39.4 years (range 5-86). No statistically significant association was identified between MEN-1 clinical manifestations and gender (primary hyperparathyroidism PHPT p: 1.0, DP-NET p: 0.83, pituitary adenoma PA p: 0.84, lung NET p: 0.64 and thymic NET p: 0.10), similarly age at diagnosis of MEN1 and its individual manifestations was similar between genders. Survival analysis revealed no statistically significant difference between genders in DP-NET patients regarding progression disease p:1.0 and death p:1.0. Mean progression free survival (PFS) of patients with DP-NET was 98.6 months (range 3-288), mean overall survival (OS) was 130.1 months (range 3-444 months), without differences between genders (PFS p: 0.67 and OS p: 0.60). The Kaplan-Meier survival curves for PFS and OS showed no differences between genders (PFS p: 0.92; OS p: 0.87).

MARKETING PRIORITIES OF COMPANIES IN THE INTERNATIONAL PHARMACEUTICAL MARKET

The article presents the current trends in the development of the international pharmaceutical market and systematizes the priority areas for implementing marketing approaches of the leading companies. The purpose of this article is to reveal the marketing priorities of international pharmaceutical companies in the context of global challenges. To study this issue, a set of methods was used, namely: analysis and synthesis, statistical method, process and institutionalist approaches, case study.The results of the study show that the international pharmaceutical market is characterized by a high level of dynamism, preservation of the priority share of economically developed countries in revenue generation, significant influence of regulatory mechanisms at the national and international levels, and active processes of economic competition through mergers and acquisitions. The analysis has shown that the modern concept of pharmaceutical marketing goes far beyond the established narrow interpretation as a set of tools for the production, sale and promotion of a pharmaceutical product and is characterized by a high level of adaptability to the challenges of the global marketing environment of the twenty-first century. The article reveals the focus of marketing of leading companies on such priorities as: scaling up marketing budgets, ensuring synergy between marketing and financial indicators of pharmaceutical companies, modernizing communication strategies by optimizing interaction with key opinion leaders, intensifying multichannel marketing, etc.The theoretical significance of the study is to deepen the concept of international marketing in the context of its individual sectoral manifestations, taking into account the influence of global competition, institutional regulations, and technological progress. The practical value is due to the potential of using local or regional benchmarking for domestic companies participating in the international pharmaceutical market. Prospects for further research are considered in the direction of assessing the mechanisms and effects of the introduction of marketing innovations in the field of international pharmaceuticals.

‘We Can Help!’ Stories of Professional Accountants’ Quest for Social Worth

The commercialization of the accounting profession has been widely criticized, raising questions about its commitment to serving the public interest. This study nuances these critiques by focusing on professional accountants for whom altruism is a core value. Specifically, we examine the process by which individual accountants attempt to embody altruism by volunteering in accounting humanitarian missions. We theorize accountants’ desire to incarnate altruism as a significance quest in which they attempt to boost their social worth. Through a case study of two humanitarian missions, we uncover how volunteer accountants approached the missions with educational aspirations, wishing to embody altruism by sharing their knowledge. They faced challenges that shaped the situated possibilities of their missions and clashed with their aspirations. To navigate the resulting tensions, they mobilized different means that revealed the difficulties of embodying altruism and the fragility with which it can be accomplished. Our study highlights individual manifestations of altruism and offers a nuanced view of professionals’ understanding of altruism. It also broadens the horizons of how accountants can act in the public interest and integrate social considerations into their practice. Finally, it provides conceptual tools to further understand how accountants can contribute to (or detract from) social issues.

SYSTEMATIC AND LEGAL ASPECTS OF LEGAL RESPONSIBILITY FOR ILLEGAL ACTS WITH AMBER

The article is devoted to the disclosure of certain systemic and legal aspects of responsibility for illegal actions with amber. Relevant judicial practice is analyzed. Proposals for improvement of Art. 240-1 of the Criminal Code of Ukraine “Illegal extraction, sale, purchase, transfer, forwarding, transportation, processing of amber”. The issue of the application of the criminal law norm of insignificance for the legal assessment of illegal amber mining and its illegal handling was considered. The existence of a conflict between the investigated criminal law ban and Art. 47 of the Code of Ukraine on Administrative Offenses “Violation of the State Property Right to Subsoil”, comments are expressed regarding its (collision) overcoming in the aspects of de lege lata and de lege ferenda. It is argued that the socially dangerous consequences of illegal mineral extraction (in particular, amber) should be labeled as damages. It is shown that carried out within the limits of Art. 240-1 of the Criminal Code of Ukraine, the differentiation of responsibility related to the size of illegal actions with amber is insufficient. The relevant provisions of the project of the new Criminal Code of Ukraine were analyzed, the advantages and disadvantages of the relevant formulations were clarified. In particular, the proposal of the drafters of a potential criminal law to distinguish the grounds of criminal responsibility for the illegal acquisition of natural resources, on the one hand, and individual manifestations of involvement in the behavior of those who commit illegal extraction of natural resources from their natural environment, on the other, was supported. The issue of the appropriateness of anchoring in Part 1 of Art. 240-1 of the Criminal Code of Ukraine instructions on actions other than illegal amber mining.

„Erzähl mir was, Großvater!“1 Geschichten über das Schicksal der Siebenbürger Sachsen nach dem Zweiten Weltkrieg anhand des Romans von Karin Gündisch Weit, hinter den Wäldern.

Abstract It is with the words „Denkst du, das Leben besteht aus Geschichten?“2 that Peterʼs grandfather answers to Peterʼs request to be told yet another story. They say that a collective memory is only imaginable and perceivable in its manifestations of individuals. This is the ace up Karin Gündischs sleeve that she uses in her novel Weit, hinter den Wäldern. A relatively unknown, yet valuable author, she manages to envision the post World War II world in a Saxonian village in a very authentic way. Filtered through the gaze of young Peter, 12, the author tells the stories of the deprivations and humiliations that Saxonians had to endure after World War II in Russian imprisonment. The novel also talks about guilt on both ends. At first, the stories are entertaining for the children, but they soon discover they are listening to stories about survival in dire times. Many storytellers get to tell their stories throughout the novel, as the book abounds in Scheherezade-like stories that soften the blow of the hard day to day life in Transylvania. This article aims at answering the question as to what roles storytelling plays in a context of atrocity. Roger Willemsen warns about the tough process of dealing with a difficult past, which Karin Gündisch, in her book for children and teenagers, but also for adults excels at: “There is no easy way to talk about the horrendous.“

Aberrant copper metabolism and hepatic inflammation cause neurological manifestations in a mouse model of Wilson’s disease

Pathogenic germline mutations in the P-type copper-transporting ATPase (ATP7B) gene cause Wilson’s disease (WD), a hereditary disorder characterized by disrupted copper metabolism. The Arg778Leu (R778L) mutation in exon 8 is prevalent among individuals with WD in East Asia and is associated with more severe phenotypes. In this study, we generated a WD mouse model harboring R778L mutation (R778L mice) using CRISPR/Cas9. R778L mice exhibit a range of pathological characteristics resembling those of patients with WD and the same point mutations, including aberrant copper metabolism, pathological cellular injury, inflammation, and severe hepatic fibrosis. At 3–5 months of age, these mice started to display neurological deficits in motor coordination and cognitive dysfunction, accompanied by increased expression of inflammatory cytokines in the central nervous system. Microglia in the striatum and cortex exhibit significant activation, shorter processes, and decreased branch points. However, the Cu2+ levels in the brain tissue of R778L mice did not differ significantly from those of wild-type mice. Notably, inhibition of hepatic inflammation with PJ34 or siNfkb markedly alleviated the deficiencies in cognitive performance and improved locomotor activity in R778L mice. Thus, this study establishes a novel murine model to investigate the pathophysiology of WD, highlights the liver-brain crosstalk responsible for neurological manifestations in individuals with WD caused by the R778L point mutation, and demonstrates the potential of modulating liver inflammation as a therapeutic strategy for alleviating the neurological manifestations of WD.

Herbal Treatment for Paralysis

Paralysis is when a person can not move or feel a part of their body. It happens when something goes wrong with the brain cells or nerves that control movement. It can be caused by inflammation, injuries, strokes, or diseases. A condition known as sleep paralysis (SP) refers to the immobility that sets in while a person is either sleeping or barely awake. It could manifest as isolated SP in healthy persons. Additionally, it has been linked to sleep, family, and other underlying psychiatric illnesses. According to the ratio, 8% of people in general have SP. Despite erroneous descriptions of this value, there is no accepted definition for the diagnosis of sleep paralysis. The literature now in publication describes SP for a number of reasons. One might see that these descriptions are either medically or culturally based. The disparity in SP diagnosis between medical professionals and members of cultural or ethnic groups has resulted in a variety of management strategies. The purpose of this review is to list medical. The exact method of action of stem cells is unknown. Objective: The aim of this study is to ascertain and contrast the prevalence, characteristics, neurological manifestation, and functional result of individuals suffering from nontraumatic spinal cord injury (SCI) with those suffering from traumatic SCI. 39% of SCI hospitalizations had a nontraumatic cause (tumor, 26%; spinal stenosis, 54%). Subjects with nontraumatic SCI were substantially (p <.01) older, more likely to be married, female, and retired than those with traumatic SCI. Within the nontraumatic SCI group, injury characteristics showed significantly higher rates of paraplegia and incomplete SCI (p <.01). From the time of admission to rehabilitation until the time of discharge, both nontraumatic and traumatic SCI patients experienced significant FIM changes (p <.01). Comparing the traumatic group to the nontraumatic SCI group, those with tetraplegia-incomplete group had significantly higher admission motor FIM scores and shorter rehabilitation duration of stay (p <.05). Compared to those with traumatic SCI, paraplegic-complete and paraplegic-incomplete nontraumatic SCI participants showed lower discharge motor FIM scores, FIM change, and FIM efficiency. Comparable rates of discharge to the home were observed in nontraumatic. This study aimed to examine the spinal cord injury experiences of younger and older individuals. Age at injury data from 866 hospitalized patients between 1973 and 1985 were examined. Results were assessed both two years following the injury and at discharge. Compared to patients aged 16 to 30, patients aged 61 or older had 2.1 times higher odds of developing pneumonia, 2.7 times higher odds of experiencing a gastrointestinal hemorrhage, 5.6 times higher odds of developing pulmonary emboli, and 16.8 times higher odds of having renal stones prior to first definitive discharge. In the second year following their accident, patients who were at least 61 years old had a 3.9-fold increased risk of being readmitted to the hospital.

Examining the Alignment of Ideological Expression with Behavior or Deception: An Experimental Investigation of Chinese Youth's Political Attitudes Towards America

<i>Background</i> In the context of globalization, as one of the most significant bilateral relations in the world, the dynamics of China-US relations exert a considerable influence on the world. Simultaneously, the accelerated advancement of Internet technology has provided a more expansive array of avenues for acquiring information. Through Social media, news websites, and international forums, Chinese youth groups demonstrate a heightened interest in global affairs. However, the divergence between disparate cultural and political systems has resulted in Chinese youth developing nuanced and multifaceted political dispositions when engaging with the United States and other Western nations. It is therefore imperative to study the political attitudes of Chinese youth, particularly to the United States. <i>Objectives</i> The concept of political attitude expression refers to the external manifestation of an individual's ideological position's usefulness. However, there is a lack of empirical research examining the alignment between an individual's inner motivation and their expression of political attitudes. Based on the aforementioned information, an experimental study was devised and executed with the aim of discerning political attitudes. The study focused on individuals' external expressions of political attitudes and their intrinsic motivations, specifically in relation to the United States. The objective was to examine whether specific factors could potentially influence the external manifestation of individuals' internal ideologies.<i> Main ideas</i> Various factors contribute to the expression of individual ideologies. The ideologies expressed by individuals do not solely reflect their ideological beliefs, but rather arise from a complex interplay of moderating factors influenced by individual rationality regarding economic costs and social circumstances. <i>Conclusions</i> (1) The political attitudes of Chinese youth toward the United States in general demonstrate a left-leaning trend, with low favorability toward the U.S. (2) Economic interests exert an influence on ideological expression, and individuals holding a left-leaning ideological position may elect to accept financial incentives and formally demonstrate high favorability toward the U.S., driven by economic interests. (3) Transformations in the social milieu may precipitate a phenomenon whereby individuals are inclined to "follow the crowd," concealing their authentic political dispositions and eschewing genuine political expression.

Intragenomic diversity of the small subunit rDNA gene shows limited impact on the pathogenicity of Blastocystis infection in clinical patients

The clinical significance of Blastocystis sp. remains to be fully elucidated. This study assesses whether Blastocystis subtype diversity can affect the outcome of the infection and the occurrence of clinical manifestations in infected individuals. Stool samples from 219 Blastocystis-positive patients by PCR targeting the ssu rDNA gene were fully genotyped by Sanger sequencing analyses. Co-infections by other parasitic, viral, and bacterial enteropathogens were identified by molecular and culture methods. Sequence analyses revealed the presence of six Blastocystis subtypes including ST1 (21.5 %), ST2 (17.8 %), ST3 (29.7 %), ST4 (22.8 %), ST6 (5.5 %), and ST7 (2.3 %), with a single sample harbouring a ST1+ST3 co-infection (0.5 %). Multivariate risk factor analyses using logistic regression models indicated that neither Blastocystis subtypes nor patient-associated variables including sex, country of origin, travelling history, and presence of nonspecific symptoms were positively associated with a higher likelihood of developing gastrointestinal symptoms (abdominal pain and diarrhoea). However, being of a young age (p-value: 0.003) and experiencing skin pruritus (p-value < 0.001) and eosinophilia (p-value: 0.016) were found to increase the odds of presenting gastrointestinal symptoms. Blastocystis subtypes based on variability within the ssu rDNA gene do not seem to be the main drivers of clinical manifestations in the surveyed clinical population.

Systematic Evaluation of Guidelines for the Diagnosis and Treatment of Hepatitis E Virus Infection.

The hepatitis E virus (HEV) is a zoonotic disease, and infection with HEV in humans primarily causes acute infections and can progress to chronic manifestation in immunocompromised individuals. Over the past decade, guidelines for diagnosing and treating HEV infection have been developed. This study aimed to systematically assess the quality of current guidelines for diagnosing and treating HEV infection, and we analyzed the differences in guideline quality and primary recommendations and explored possible reasons for these differences. Guidelines published between 2013 and 2022 were searched, and studies were identified using selection criteria. The study assessed the quality of the included guidelines using the Appraisal of Guidelines for Research and Evaluation tool, extracted the primary recommendations in the guidelines, determined the highest level of evidence supporting the recommendations, and reclassified the evidence using the Oxford Centre for Evidence-Based Medicine grading system. Seven guidelines were included in the final analysis. The quality of the guidelines varied widely. The discrepancies may have been caused by the lack of external experts, the failure to consider influencing factors in guideline application, and the lack of consideration of the public's opinion. Analysis of the heterogeneity in primary recommendations revealed differences in algorithms for managing chronic HEV infection, the dosage of ribavirin, and a low level of evidence supporting the primary recommendations. Guideline quality and primary recommendations vary considerably. Refinement by guideline developers and researchers would facilitate updating and applying guidelines for diagnosing and treating HEV infection.

Dreaming at the End of Empire: The Baltic Dreamscape of Jakob Vaarask, 1885-1917

ABSTRACT This article examines the dreams of Jakob Vaarask (1862-1936), an Estonian Orthodox teacher and priest who, from 1889 to 1926, lived and worked on the island of Vormsi, for much of that period part of the Russian Empire’s Estland province. I intend to show that dreams, rather than random and purely individual manifestations of the subconscious, can be used as historical sources, in Vaarask’s case demonstrating the extent to which political propaganda and social hierarchies were internalised by individuals in the late Russian Empire.

Axial Disease in Psoriatic Arthritis: A Challenging Domain in Clinical Practice.

Psoriatic arthritis (PsA) is a chronic inflammatory condition affecting about one-third of individuals with psoriasis. Defining axial involvement in PsA (axPsA) remains debated. While rheumatologists guide clinical practice, consensus on axPsA is still lacking. This paper explores historical and upcoming definitions from the Axial Involvement in Psoriatic Arthritis (AXIS) study, which aims to establish a validated axPsA definition. Epidemiological data reveal diverse axPsA prevalence rates, emphasizing its complex relationship with peripheral arthritis and enthesitis. Unique genetic, clinical, and radiological features differentiate axPsA from ankylosing spondylitis (AS), necessitating refined classification criteria. The recommendations from the Assessment of Spondylarthritis international Society (ASAS) provide valuable guidance due to the limited direct evidence. Emerging therapies, including interleukin-23 (IL-23) inhibitors or Janus kinase (JAK) inhibitors, are under investigation for axPsA. Currently, secukinumab, an interleukin-17 (IL-17) inhibitor, is an evidence-based option for axPsA management. However, given the variability in individual patient responses and disease manifestations, personalized, evidence-based treatment approaches remain essential for optimizing patient outcomes. In the final section, two real-life cases illustrate the challenges in managing axPsA, emphasizing the importance of tailored therapies. Achieving precision in defining axPsA remains a formidable task, making detailed criteria essential for effective strategies and improving patient outcomes.

Severe Organ Impairment Was Common in Elderly Individuals with Dengue in Guangdong, China.

Guangdong, China, has experienced several dengue epidemics involving thousands of confirmed cases in recent decades, and elderly individuals suffered severe dengue (SD) most seriously. However, the clinical characteristics and risk factors for SD among elderly patients in Guangdong have not been investigated. Patients older than 65 years were recruited and divided into a dengue fever (DF) group and an SD group according to the 2009 Dengue Guidelines of the WHO. We analyzed the clinical manifestations of the elderly patients with dengue and then assessed the risk factors for SD. Of a total of 1,027 patients, 868 patients were diagnosed as having DF and 159 as having SD. Of the 159 elderly patients with SD, 129 (81%) had comorbidities, with hypertension being the most common. Severe organ impairment (SOI) (115, 54%) was the most common presentation in SD patients, followed by severe plasma leakage (52, 24.4%) and severe hemorrhage (46, 21.6%). The most common symptom of SOI was kidney injury, followed by heart injury and central nervous system injury. Furthermore, multivariate regression revealed that the presence of chronic obstructive pulmonary disease (COPD), a lower red blood cell (RBC) count (≤3.5 × 1012/L; odds ratio [OR], 0.35; 95% CI, 0.17-0.55; P <0.001), lower serum albumin (ALB) (≤35 U/L; OR, 0.18; 95% CI, 0.09-0.32; P <0.001), and hyperpyrexia (body temperature ≥39°C; OR, 1.8; 95% CI, 1.2-2.6, P <0.001) were risk factors for SD. Severe organ impairment was the predominant manifestation in elderly individuals with SD characterized by kidney injury. The potential risk factors of SD such as presence of COPD and hyperpyrexia and lower RBC and ALB levels might help clinicians identify patients with SD early.

Clinical Patterns of Sarcoidosis Patients with and without Uveitis: Insights from a Dutch Sarcoidosis Centre

ABSTRACT Purpose Uveitis is a common ocular manifestation in individuals with sarcoidosis, a multisystem inflammatory disorder. This study aimed to explore clinical and genetic factors associated with the presence or absence of uveitis in sarcoidosis patients. Methods Total 625 Dutch sarcoidosis patients were included. Among these, 170 underwent ophthalmic examination, and 61 were diagnosed with uveitis. Demographic and clinical data, including age, gender, race, biopsy status, chest radiography findings, TNF-α inhibitor treatment, and uveitis classification were collected retrospectively from medical records. Genetic data was available for HLA haplotypes, TNF-α G-308A, and BTNL2 G16071A polymorphisms. Results The majority of the patients presented with bilateral uveitis (80.3%). The proportion of women was higher in the uveitis group compared to the non-uveitis group (67.2% and 47.7%; p = 0.014). Pulmonary involvement (chest radiographic stage II-III) was significantly lower in patients with uveitis (36.1% versus 64.2%; p < 0.001). Patients with uveitis were more often treated with TNF-α inhibitors (67.2% versus 29.4%; p < 0.001) and the outcome was better compared with the non-uveitis group, 92% vs 68%, responders (p < 0.012). Uveitis patients treated with TNF-α inhibitors (either adalimumab or infliximab) were more likely to suffer from intermediate or posterior uveitis than anterior uveitis. Genetic analysis identified a significant association between the BTNL2 G16071A GG genotype and uveitis (p = 0.012). Conclusion This study highlights distinctive demographic, clinical and genetic features associated with uveitis in sarcoidosis patients. Ocular sarcoidosis was more prevalent in women. Further research is warranted to explore the implications of these findings for treatment strategies and prognostic assessments.

Philosophical significance of Bukhar zhyrau’s wise views

The role of the continuity of generations, which has absorbed the thousand-year-old wisdom of its people, is very important as a spiritual connection. The actions and activities of the great sons of the nation, who put the rational and conscious views of the nation at the head, opened a wide field for national knowledge and spiritual life. Surprising other countries not only with the mind and intellect of their people, they entered a new stage in history, believing in a happy future for their country. At a time when the civil history of our people is new, the period from ancient times to the present day is studied from the point of view of national ideals and is subjected to intellectual, artistic and the most extensive research.The life and work of great people, who are the core of the nation, evidence of bright intellect and honor, who have reached the world level with their individual manifestations, have become the theme of the time.The purpose of the author of the work is to analyze the works of those who called to protect and realize the dreams and goals of their people, to fight for the interests of a strong country.The article comprehensively analyzes that the worldview of the Kazakhs, the ideals and values of the Great Steppe are closely related to the development of the country's history, as well as the role and place of folk wisdom in shaping the modern worldview.The author believes that the historical lessons of ancestral traditions are the key to the revival of independent national consciousness.

Female Individuality and Social Conventions of the Enlightenment in the Correspondence between Valentin Jamеrai-Duval and Anastasia Sokolova

This article examines the interpretation of the theme of the manifestation of female individuality in mid-eighteenth-century Russia on the basis of the correspondence (1762–1774) between Valentin Jamerai-Duval, a French philosopher and autodidact in the Austrian service, and Anastasia Sokolova, a lady-in-waiting to Empress Catherine II, married to De Ribas. At the beginning of the correspondence, Jamerai-Duval’s interest in Russia, like that of many Europeans, is based on inaccurate book sources and common stereotypes. Their conceptual motifs are “barbarism”, ignorance and violence, both in the family and in society. The dialogue between the two correspondents gradually overcomes these stereotypes. They discuss a wide range of issues related to the expression of the female personality: choice of spouse and celibacy, love and sensual pleasure in marriage; criteria of attractiveness (physical and mental beauty), following fashion and individual style, etc. Special attention is paid in the correspondence to the questions of women’s education and intellectual development, in which reading plays an important role. The Russian-Turkish war of 1768–1774 reactivated the issue of violence against women, this time as a need to protect them from the despotism of the infidels in the Ottoman Empire. Ignorance and religious prejudice in the environment of the Old Believers are also seen by the correspondents as a manifestation of tyranny over women’s personality.

PA24 Concomitant Crohn disease and scurvy: an unusual presentation revealing nutritional challenges

Abstract This case report presents a 15-year-old boy newly diagnosed with Crohn disease (CD), currently under treatment with prednisone and azathioprine. The patient was admitted to the hospital due to diffuse abdominal pain, diarrhoea and fever. Remarkably, after 5 days of hospitalization, he developed purpuric lesions on his wrists, abdomen and lower limbs. Dermoscopic examination of the cutaneous petechiae revealed an intriguing finding: whitish hair follicles exhibiting a distinctive ‘corkscrew’ hair pattern surrounded by a haemorrhagic violaceous halo. This dermoscopic profile strongly suggested the presence of scurvy. Histological analysis provided further insight, demonstrating perifollicular haemorrhage and interstitial extravasation of red blood cells. While nutritional deficiencies are commonly linked to CD, vitamin C deficiency is less frequently identified and reported, despite its prevalence. The challenge lies in the potential overlap of symptoms between active CD and scurvy, making the diagnosis of vitamin C deficiency more elusive in patients with CD. This case underscores the importance of considering vitamin C deficiency in the differential diagnosis of cutaneous manifestations in individuals with CD. Clinicians should be vigilant in identifying such nutritional deficiencies to ensure timely intervention and prevent complications associated with scurvy.

DEVELOPMENT OF THE ABILITY OF FUTURE DOCTORAL LEVEL SPECIALISTS TO IMPLEMENT AN INDIVIDUAL EDUCATIONAL RESEARCH TRAJECTORY: CONTOURS OF PEDAGOGICAL DISCOURSE

The article highlights some of the results of the conducted pedagogical discourse regarding the development of postgraduate students' ability to realize an individual educational and scientific trajectory; the latter is considered as a factor in the formation of image features of the future scientist. The exceptional importance of the goal-oriented process of forming the individual educational trajectory of a PhD student is substantiated; it is about the decisive factor in the success of personalized mastery as both an educational and a scientific component of post-graduate training, as well as about the optimality of professional support for the preparation of the applicant's own dissertation project, which, as a rule, is characterized by originality both at the level of the topic and from the perspective of tools for solving key contradictions, which increase the relevance of the research problem raised by him, in the aspect of the spectrum of manifestation of the creative individuality of the future Doctor of Philosophy. In particular, the constructive Polish experience in terms of stimulating personal and professional activity and increasing the personal responsibility of the scientific supervisor of graduate students is taken into account (during the fourth semester of study, Polish doctoral students undergo an intermediate certification before a commission, which must include a doctor with a habilitation or a professor from the scientific specialty chosen by the graduate student, and does not work at the institution where postgraduate training of the future doctor of philosophy takes place; in case of successful attestation of the applicant, his postgraduate scholarship is significantly increased). It was established that the historical and pedagogical origins of the chosen approach are laid in the fundamental research of the construct "measures of European success – a chance for Ukraine". As for modern scientific and pedagogical ideas about the content of the concept of "individual educational trajectory", it is noted that such diverse dimensions as: "path", "style", "and program" and "movement" are emphasized. It has been proven that for graduate students, it is legitimate to leave an individual educational and scientific trajectory, where attention is mainly focused on the processes of self-realization and self-regulation. Subjective self-realization is interpreted as the manifestation of a specific form of activity by the student, aimed at acquiring the status of a subject of his own development in the field of the chosen profession. As for self-regulation, it is understood as an important aspect of self-improvement of the future Doctor of Philosophy, because it occurs through the involvement of mechanisms of self-evaluation, self-control, and reflection; the activity of professional self-regulation is both directly and indirectly related to the process of self-creation. Therefore, the ability of the acquirer to "be" simultaneously in the content of formal, non-formal, and informal education is assumed.

HIV-related public stigma in the era of “Undetectable = Untransmittable”: a population-based study in Hong Kong

BackgroundWhile global efforts are increasingly relying upon biomedical advancements such as antiretroviral therapy and pre-exposure prophylaxis (PrEP) to end the HIV epidemic, HIV-related stigma remains a concern. This study aimed to assess the general public’s awareness and perception of “Undetectable = Untransmittable” (U = U) and PrEP, and the patterns of public stigma towards people living with HIV (PLWH) and their determinants in an Asian Pacific city.MethodsA population-based, self-administrated online survey was conducted between 10–20 March 2023. All adults aged ≥ 18 years and currently living in Hong Kong were eligible. Participants’ socio-demographic characteristics, awareness and perception of U = U and PrEP, as well as HIV-related stigma drivers, experience and practices were collected. Latent class analysis was used to delineate population subgroups based on their stigma profiles as reflected by 1.) fear of infection, 2.) concern about socioeconomic ramification of the disease, 3.) social norm enforcement, 4.) perceived stigma in the community, and 5.) stigmatising behaviours and discriminatory attitudes. Memberships of identified subgroups were then correlated with sociodemographic factors, awareness and perception of U = U and PrEP, using multinominal logistic regression.ResultsResponses from a total of 3070 participants (55% male; 79% aged 18–54) were analysed. A majority, 69% and 81%, indicated that they had never heard of U = U and PrEP respectively, and only 39–40% of participants perceived these to be effective in protection from HIV. Four distinct subgroups were identified, namely “Low stigma” (37%), “Modest stigma” (24%), “Moderate stigma” (24%), and “High stigma” (15%). Compared with “Low stigma”, lack of awareness of and/or negative perceptions towards U = U and/or PrEP, not knowing any PLWH were associated with increased odds of higher stigma group membership. Lower educational level and not in employment were associated with increased odds of membership in “Moderate stigma” and “High stigma”. While older people were more likely to belong to “High stigma”, female were more likely to belong to “Moderate stigma”. “Modest stigma” included more younger people who were economically active.ConclusionTwo-thirds of participants endorsed modest-to-high HIV-related stigma, suggesting the prevalence of HIV-related stigma was high among the general population in Hong Kong. Tailored interventions targeting specific stigma drivers and manifestations of individuals as reflected from the stigma profiles of distinct subgroups could form an important strategy for stigma reduction.

Catastrophic rupture of an internal carotid aneurysm in a neurofibromatosis type 1 patient: A critical case study

Catastrophic rupture of an internal carotid aneurysm in a neurofibromatosis type 1 patient: A critical case study