bluuebunny/crossref_metadata_2025 huggingface dataset:
PERAN BIG DATA DAN AUDIT FORENSIK TERHADAP PENDETEKSIAN FRAUD
Authors: Pratiwi Suci Rosa , Surya Firman , Djefris Dedy
Published: June 2024

The large number of fraud cases that occur is still a concern for many parties, so there is a need for action that can detect fraud. One effort that can be made to detect fraud is by utilizing technology through the role of big data. Apart from that, the use of forensic audit science can also be applied in an effort to detect fraud. This research aims to analyze the role of big data in forensic auditing, and this research was also carried out to analyze the role of big data and forensic auditing in fraud detection. The research method used is a survey method with a quantitative approach. The population of this study are auditors who work in Public Accounting Firms (KAP) which researchers can reach in DKI Jakarta, Pekanbaru and Surabaya. The type of data used is primary data and the sampling technique uses the snowball sampling technique with the number of respondents obtained being 132 respondents. Data collection was carried out by distributing questionnaires via Google Form which were distributed to auditors who worked at KAP. The data analysis method uses Structural Equation Modeling (SEM) with Partial Least Squares (PLS) technique. Data processing uses SmartPLS 3.0 software. The results of this research show that big data has a positive effect on forensic audits, big data has a positive effect on fraud detection, and forensic audits have no effect on fraud detection.
Implementasi Corporate Sosial Responsibility Pada PT. Eloda Mitra Palembang
Authors: Dedi Handoko  , Niken Ayuningrum  , Yesita Astarina  , Ferdyan Wana Saputra
Published: June 2024

This study aims to provide an overview of the implementation of Corporate Social Responsibility and find out the CSR implementation efforts implemented by PT Eloda Mitra Palembang. The type of research used is qualitative descriptive research, this study seeks to describe the implementation of CSR as a form of business ethics related to the social responsibility of a company. Sampling was carried out using purposive sampling method, where the respondents interviewed were employees of PT Eloda Mitra Palembang, as well as questionnaires and in-depth interviews with operational managers of PT Eloda Mitra Palembang. The results of the study show that the CSR carried out by PT Eloda Mitra Palembang for the community and the environment in the aspect of education is in the form of buildings, educational facilities and subsidies. Improve health by building puskesmas in villages, providing equipment, deploying health workers as well as vehicles to provide health services to surrounding villages. Vocational training as well as efforts to develop businesses, provide support for SME initiatives and financing. For employees, the implementation of CSR programs aims to improve employee welfare, provide services, and training opportunities.
Early Identification of Neuropathy in Patients with Diabetes Mellitus at RSUD Haji Adam Malik Medan Using the IpTT Method
Authors: Dewi Simanullang Murni Sari , Rante Rupang Ernita , Cellline Ayu Putri Grace
Published: June 2024

Background: Neuropathy is a condition of damage to the nerves of diabetes mellitus patients. Neuropathy can cause serious complications and can even cause amputation in sufferers. So it is necessary to do early detection of neuropathy, one of which is by using the IpTT method. Adam Malik General Hospital is one of the hospitals with the highest percentage of diabetes in Medan, with the cases reported by 1,323 people in 2020. This study aims to identify the incidence of neuropathy in DM patients at Haji Adam Malik General Hospital in Medan using the IpTT method.
Methods: The research design used was a descriptive study with a cross-sectional approach with a population of 1470 inpatients. The sampling technique used accidental sampling with a sample of 52 respondents. The instrument used in this study is in the form of an observation sheet using the SOP of the IpTT Method.
Results: The results of the study found that out of 52 respondents who had neuropathy, 5 respondents (10%) and 47 respondents (90%) did not experience neuropathy.
Conclusion: It is hoped that from the results of this study, DM patients can prevent neuropathy by using the IpTT method.
Natural polysaccharides-based postbiotics and their potential applications
Authors: Du Weinan , Di Martino Luca , Li Juxiu
Published: June 2024

Postbiotics, representing the newest member of the family of biotics, are metabolites produced as a result of fermentation of lactic acid bacteria (LAB) in the De Man, Rogosa, and Sharpe (MRS) medium which includes proteins, sugars and minerals. The components of postbiotics includes exopolysaccharides (EPS), short-chain fatty acids (SCFAs), bacteriocins, antioxidants, and metabolizing enzymes. Several studies indicate that postbiotics have multiple properties such as antimicrobial, immunomodulatory, antioxidant, anti-inflammatory, anti-obesity, anti-diabetic, and anti-tumoral properties. Natural polysaccharides refer to the polysaccharides obtained from biological organisms including algae, plants, animals, and microorganisms. Polysaccharides are either branched or linear macromolecules and are composed of a few major and some minor monosaccharides, including glucose, fructose, mannose, arabinose, galactose, fucose, galacturonic acid, glucosamine, galactosamine or their derivatives. Similar to postbiotics, polysaccharides also exhibit anti-inflammatory, antibacterial, antitumor, antiviral, immunomodulatory, and antioxidant properties. Although polysaccharides cannot be directly digested by the human body due to the lack of specific enzymes, they can be digested by gut-residing bacteria including but not limited to LAB. Recent studies indicate that large non-starch polysaccharides such as alginate, fucoidan, chitosan, carrageenan, and guar gum can be degraded into low molecular weight oligosaccharides which in turn can provide health benefits to the human health. These new findings inspired us to propose a polysaccharides-based postbiotics, also called glycanbiotics, and their potential applications. We propose that polysaccharides can be fermented by probiotics, and subsequent removal of bacteria will increase the safety of their produced metabolites, including oligosaccharides, disaccharides, monosaccharides and their derivatives. These polysaccharides-based postbiotics may mimic metabolization of polysaccharides in vitro and consequently broaden the applications of postbiotics. Non-probiotics such as Akkermansia muciniphila and other bacteria can also be used for glycanbiotics production, thus providing novel applications for human health.
Response to trametinib, hydroxychloroquine, and bevacizumab in a young woman with NRAS-mutated metastatic intrahepatic cholangiocarcinoma: a case report
Authors: Musaelyan Aram A. , Anokhina Ekaterina M. , Turdubaeva Alina I. , Mitiushkina Natalia V. , Ershova Anastasia N. , Shestakova Anna D. , Venina Aigul R. , Imyanitov Evgeny N. , Orlov Sergey V.
Published: June 2024

Systemic chemotherapy is the main treatment option for patients with advanced intrahepatic cholangiocarcinoma (iCCA), however, its efficacy is limited. Herein, we report a young patient with NRAS-mutated chemoresistant metastatic iCCA, who received second-line therapy with a combination of trametinib (MEK1/2 inhibitor), hydroxychloroquine (autophagy inhibitor), and bevacizumab (angiogenesis inhibitor). A significant response was achieved during therapy, resulting in a 25% decrease in the size of tumor lesions after 2 months of treatment and an improvement in the patient’s condition. The duration of this response was 4 months, but the patient died 10 months after the initiation of this triple therapy. This case report and the analysis of other available studies warrant further investigations on combined MEK and autophagy inhibition in RAS-mutated tumors.
Tanssiva viulisti ja avainviulisti muusikko-säveltäjänä ja nykypäivän perinteenkantajana
Authors: Lajunen Emilia
Published: June 2024

Emilia Lajunen avaa lektiossaan käytäntölähteistä taiteellista tutkimustaan, joka keskittyi arkistosävelmien ja muun aikalaistiedon rooliin historiatietoisen, tanssivan muusikko-säveltäjän praktiikassa ja tuo siten uuden näkökulman nykypäivän kansanmuusikkouden tutkimukseen. Keskeistä tutkimuksessa on muusikon samanaikainen soittaminen ja tanssiminen sekä monikanavainen kuuntelu, jonka Lajunen on tunnistanut soittamisen ja tanssimisen yhdistämiseen liittyväksi ilmiöksi. Opinnäytteeseen sisältyy neljä taiteellista osiota – Artjamei – riitit ja liike (2017), Katrillia kahdessa ajassa (2018), Mytty-iltamat (2018) ja Vainaan pe- rua (2020).
Proaktiivista tutustumista mobiiliteknologiaan – Työntekijöiden teknologiaa kotoistavat kysymykset hoitoalan koulutusvuorovaikutuksessa
Authors: Kääntä Liisa
Published: June 2024

Artikkelissa tarkastellaan mobiiliteknologian käyttöönottokoulutuksia terveysalan julkisessa organisaatiossa. Tutkimuksen tavoitteena on analysoida koulutettavien eli työntekijöiden kysymyksiä ja kouluttajien vastauksia hyödyntämällä multimodaalista keskustelunanalyysia. Teoreettisesti tutkimus kytkeytyy näkemykseen teknologian diskursiivisesta kotoistamisesta ja työelämän teknologiakeskeisestä vuorovaikutuksesta. Artikkelissa osoitetaan, että työntekijöiden kysymykset suuntautuvat pääosin tulevaisuuteen, koska niillä selvitetään ja selvennetään kohdeteknologian ominaisuuksia ja käyttötapoja tuottaen samalla diskurssia kohdeteknologian merkityksestä. Toisin sanoen työntekijät ennakoivat kysymyksissään niitä hetkiä, kun he käyttävät sovellusta arkisissa työtehtävissään. Kouluttajien vastaukset vaihtelevat tukemisesta neuvomiseen ja tiedon välittämisestä kokemuksista kertomiseen, joilla myös diskursiivisesti kotoistetaan kohdeteknologiaa. Tällainen kysymys-vastaus-toiminta ilmentää proaktiivista vuorovaikutusta, jossa osallistujat omalla toiminnallaan luovat ja merkityksellistävät työn muutoksesta ja digitalisaatiosta käytävää keskustelua samalla sitä muokaten.
Ajautumista, ammatillisuutta ja maailman parantamista – potilas- ja kansanterveysjärjestöjen johtajien urakertomukset kaaosteorian näkökulmasta
Authors: Lindfors Anne
Published: June 2024

Tarkastelen tutkimuksessani sosiaali- ja terveysjärjestöjen johtamista uratutkimuksen keinoin. Aineistona on 19 haastattelemalla kerättyä valtakunnallisen potilas- ja kansanterveysjärjestön johtajan urakertomusta. Teoreettisena viitekehyksenä käytän työurien kaaosteoriaa (CTC). Kysyn, miten järjestöjohtajat kertovat urastaan ja millaisia urasiirtymiä ja attraktoreja urakertomuksista on löydettävissä. Analyysin tuloksena muodostin kolme uratyyppiä: johtaja, alanvaihtaja ja järjestötyöntekijä. Järjestöjohtajien urat ovat monivaiheisia ja polveilevia, ja ne sisältävät paljon urasiirtymiä. Urat noudattavat vieraan attraktorin työuraa, jossa sattumilla ja ajautumisella on suuri merkitys. Järjestöjohtamisen erityispiirteinä tunnistetut henkilökohtaisuus, arvopohjaisuus, sattumanvaraisuus ja kompleksisuus tulevat esiin urakertomuksissa ja ohjaavat uran suuntaa. Urakertomuksissa ilmenee avoimuutta muutoksille ja valmiutta reagoida niihin. Työelämä ja työssä tarvittavat osaamiset muuttuvat yhä nopeammin, joten samoista valmiuksista olisi hyötyä tulevaisuudessa myös muun tyyppisillä työurilla.
PELAKSANAAN PEMBELAJARAN DARING KOLABORATIF PENGEMBANGAN KURIKULUM DAN PEMBELAJARAN SEKOLAH DASAR
Authors: Qudwatullathifah Ratri Nuryani , Bito Gregorius Sebo , Hasanah Dede
Published: June 2024

Pembelajaran Daring Kolaboratif programmes are learning models that combine learning using technology. This learning approach relies on the use of information and communication technology (ICT) to support students in interacting and collaborating as the learning process of teaching takes place. The aim of this study is to evaluate student perceptions related to the Pembelajaran Daring Kolaboratif (PDK) Pengembangan Kurikulum dan Pembelajaran SD program in several aspects, such as learning models, the quality of teachers, and the educational institutions involved. This research uses qualitative method. Research subjects of 31 students who are involved in the PDK Pengembangan Kurikulum dan Pembelajaran SD program. The test instrument in research is a questionnaire. Study results showed that students' perception of PDK Pengembangan Kurikulum dan Pembelajaran SD, 92% was successfully established, 92% students accepted that the Learning Management System (LMS) learning model made it easier for students to access information about lectures.
Global and local spatial autocorrelation: methods of calculation and mapping
Authors: Okunev Igor
Published: June 2024

The first law of geography by V. Tobler — “everything influences everything, but what is closer influences more” — implies that the distribution of any phenomenon in the world is determined by a geographical factor. Spatial dependence, or the so-called neighborhood effect, is of interest to researchers for various reasons, including, for example, the potential for spatial interpolation, when observation at a given point can provide information about phenomena in nearby ones. In turn, spatial dependence can be expressed in positive or negative spatial autocorrelation of phenomena in neighboring objects of analysis. According to the second law of geography formulated by V. Tobler in 2004, a phenomenon external to the geographical area being analyzed affects what happens inside it. These words can be deciphered as a statement that a phenomenon is influenced not only by the properties of the region in which it is located, but also by phenomena characteristic of other regions (say, adjacent ones, while proximity can also be measured differently). The article provides a classification of spatial autocorrelation methods and describes three basic spatial autocorrelation indices: Moran's, Geary's and Gettys-Ord's. An algorithm for calculation and mapping is given.
Territorial structure of the exarchate of Africa of the Russian Orthodox Church at the present stage
Authors: Andreeva Tatyana
Published: June 2024

Currently, the confessional structure of the world is experiencing various changes. One notable change is the spread of the activities of various religious organizations to those territories where they were previously either not present or minimally represented.
In particular, the Russian Orthodox Church, the largest of the Orthodox churches in the world, has launched extensive activities on the African continent in recent years, creating a new entity there — the Patriarchal Exarchate of Africa. The article presents the results of a study of the territorial structure of the exarchate that had developed by the end of 2023.The number of parishes included in the exarchate, known from open sources, was calculated, both for the exarchate as a whole and for its constituent dioceses and individual countries. Based on data on the geographical location of the parishes of the Exarchate of Africa, a map of their location has been compiled. A significant uneven distribution of parishes of the Russian Orthodox Church within the African continent has been revealed, including variations between the North African and South African dioceses within the exarchate, across countries, and within individual countries. The countries most suitable for the further development of the activities of the Russian Orthodox Church on the African continent have been identified.
International tourism of the Russian borderland (2016–2019)
Authors: Kondrateva Svetlana
Published: June 2024

The article analyzes the border regions of the Russian Federation for the period 2016–2019 as an attractive destination for international tourists. Does the localization of a region in the border area affect the activity of the development of international tourism in comparison with the inland regions of the state? How dependent are border regions on the preferences and interests of tourists from neighboring countries? This article is devoted to finding answers to these questions, the purpose of which is to substantiate the importance of cross-border tourist exchanges in the development of international organized tourism in the period 2016–2019. The study showed that the border regions of the Russian Federation are quite diverse in terms of the level of development of international tourism. An analysis of the dynamics of inbound international tourism revealed the presence of causal connections between the localization of a constituent entity of the Russian Federation in the border region and its attractiveness for foreign tourists in general. Border regions receive a volume of incoming organized tourist flow from abroad almost comparable to two federal cities (Moscow and St. Petersburg), ahead of the deep regions of the Russian Federation in servicing international tourists. At the same time, a significant share comes from cross-border tourism. Thus, the observed significant interregional differentiation reveals the importance of the development of international tourism for some border regions, accompanied in some cases by a high degree of dependence on the preferences of tourists from neighboring states; for other subjects of the Russian Federation ¾  a neutral attitude towards the development of inbound tourism.
The influence of the economic and legal concepts of an organization's assets on their interpretation in retrospect and modern conditions
Authors:   North-Ossetian state University named after K. L. Khetagurov, Galasova M. V.
Published: June 2024

The ambiguous interpretation of economic, legal concepts, static, dynamic theories of the organization's assets in the Russian and foreign literature in the historical and modern period of development justifies the need for their scientifically based argumentation and implementation. It is important to use the most effective concepts, theories of the organization's assets from the position of determining the real directions of their development, improvement, which justifies the relevance and timeliness of the study. The conducted research states that the problematic aspect implies the presence of many positions, discussions on the applicability of the economic, legal concepts of assets, their static, dynamic theories, which requires a detailed comparison of the economic and legal concepts of the assets of the organization from the standpoint of static and dynamic theories. With the help of general scientific and special methods was carried out, which made it possible to identify their essential provisions that can be developed in modern the period of development. In the field of research a comparison of the legal and economic concepts of the assets of an organization within the framework of static and dynamic theories was carried out; the dynamic theory of the assets of an organization within the framework of legal and economic concepts was considered. As a result it is established that on the basis of an optimal combination of economic and legal concepts of assets within the framework of static and dynamic theories, it is possible to form a concept of a digital asset characterized by such criteria as obtaining economic benefits, ownership of the asset, immateriality, etc.
Academic community of the Kola North (literature review)
Authors:   Barents Centre of the Humanities of the Kola Science Centre of the Russian Academy of Sciences, Apatity, Busyreva Elena V.
Published: June 2024

The article provides an overview of publications devoted to the history of the formation and development of academic life in the Kola North, and about the employees of the Kola Scientific Center. In post-Soviet times, the subject of publications has expanded significantly, primarily due to the diversity of types of sources and the development of anthropological aspects of the study of academic science, however, many issues have not yet been sufficiently studied. The author considers the study of the history and culture of academic families to be one of the promising directions.
Migrant workers at Murmanstroyka: reflections of an anthropologist on the number of Chinese
Authors:   Barents Centre of the Humanities of the Kola Science Centre of the Russian Academy of Sciences, Zmeeva Olga V.
Published: June 2024

The problem is the difference in historical approaches to the use and interpretation of statistical data concerning various aspects of personnel decision-making during the construction of specific railway facilities and, in general, when studying the history of labor migration. For the first time, detailed information is provided on the number of Chinese nationals hired to participate in the construction of the Murmansk railway in 1916. They reflect the systematic organization and subsequent implementation of group transportation of Chinese citizens from Harbin to Arkhangelsk. For the first time, statistical documents from the funds of the National Archive of the Republic of Karelia related to the hiring of Chinese labor migrants in the European North of Russia during the First World War have been introduced into scientific circulation.
Sergey Uvarov's ministerial chancellery as education management tool in the 1830s–1840s
Authors:   Russian State Historical Archive, Saint Petersburg, Russia, Ashikhmin Andrey V. ,   Institute of History of St. Petersburg State University, Saint Petersburg
Published: June 2024

The article examines the administrative functions of Sergey Uvarov's ministerial chancellery based on the materials of the clerical office of the Department of Public Education of the 1830-1840s. The functional features of the “special chancellery” of Alexander Golitsyn and the Chancellery of the Minister of Public Education in the studied period are compared. The author demonstrates the results of a statistical study of the reports of the Ministry of Public Education for 1833–1849, from which it follows that the highest burden on the ministerial chancellery took place in the years of crisis for the institution (1839 and 1849). For the first time, information about Uvarov clerks, their career trajectories and social appearance is introduced into academic sphere. On the basis of formulary lists and other sources, an attempt is made to prosopographically study the persons who served in the Office of the Minister of Public Education (1833–1849). The author also presents the results of a content analysis of the materials of the archival fund of the Office of the Minister (RSHA, fund No. 735), on the basis of which conclusions can be drawn about the main areas of work of this institution, fixed not legally, but de facto.
New archaeological monuments on the northern coast of the Kandalaksha Bay of the White Sea
Authors:   Barents Centre of the Humanities of the Kola Science Centre of the Russian Academy of Sciences, Shakhnovitch Mark M.
Published: June 2024

The article is devoted to the results of the archaeological expedition of the Kola Scientific Center of the Russian Academy of Sciences on the northern shore of the Kandalaksha Bay of the White Sea near the city of Kandalaksha and on the Kolvitsa River in 2023. Three new archaeological monuments have been recorded: Niva XXIII — boulder pit, Kandalaksha XVI – charcoal pits and Kolvitsa – stone structures. The boulder pit is located on an ancient sea terrace, on the western slope of Mount Volosyanaya, 1 km from the Niva River. Three charcoal pits are located on the northern shore of Malaya Pitkulya Bay, near the southern slope of Mount Krestovaya, not far from the labyrinth. This is the first discovery of such objects in Russian Lapland and they date back to the late 15th–16th centuries. Seven formations of boulders are located on the northern bank of the Kolvitsa River near the rapids. Analogs are known to them in other places of Russian Lapland. There are also boulder pits on the Khlebnaya River and on the coast of the Barents Sea. The dating and ethnicity of the boulder structures are still speculative.
RUSSIAN-SERBIAN LITERARY TIES IN FOREIGN AUDIENCES (DOSTOEVSKY–NEGOSH)
Authors: Гаврич В.
Published: June 2024

Статья посвящена специфике русско-сербских историко-литературных связей XIX в. и восприятию русской литературы в иностранной аудитории (РЛИ). Проводится компаративистский анализ феноменов «русская идея» и «Косовский завет» на примере творчества Ф. М. Достоевского и П. П. Негоша. Иностранным студентам предлагается методика выявления взаимосвязей данных феноменов в сложной художественной реальности Достоевского и Негоша. На основе продемонстрированного методологического потенциала российских и сербских студенческих исследовательских проектов предложено использование и разработка нового раздела методики преподавания русской литературы как иностранной – русская литература в славянской аудитории (РЛС).

The article is devoted to the specifics of Russian-Serbian historical-literary ties of the XIXth century and the perception of Russian literature in foreign audiences (RLF). A comparativist analysis of the phenomena «Russian idea» and «Kosovo covenant» is carried out, using the example of the works of F. M. Dostoevsky and P. P. Negosh. Foreign students are offered the methodology of revealing the interrelations of these phenomena in the complex artistic reality of Dostoevsky and Negosh. Based on the demonstrated methodological potential of Russian and Serbian student research projects, the use and development of a new section of the methodology of teaching Russian Literature as a Foreign – Russian Literature in Slavic Audiences (RLS) is proposed.
THE “(UN)WELL-READABILITY” OF OUR TIME IN FOREIGN LANGUAGE EDUCATION
Authors: Буйняк М.
Published: June 2024

В статье представлены положения словацкой школы культуроведческого направления иноязычного образования в области отбора авторов художественной литературы и прецедентных текстов в рамках преподавания РКИ. В соответствии с философией человека начитанного, а не «нагугленного» (человека, использующего поисковую систему для быстрого поиска информации) мы уточняем критерии определения нового культуроведческого литературного содержания в контексте синтетической художественной культуры. Мы представляем подборку литературных текстов с подтекстовой направленностью – затронуть душу учащегося с целью прочитать литературный текст, понять его и совместно с учителем создать «коммуникативно-увлекательную» образовательную модель, основанную на информации-импрессии.

The article presents the starting points of the Slovak school of culturological direction of foreign language education in the field of selection of literary authors in school textbooks and their precedent texts as part of the teaching of Russian literature in foreign language education in Slovakia in the context of the past and present. In accordance with the philosophy of well-read person, not a “google-read” (person using a search engine for a quick search for information) we clarify the criteria for defining new culturological literary content in the context of synthetic artistic culture. We present a selection of literary texts with the subtextual focus of touching the depths of the student's soul, with the goal that learners read the literary text, understand it, and co-create with the teacher a communicative-experiential model of teaching.
MOBILE APP «RUSSIAN LITERATURE AND CINEMA» FOR CHINESE STUDENTS: FEATURES OF THE DISTANCE LEARNING COURSE DESIGN
Authors: Шишков М.С.
Published: June 2024

В статье представлено содержание курса дистанционного обучения «Русская литература и кино», реализованного в виде мобильного приложения. Описываются предпосылки создания курса, основные положения его концепции, а также интерфейс и технические характеристики программного продукта. Отмечаются особенности проектирования данного курса, обусловленные его ориентацией на китайских (и иностранных вообще) студентов, обучающихся в вузах по специальности «Русский язык». Большое внимание в курсе уделено предлекционной языковой работе, знакомству с основными понятиями теории литературы, а также заданиям историко-культурного плана, которые готовят студентов к осмысленному освоению лекционного материала.

The article presents the content of the distance learning course «Russian literature and cinema», implemented in the mobile app. The author describes prerequisites for the creation of the course, the main provisions of its concept, as well as the interface and technical characteristics of the created software product. The peculiarities of this course design are based on its orientation on Chinese (and generally foreign) Russian language program university students. The authors of the course paid attention to the pre-teaching language work, gradual acquaintance with the basic concepts of literature theory, as well as the tasks of history and culture, which should prepare students for perception of lecture material.
ДИВНИЙ ПРОФЕСОР. СПОГАДИ ДОЦЕНТА КАФЕДРИ «ТРАВМАТОЛОГІЇ, ОРТОПЕДІЇ ТА ВІЙСЬКОВО-ПОЛЬОВОЇ ХІРУРГІЇ» ХАРКІВСЬКОГО МЕДИЧНОГО УНІВЕРСИТЕТУ А. О. МАРЮХНІЧА
Authors: Board Editorial
Published: June 2024

ДИВНИЙ ПРОФЕСОР. СПОГАДИ ДОЦЕНТА КАФЕДРИ «ТРАВМАТОЛОГІЇ, ОРТОПЕДІЇ ТА ВІЙСЬКОВО-ПОЛЬОВОЇ ХІРУРГІЇ» ХАРКІВСЬКОГО МЕДИЧНОГО УНІВЕРСИТЕТУ А. О. МАРЮХНІЧА
NFLUENCE OF RECTUS ABDOMINIS DIASTASIS ON DAILY ACTIVITIES
Authors: Vasyliuk S. M. , Petrash A. V.
Published: June 2024

Introduction. While for a long time rectus abdominis diastasis was largely associated with cosmetic issues, modern research increasingly demonstrates a spectrum of clinical symptoms that are clearly linked to the presence of rectus abdominis diastasis in patients: back and lower abdominal pain, urinary and fecal incontinence, pelvic organ prolapse, and fixation. Materials and Methods. We conducted a clinical examination of 120 patients with rectus abdominis diastasis. Among the examined patients, there were 92 females (76.7%) and 28 males (23.3%). Type A according to Keramidas was present in 39 patients (32.5%), type B in 60 (50.0%), type C in 15 (12.5%), and type D in 6 (5.0%). The assessment of patients’ daily activity was conducted using the specialized Ventral Hernia Pain Questionnaire (VHPQ). Results. Problems with rising from a chair were reported by 36 patients (30.0%) (p=0.001; χ2=36.82). Discomfort while sitting on a chair was complained of by 23 patients (19.2%) (p=0.001; χ2=88.82). Problems with prolonged standing were present in 41 patients (34.2%) (p=0.001; χ2=22.82). Climbing stairs was difficult for 38 patients (31.7%) (p=0.001; χ2=30.82). Difficulties in driving a car were experienced by 6 patients (5.0%) (p=0.001; χ2=190.82). The majority of patients (62, 51.7%) experienced difficulties in performing sports or physical activities (p=0.698; χ2=0.15). Conclusions. Among patients with rectus abdominis diastasis, impairment of daily life quality and activities was observed in 69.2% of cases. Only 30.8% of patients perceived diastasis exclusively as a cosmetic problem. The frequency of manifestations depended on the severity of rectus abdominis diastasis.
TACTICS OF SURGICAL TREATMENT OF ACUTE DIVERTICULITIS OF THE COLON COMPLICATED BY PERFORATION
Authors: Knyhin M. V.
Published: June 2024

Resume. Acute colonic diverticulitis is defined as inflammation of one or more colonic diverticula. The most frequent complications of acute diverticulitis of the large intestine are phlegmon or abscess (in approximately 70% of patients with complications), perforation of the large intestine with the development of peritonitis, large intestinal obstruction and fistula. Tactics of surgical treatment of patients with diverticular perforation of the colon is widely discussed in modern urgent coloproctology.
The purpose of the work is to analyze literary sources related to the results of surgical interventions in patients with acute diverticulitis of the large intestine complicated by perforation, in order to determine the strategy of their surgical treatment.
Materials and methods. The paper analyzed and systematized the data of full-text publications, which were obtained as a result of a literature search in the Scopus and PubMed databases for the period from 2017 to 2023, devoted to the issues of surgical treatment of acute diverticulitis of the large intestine complicated by perforation.
Results and their discussion. The Hartmann procedure is recommended for the treatment of disseminated peritonitis in critically ill patients and those with multiple comorbidities, but in clinically stable patients without comorbidities primary resection with anastomosis with or without a diverting stoma may be performed. Primary anastomosis is a better option compared to the Hartmann procedure in hemodynamically stable patients. The advantages of laparoscopic lavage compared to Hartmann’s colon resection for patients are a reduction in the risk of secondary operations and the presence of a permanent stoma. The use of “damage control” tactics is indicated for clinically unstable patients with diverticular peritonitis (severe sepsis/ septic shock), its goal is to control the source of infection, with the subsequent transfer of the patient to the intensive care unit for physiological resuscitation and sepsis management, and the next stage of performing delayed surgery for final treatment.
Conclusions. Surgical treatment is indicated in patients with diverticulitis complicated by perforation that has caused contamination of the abdominal cavity and purulent or fecal peritonitis (Hinchey grade III or IV, respectively). The choice of surgical intervention tactics is primarily determined by the general condition of the patient, the presence of concomitant pathology, clinical manifestations of sepsis or septic shock, and multiple organ dysfunction. Laparoscopic lavage is a better option for perforated diverticulitis with purulent peritonitis than open resection and colostomy. Damage control remains an effective surgical strategy in critically ill patients with sepsis/septic shock and hemodynamic instability.
DIAGNOSIS OF SENILE ASTHENIA USING THE EDMONTON FRAIL AND FRAILTY PHENOTYPE QUESTIONNAIRE IN PATIENTS WITH ACUTE CHOLECYSTITIS
Authors: Bulba P. O. , Danilyuk M. B. , Kubrak M. A. , Zavgorodnyi С. M. , Kapshitar O. V.
Published: June 2024

Summary. About 80 million surgical interventions are performed annually in Europe, and according to the observations of the National Centre for Statistics of Germany, about a third of them are performed in patients over 65 years of age. The syndrome of senile asthenia is of particular concern as one of the factors influencing the general condition of the patient and the course of the perioperative period. Objective: to compare the effectiveness of the diagnosis of senile asthenia using the Edmonton Frail and Frailty Phenotype Questionnaire scales in patients with emergency abdominal surgical pathology.
Materials and methods. To compare the effectiveness of the diagnosis of senile asthenia using the Edmonton Frail and Frailty Phenotype Questionnaire scales in emergency abdominal surgery, we analysed the results of treatment of 80 (100.0%) elderly and senile patients with acute cholecystitis in the setting of cholelithiasis.
Results and discussion. The syndrome of senile asthenia has a great impact on the perioperative period. Early detection of the syndrome with the help of scales allows modifying perioperative treatment and reducing the number of postoperative complications in this group of patients. Therefore, the definition of a scale that can be used to quickly and accurately assess the syndrome of senile asthenia is of great importance for emergency surgical care of elderly and senile patients.
Conclusions. The use of scales for the assessment of senile asthenia allows predicting the course of the perioperative period in patients with emergency surgical pathology.
BACTERIAL OVERGROWTH SYNDROME OF GASTROINTESTINAL TRACT I N ACUTE NECROTIZING PANCREATITIS
Authors: Rotar O. V. , Khomiak I. V. , Polioviy V. P. , Hrama O. V.
Published: June 2024

Summary. Purpose: to study the changes in the microflora of the upper parts of digestive tract during acute necrotizing pancreatitis.
Material and methods: acute necrotizing pancreatitis was induced in 42 white rats, changes in the mucous microflora of the upper part digestive tract have been dtudied. Bacteriological examination of the contents of the proximal small intestine was performed in 42 patients with acute necrotic pancreatitis during gastrofibroscopy.
Results and discussion: Induction of acute necrotic pancreatitis was accompanied by impaired colonization resistance of the intestinal mucosa due to the elimination of bifidobacteria and lactobacilli: the frequency of their growth from the mucosa decreased threefold (p<0.01), and the population level, respectively, by 25% (p<0.05) and by 36% (p<0.02). The mucosa was actively colonized by gram-negative pathogenic and conditionally pathogenic enterobacteria on a high population level (3.07-5.39 lg CFU/g), which allowed this microflora to overcome the damaged intestinal barrier and translocate. Pathogenic Escherichia spp and Proteus spp were cultivated from the mesenteric lymph nodes 24 hours, Enterobacteria spp and Staphylococci spp were isolated from portal blood, pancreatic tissue, and peritoneal cavity 48 hours after induction of acute pancreatitis. Eight strains of gram-negative microorganisms were isolated from the small intestine and identified in 69% of patients before surgical interventions. Same microflora was cultivated from pathological foci in 57.4% of patients during the postoperative period.
Conclusions: During acute necrotizing pancreatitis severe deficiency of autochthonous anaerobic microflora occurred in the upper parts of the digestive tract, which caused excessive colonization by pathogenic and conditionally pathogenic microorganisms and promotes bacterial translocation.
ANALYSIS OF MODERN COMPLEX TREATMENT OF PATIENTS WITH PERFORATED GASTRODUODENAL ULCER
Authors: Pokidko M. I. , Balabuyeva V. V. , Goncharenko O. V. , Bogachuk M. G.
Published: June 2024

Abstract. The goal is to improve the results of complex treatment of patients with a perforated gastroduodenal ulcer by analyzing the results of treatment using traditional surgical techniques and using minimally invasive, including endoscopic vacuum-associated (E-VAK) interventions. The results of treatment of 287 patients with gastric and duodenal ulcers complicated by perforation, who were treated in the surgical department of the city clinical emergency medical hospital during 2019-2023, were studied. Among gastric ulcers, chronic ulcers were found in 78 (27.2 %) cases, acute – in 34 (11.8 %) cases. There were 132 (46.0 %) chronic duodenal ulcers, 43 (15.0 %) acute ones. At the same time, in total, diagnostic laparoscopy was performed in 40 (13.9 %) patients, laparoscopic suturing of the perforating hole was performed in 32 (11.1 %) patients, and 8 (2.8 %) had indications for conversion. In 2 cases (0.69 %) endoscopic vacuum-associated (E-VAC) intervention was used for the treatment of duodenal ulcer perforation. 34 (11.8 %) patients underwent laparocentesis with subsequent drainage of the abdominal cavity and peritoneal lavage with decamethoxin solution before surgery. Among the complications in the postoperative period, failure of intestinal sutures was observed in 6 (2.1 %) patients. Postoperative mortality was 12.5 %. The cause of mortality in 27 (77.1 %) patients was the progression of multiple organ failure against the background of the terminal stage of peritonitis. Today, when choosing a method of treatment for a perforated gastroduodenal ulcer, preference should be given to minimally invasive laparoscopic methods before surgery with a laparotomy approach. The use of endoscopic vacuum-associated (E-VAK) interventions, especially in patients with IV-V degree of risk according to the ASA scale, is a promising direction in the treatment of patients with perforated gastroduodenal ulcer.
TECHNIQUE ON THE STOMACH DURING PANCREATICO-DUODENECTOMY
Authors: Veligotskyy M. M. , Arutyunov S. E. , Veligotskyi O. M.
Published: June 2024

Summary. Objective. To develop an algorithm for the differential choice of resection or pylorus-preserving techniques on the stomach with the choice of the reconstructive stage and determination of the location of the gastroenteroanastomosis (GEA).
Materials and methods. The paper presents an analysis of the treatment of 302 patients with obstructive diseases of the pancreaticoduodenal zone who underwent pancreaticoduodenectomy (PDЕ).
The following surgical procedures were performed on the stomach: resection of ½ of the stomach, antrumectomy (hemianthrumectomy) in combination with vagotomy (or without vagotomy), pylorus-preserving PDE. The gastroenteroanastomosis (GEA) (or duodenojejunoanastomosis) was located anteriorly and posteriorly. The severity of postoperative gastrostasis was assessed according to the ISGPS classification, 2007.
Results and discussion. Resection of ½ of the stomach was performed in 88 (59.9%) patients in the main group and in 98 (64.1%) in the comparison group, antrumectomy (hemianthrumectomy) without vagotomy – in 42 (28, 6 %) and 22 (14.4 %), respectively, antrumectomy with vagotomy – in 8 (5.4 %) and 32 (20.9 %), respectively, pylorus-preserving PDЕ – in 9 (6.1 %) and 1 (0.7 %), respectively. Pre-operative GEA was used in 110 (74.8%) patients in the main group and 52 (34.0%) in the comparison group, post-operative GEA – in 37 (25.2%) and 101 (66.0%) patients, respectively.
Postoperative gastrostasis developed in 18 patients: 7 (38.9%) in the main group and 11 (61.1%) in the comparison group.
Conclusions. Among the techniques used in the stomach for PDE, organ-preserving and organ-sparing techniques with predominantly anteroseptal location of the GEA or duodenoenteroanastomosis are preferred.
VIDEOLAPAROSCOPIC TECHNOLOGIES FOR ACUTE SURGICAL ABDOMINAL PATHOLOGY COMPLICATED BY AN ABSCESS OF THE ABDOMINAL CAVITY
Authors: Kapshitar O. V. , Kapshitar O. O.
Published: June 2024

Resume. The purpose of the study: to improve the results of treatment of acute surgical abdominal pathology complicated by an abscess of the abdominal cavity, through the introduction of video laparoscopic surgery.
Material and methods. The results of surgical treatment of 20 patients with abdominal cavity abscess (ACA) as a result of acute surgical abdominal pathology, which underwent minimally traumatic video laparoscopic (VLS) technology, were analyzed, which accounted for 31.3 % of all ACB.
Research results and their discussion. Up to 2 hours after hospitalization in the surgical clinic, 9 (45 %) patients with acute destructive appendicitis were operated on, on the 2nd-12th day - 11 (55 %) for ineffective conservative therapy (acute destructive stone cholecystitis, infected pancreonecrosis, appendicular abscess, cancer colon?). During VLS, ACA was confirmed in 6 (30 %) patients and established for the first time in 14 (70 %). Nosological forms of acute surgical abdominal surgical pathology were also diagnosed. In group A, in 13 (65 %) patients, VLS operations were prioritized (cholecystectomy — 5, appendectomy — 4, only dissection of an appendicular abscess — 1, right-sided hemicolectomy — 1). Conversion was required in 2 (15.4 %) patients (in addition, dissection of an abscess of the head of the pancreas — 1, right-sided hemicolectomy — 1). Relaparotomy was performed in 1 (7.7 %) patient. Group B consisted of 7 (35 %) patients who underwent conversion due to the impossibility of dividing a dense ACA (appendectomy — 5, cholecystecto-my — 1, dissection of multiple pancreatic abscesses-1). After surgery, complications occurred in 3 (42 %) patients (wound suppuration, peritoneal phlegmon, pneumonia). 1 (14 %) patient with pancreatogenic sepsis died.
Conclusions. VLS established or confirmed ACA, its cause and other complications in all patients, optimized treatment. Minimally invasive video laparoscopic operations reduced the duration of the operation, stay in bed and in the clinic, complications, relaparotomy, and mortality.
COMBINED APPLICATION OF COPPER NANOPARTICLES AND LOW-FREQUENCY ULTRASOUND IN THE TREATMENT OF PURULENT WOUNDS
Authors: Duzhyi I. D. , Myronov P. F. , Ivakhniuk T. V. , Holubnycha V. M. , Pshenychnyi R. M. , Bugaiov V. I.
Published: June 2024

Summary. The effectiveness of treatment of experimental purulent wounds with the simultaneous use of copper nanoparticles (CuNPs) and low-frequency ultrasound (US) was investigated.
Aim. To study the effectiveness of the treatment of experimental purulent wounds of the CuNPs under conditions of ultrasonic cavitation.
Materials and methods. The study was performed on an experimental model of purulent wounds of 36 laboratory rats. All experimental animals were divided into 3 groups: in the first group, treatment was carried out with CuNPs, in the second group - CuNPs and low-frequency US, in the third – with 0.05 % chlorhexidine solution. The following parameters of the course of the wound process were investigated: the presence of perifocal edema, hyperemia, exudation, purulent secretions, fibrin, detritus, the terms of wound cleansing from purulent-necrotic tissues, the appearance of granulations and epithelization were determined.
Results and discussion. A detailed analysis of the wound process indicators showed that the use of copper nanoparticles in combination with low-frequency ultrasound accelerates the regression of local signs of inflammation, leads to faster rejection of purulent-necrotic tissues, stimulates the appearance of granulations, and ensures faster epithelization of wound surfaces. Rejection of purulent-necrotic tissues in the CuNPs group took place in (6.3±1.3) days, in the CuNPs/US group – in (2.9±0.7) days, in the control group – in (7.1±0.7) days. The appearance of granulations in the CuNPs group was observed for (7.1±1.4) days, in the CuNPs/US group – for (3.6±0.9) days, and in the control group – for (7.4±0.9) days.
Conclusions. The combined use of copper nanoparticles and low-frequency ultrasound allows to shorten the treatment period of experimental purulent wounds and has prospects for application in the practice of purulent surgery.
SURGICAL TREATMENT OF A PATIENT WITH A COMBAT POLYSTRUCTURAL INJURY OF THE UPPER EXTREMITY
Authors: Honcharova N. M. , Kolesnyk V. P. , Sivozhelizov A. V. , Svirepo P. V. , Sova V. S.
Published: June 2024

Resume. Until now, the main shortcoming in the provision of medical care to the wounded with polystructural injuries of the shoulder is the lack of comprehensive approaches to determine the level and types, terms of performing reconstructive-plastic interventions and further rehabilitation of these patients.
The goal is to improve the results of surgical treatment of patients with polystructural injuries of the upper and lower extremities.
Materials and methods. The work has a clinical component and is presented by a clinical case of a patient with a polystructural injury of the right shoulder.
Results and their discussion. The results of the treatment of a patient diagnosed with a blind shrapnel wound of the right shoulder with damage to the right axillary artery (arteria axillaris) and right axillary vein (vena axillaris) are presented, who underwent autovenous prosthetics of the right axillary artery and suturing of the defect of the right axillary vein at the second level of medical care. In the postoperative period, the patient showed signs of distal secondary lymphostasis of the superficial venous part of the right hand, during electromyography, a decrease in the asymmetry of muscle activity in the proximal muscle groups was determined (m. biceps brachii dexter up to 27% and m. triceps brachii dexter up to 30% ), by distal muscle groups (m. flexor digiti minimi dexter up to 34%), due to the hypotrophic component. After treatment and rehabilitation, a decrease in the asymmetry of muscle activity was determined by proximal muscle groups (m. biceps brachii dexter to 15% (-12%) and m. triceps brachii dexter to 17% (-13%)), by distal muscle groups (m. flexor digiti minimi dexter - up to 20% (-14%)).
Conclusions. The system of surgical treatment of the wounded with polystructural injuries of the upper limb with the help of new and improved methods for the restoration of damaged structures, as well as a differentiated approach with establishing the degree of severity, predicting the rehabilitation potential and clinical outcome after surgery, is of great importance for modern combat surgery, because there was an opportunity to improve the efficiency and timeliness of treatment after traumatic recovery.