The unified state qualification exam STEP-1 as a marker of the success of the education of pediatric doctors in Ukraine and Bogomolets National Medical University.

BACKGROUND: Ukraine's higher medical education goes deeper and deeper every year in the European integration processes in the field of «Health Care¼ knowledge. Since 2005, the integrated license integrated exam STEP "General medical training" has been introduced in the country to diagnose the quality of training of specialists in all medical specialties. Since 2019, Ukraine, unlike other countries in Europe and the world, has been training specialists in the specialty "Pediatrics" at the stage of undergraduate training. The quality control of the training of specialists is carried out in the form of passing the Unified State Qualification Exam STEP (USQE STEP) separately for each medical specialty (Medicine and Pediatrics). Therefore, the purpose of our research is to conduct a comparative analysis of the results of the success of the first stage of the USQE STEP-1 by students of higher medical education in the specialty "Pediatrics" with the specialty "Medicine" in Ukraine and in the Bogomolets National Medical University (Bogomolets NMU). METHODS: Analytical references to the results of the first stage of the USQE STEP-1 for the students who have completed theoretical medical disciplines specialty "Pediatrics" and the specialty "Medicine" in Ukraine and Bogomolets NMU, which are provided by the Testing Center at the Ministry of Health of Ukraine. Тhe statistical significance of comparative indicators was proved using Fisher's test, with a statistical error that corresponded to the specified value for ≤ 0.05. RESULTS: It is shown that in 2022, applicants of higher medical education of Ukraine with the specialty "Pediatrics" improved the overall success rate by 8.4%, and the success rate of subtests by an average of 10.5%, despite the state of war in Ukraine. The exception was the results of the licensing exam for the subtest component "Biochemistry": compared to 2021, the pass rate decreased by 3.6% in the specialty "Medicine" and by 6.4% in the specialty "Pediatrics". At Bogomolets NMU, the leaders of 2022 were the students of the "Pediatrics" specialty, their success rate is 2% higher than that of the "Medicine" specialty. CONCLUSIONS: The analysis of the results of USQE STEP-1 by applicants of higher medical education of the specialties "Pediatrics" and "Medicine" in Ukraine showed the effectiveness of the selection of the specialty "Pediatrics" into a separate section of the training of specialists at the undergraduate level in the field of "Health Care". Using the methods of mathematical statistics, the effectiveness of organizational methodological techniques in the organization of the educational process in the conditions of the martial law of Ukraine and Bogomolets NMU as a leader in the training of specialists in Pediatric doctors has been proved.

Analysis of Biomechanical and Biochemical Markers of Rat Muscle Soleus Fatigue Processes Development during Long-Term Use of C60 Fullerene and N-Acetylcysteine.

The development of an effective therapy aimed at restoring muscle dysfunctions in clinical and sports medicine, as well as optimizing working activity in general remains an urgent task today. Modern nanobiotechnologies are able to solve many clinical and social health problems, in particular, they offer new therapeutic approaches using biocompatible and bioavailable nanostructures with specific bioactivity. Therefore, the nanosized carbon molecule, C60 fullerene, as a powerful antioxidant, is very attractive. In this study, a comparative analysis of the dynamic of muscle soleus fatigue processes in rats was conducted using 50 Hz stimulation for 5 s with three consistent pools after intraperitoneal administration of the following antioxidants: C60 fullerene (a daily dose of 1 mg/kg one hour prior to the start of the experiment) and N-acetylcysteine (NAC; a daily dose of 150 mg/kg one hour prior to the start of the experiment) during five days. Changes in the integrated power of muscle contraction, levels of the maximum and minimum contraction force generation, time of reduction of the contraction force by 50% of its maximum value, achievement of the maximum force response, and delay of the beginning of a single contraction force response were analyzed as biomechanical markers of fatigue processes. Levels of creatinine, creatine phosphokinase, lactate, and lactate dehydrogenase, as well as pro- and antioxidant balance (thiobarbituric acid reactive substances, hydrogen peroxide, reduced glutathione, and catalase activity) in the blood of rats were analyzed as biochemical markers of fatigue processes. The obtained data indicate that applied therapeutic drugs have the most significant effects on the 2nd and especially the 3rd stimulation pools. Thus, the application of C60 fullerene has a (50-80)% stronger effect on the resumption of muscle biomechanics after the beginning of fatigue than NAC on the first day of the experiment. There is a clear trend toward a positive change in all studied biochemical parameters by about (12-15)% after therapeutic administration of NAC and by (20-25)% after using C60 fullerene throughout the experiment. These findings demonstrate the promise of using C60 fullerenes as potential therapeutic nanoagents that can reduce or adjust the pathological conditions of the muscular system that occur during fatigue processes in skeletal muscles.

Protective Effect of Water-Soluble C60 Fullerene Nanoparticles on the Ischemia-Reperfusion Injury of the Muscle Soleus in Rats.

The biomechanical parameters of muscle soleus contraction in rats and their blood biochemical indicators after the intramuscular administration of water-soluble C60 fullerene at doses of 0.5, 1, and 2 mg/kg 1 h before the onset of muscle ischemia were investigated. In particular, changes in the contraction force of the ischemic muscle soleus, the integrated power of the muscle, the time to achieve the maximum force response, the dynamics of fatigue processes, and the parameters of the transition from dentate to smooth tetanus, levels of creatinine, creatine kinase, lactate and lactate dehydrogenase, and parameters of prooxidant-antioxidant balance (thiobarbituric acid reactive substances, hydrogen peroxide, and reduced glutathione and catalase) were analyzed. The positive therapeutic changes in the studied biomechanical and biochemical markers were revealed, which indicate the possibility of using water-soluble C60 fullerenes as effective prophylactic nanoagents to reduce the severity of pathological conditions of the muscular system caused by ischemic damage to skeletal muscles.

Analysis of Biomechanical Parameters of Muscle Soleus Contraction and Blood Biochemical Parameters in Rat with Chronic Glyphosate Intoxication and Therapeutic Use of C60 Fullerene.

The widespread use of glyphosate as a herbicide in agriculture can lead to the presence of its residues and metabolites in food for human consumption and thus pose a threat to human health. It has been found that glyphosate reduces energy metabolism in the brain, its amount increases in white muscle fibers. At the same time, the effect of chronic use of glyphosate on the dynamic properties of skeletal muscles remains practically unexplored. The selected biomechanical parameters (the integrated power of muscle contraction, the time of reaching the muscle contraction force its maximum value and the reduction of the force response by 50% and 25% of the initial values during stimulation) of muscle soleus contraction in rats, as well as blood biochemical parameters (the levels of creatinine, creatine phosphokinase, lactate, lactate dehydrogenase, thiobarbituric acid reactive substances, hydrogen peroxide, reduced glutathione and catalase) were analyzed after chronic glyphosate intoxication (oral administration at a dose of 10 µg/kg of animal weight) for 30 days. Water-soluble C60 fullerene, as a poweful antioxidant, was used as a therapeutic nanoagent throughout the entire period of intoxication with the above herbicide (oral administration at doses of 0.5 or 1 mg/kg). The data obtained show that the introduction of C60 fullerene at a dose of 0.5 mg/kg reduces the degree of pathological changes by 40-45%. Increasing the dose of C60 fullerene to 1 mg/kg increases the therapeutic effect by 55-65%, normalizing the studied biomechanical and biochemical parameters. Thus, C60 fullerenes can be effective nanotherapeutics in the treatment of glyphosate-based herbicide poisoning.