PANDEMIC LESSONS: DIGITALIZING TRENDS ON MEDICAL EDUCATION IN THE COVID-19 ERA

The beginning of the COVID-19 pandemic and the response of the Institutes of health aimed at reducing the spread of the disease required an immediate change in the traditional approach to education, especially medical. Against the background of severe restrictions in the implementation of educational programs – normative, situational and managerial - universities have an acute question about the available opportunities for mastering the competencies of the educational standard in a remote format. Forced emergency changes in approaches, forms, and methods of training allowed overcoming the crisis in the field of medical education. The article highlights the main trends in medical education formed during the crisis associated with the new coronavirus infection. The experience of organizing training in a pandemic in an educational organization is presented. The purpose of this work is to identify the main trends in the digitalization of medical education during the period of the threat of the spread of a new coronavirus infection. Methods of comparative analysis, description and subject modeling of indicators recorded in the electronic educational environment of the University for the period of 2020 were applied, as well as information from the Portal of continuing medical and pharmaceutical education was used. As a result, the main trends in the digitalization of medical education during the period of high alert on the example of COVID-19 were identified: the introduction of online education; personalization of medical education; transformation of working time and revision of process management practices at the university. The identified trends have led to the preservation of the quality of training for practical health care and have become a new starting point in the strategy for the development of medical education.

Solvation, Cancer Cell Photoinactivation and the Interaction of Chlorin Photosensitizers with a Potential Passive Carrier Non-Ionic Surfactant Tween 80

Cancer and drug-resistant superinfections are common and serious problems afflicting millions worldwide. Photodynamic therapy (PDT) is a successful and clinically approved modality used for the management of many neoplastic and nonmalignant diseases. The combination of the light-activated molecules, so-called photosensitizers (PSs), with an appropriate carrier, is proved to enhance PDT efficacy both in vitro and in vivo. In this paper, we focus on the solvation of several potential chlorin PSs in the 1-octanol/phosphate saline buffer biphasic system, their interaction with non-ionic surfactant Tween 80 and photoinactivation of cancer cells. The chlorin conjugates containing d-galactose and l-arginine fragments are found to have a much stronger affinity towards a lipid-like environment compared to ionic chlorins and form molecular complexes with Tween 80 micelles in water with two modes of binding. The charged macrocyclic PSs are located in the periphery of surfactant micelles near hydrophilic head groups, whereas the d-galactose and l-arginine conjugates are deeper incorporated into the micelle structure occupying positions around the first carbon atoms of the hydrophobic surfactant residue. Our results indicate that both PSs have a pronounced affinity toward the lipid-like environment, leading to their preferential binding to low-density lipoproteins. This and the conjugation of chlorin e₆ with the tumor-targeting molecules are found to enhance their accumulation in cancer cells and PDT efficacy.

Transurethral Resection of Non-Muscle Invasive Bladder Tumors Combined with Fluorescence Diagnosis and Photodynamic Therapy with Chlorin e6-Type Photosensitizers

Bladder cancer is a common disease with a high recurrence rate. In order to improve the treatment of superficial bladder tumors, we evaluated the efficacy and safety of transurethral resection (TURB) followed by fluorescence diagnosis (FD) and photodynamic therapy (PDT) with chlorin e6 photosensitizers (PSs), viz. "Fotoran e6" and "Fotoditazin". It was found that both PSs generated singlet oxygen and revealed moderate affinity toward the lipid-like compartment. Between November 2018 and October 2020, 12 patients with verified non-muscle invasive bladder cancer (NMIBC) were treated by TURB combined with FD and PDT. Eight patients received "Fotoran e6" intravenously, while four patients received intravesical PSs. The patient ages were between 31 and 79 years, with a median age of 64.5 years (mean 61.3 ± 14.2). The total light dose was 150 J/cm2 for the local irradiation of the tumor bed with a red light at the λ = 660 nm wavelength, and 10-25 J/cm2 were additionally delivered for diffuse irradiation of the entire bladder mucosa. At the median follow-up period of 24 months (mean 24.5 ± 5.4 months, range 16-35 months), 11 patients remained tumor-free. One 79-year-old patient developed a recurrence without progression to the muscle layer. This pilot study shows that the TURB + FD + PDT technique is an effective and safe option for the first-line treatment of superficial bladder tumors.

ERBIUM AND SANDWICH-TYPE LUTETIUM COMPLEXES CONTAINING FRAGMENTS OF TETRAANTHRACHINOPORPHIRAZINE AND SUBSTITUTED PHTHALOCYANINES

The present work relates to the synthesis and spectral properties of erbium and sandwich type metal complexes containing tetraanthraquinoporphyrazine as well as phthalocyanine fragments. By reacting tetraanthrachinoporphirazine erbium (lutetium) acetate with excess phthalonitrile, 4-chloro, 4-bromophthalonitrile and unsubstituted phthalonitrile, sandwich-type complexes of an unsymmetrical structure were obtained. The compounds were extracted from the reaction mixture with a suitable organic solvent (DMF or toluene) and purified by prolonged extraction of impurities with acetone in a Soxlet apparatus. Final purification was carried out by column chromatography. The obtained complexes are green solids having solubility in DMSO, DMF, and concentrated sulfuric acid. The composition and structure of complexes were confirmed by elemental analysis, IR and electron spectroscopy. Influence of chemical structure of new "sandwich" compounds on their spectral properties and possible applications has been investigated. In particular, when analyzing the electron absorption spectra, it was found that the metal, the nature of the substituents in the tetraanthraquinone moiety and the replacement of hydrogen atoms with halogen atoms in the phthalocyanine moiety slightly affect the nature and position of the absorption maxima. Studies have been carried out on the coloristic properties of synthesized organosoluble metal complexes erbium and lutetium. The compounds have been found to exhibit the properties of pigments and dyes for polymeric materials such as polystyrene and polyethylene. The temperature parameters of thermal oxidative degradation were determined and it was found that the obtained "sandwich" type phthalocyanines have high resistance to thermal oxidative degradation.