bluuebunny/crossref_metadata_2025 huggingface dataset:
The Politics of Law of Pancasila-based Democracy in Indonesia as the World’s Third Largest Democracy
Authors: Wisnaeni Fifiana , Herawati Ratna
Published: July 2020

The Indonesian Constitution explicitly states that Indonesia is a country that manages the democratic political system. In the practice of managing the State, democracy that takes place in Indonesia always changes following the development of the Indonesian constitutional system. The aim of this research is to investigate the political development of democratic law in the world's third largest democracy and the ideal democratic system for Indonesia at this time. The research method used is normative juridical, with descriptive analytical research specifications and secondary data types. The data collection method was carried out through a literature study and research results were analyzed by qualitative methods. The results showed that the ideal democracy for the Indonesian state was Pancasila democracy as stated in the Preamble to the Constitution, which stated that democracy was led by wisdom in the deliberative representation and stated that sovereignty was in the hands of the people and implemented according to the Constitution.
Analysing Gender Effect on the Speech Act of Suggestion: A Pilot Study
Authors: Sharqawi Mushtaq A. , Anthony Elizabeth M.
Published: July 2020

This is a pilot study on analyzing the effect of gender on the speech act of suggestion. It introduces preliminary analyses of whether gender affects the use of suggestion strategies produced and recognized by Iraqi EFL learners. The strategies are dealt with from three perspectives: structural, directness, and politeness. The purpose of this small-scale study is twofold, (1) to explore if there is a relationship between gender and suggestions and (2) to check the validity and reliability and thus the workability of the instruments in question to a large-scale study. To this end, the study sampled voluntarily, on an equal base, 10 male and 10 female fourth-year undergraduates using a name-in-box method. The study used two quantitative-based instruments to elicit suggestions: Written Discourse Completion Task (WDCT) and Multiple-choice Discourse Completion Task (MDCT). Each of which consisted of 12 situations approximating real-like interactions. The corpus was statistically analyzed via SPSS and yielded that gender affected the use of structural and directness strategies of suggestions, but it had no effect on the politeness strategies. Results along with the feedback of the raters, who were chosen to rate the situations, have both proven that the instruments in question are valid and reliable to work on relevant further studies.
The Potential of Organisations’ SWOT Diagnostic Assessment
Authors: Serpa Sandro , Ferreira Carlos Miguel , José Sá Maria
Published: July 2020

The need to demonstrate high organisational efficiency has become central. In this context, organisational assessment becomes a critical element, although the specificities of each organisation are indisputable and have to be considered in their assessment. This paper aims to reflect on a specific type of diagnostic assessment – SWOT (Strengths, Weaknesses, Opportunities and Threats) – in its potential, implementation and limitations and, thus, to add to the analysis of organisations. For this purpose, the methodology used was based on the researchers’ reflection and discussion of an empirical process of organisational diagnosis. The results of this reflection allow concluding that the SWOT diagnostic assessment needs to incorporate, in its systematic analysis, a prospective dimension to improve its efficiency in organisational strategy.
Post-War Development and Women’s Empowerment in Eastern Sri Lanka: A Case Study of Batticaloa District in Eastern Province
Authors: Rameez A.
Published: July 2020

The civil war in Sri Lanka had caused enormous impacts on the physical as well as infrastructure development of Eastern Province. Since the end of war in 2009, the province has immensely benefitted from the state and non-state sectors, particularly in the sphere of women empowerment in terms of their livelihood, education, health, etc. Although, many previous studies have delved into a number of post-war development interventions in the province, it failed to explore the dimension of women’s empowerment. Using both qualitative as well as quantitative methods, this study specifically explores the impacts of socio-economic development initiatives on women’s empowerment in the post war context. The findings show women received much support such as housing assistance, dry rations, livelihood assistance, micro-credit loans and psycho-social counselling from state and non-state sectors including NGOs, and UN organizations in the post war period in the Batticaloa district of Eastern Province and such supports have largely been effective as it contributed to women’s empowerment. Nevertheless, such supports have significantly dried up in recent times with priorities of state and non-state sectors being shifted. Thus, it is crucial for state and non-state sectors to focus on the empowerment of women in future, especially enhancing their capacity in terms of their knowledge and skills, and providing financial assistance for their self-employment on a soft loan basis or under grant schemes.
Electronic Money and Payments as Means of Committing Crimes
Authors: Vozniuk Andrii A. , Savchenko Andrii V. , Tarasevych Tetiana Yu. , Dudorov Olexandr O. , Klymenko Olga A.
Published: July 2020

The article deals with the main problems of criminal characteristics of electronic money and payments as instruments of crime. The article reveals the economic and legal nature of electronic money (e-money). The features of e-money and its relation to electronic payments are identified. It is proved that intensive development of the IT sector results in an increasing replacement of cash by cashless methods of payment, and e-money is required for making payments online. E-money is previously created in all cases where they are stored on an electronic device and are used as means of payment, therefore they significantly reduce the level of abuse against property. Criminals in the real estate leasing sector use it as a tool when they commit cybercrime - a new place that has been transformed into a powerful source using for crime. Particular attention in this article is paid to the criminal characteristics of electronic money as an instrument of crime. Electronic money has been updated to account for a significant number of offending characters, while these crimes operate in free currency from a non-supported market and move to electronic services, they are used, and may be joined by warehouse resources, which require a criminal law level. It also indicates that e-money is being received by its billing service, and then can be exploited by attackers to trick owners who have already participated in their work. Through this process, using e-money and electronic payment is almost legal and covers the concept of legality. It is disclosed that the main complexity in detecting malicious tools creates electronic money, which makes it difficult to track the traces of such crime, which uses its delays in cyber space. The author also reveals an accurate view of electronic money resources, such as what is more likely to be abused, which is an additional element of criminal execution qualification.
Writing in Science
Authors: Santos Ana Isabel , Ferreira Carlos Miguel , Serpa Sandro
Published: July 2020

Scientific knowledge entails rigour and control, both as a process of creating a reasoned view of reality and also as the product of results that shape the dissemination of science. The publication is critical for the development of science and the career of the academic/scientist. This article discusses some aspects of writing in science, in a stance that starts from the authors’ scientific area – Sociology/Social Sciences –, using the scientific publication in specialized journals as a paradigmatic case. The results allow concluding that writing in science does not provide the indication of principles to be pursued and that it is shaped as more than rigid self-sufficient rules for the production of a scientific-type text. This topic is particularly relevant in the current context, in which the process of scientific publication is undergoing a profound reformulation.
Testing the Construct Validity and Reliability of Curiosity Scale Using Confirmatory Factor Analysis
Authors: Sujati Heronemus , Sajidan  , Akhyar Muhammad , Gunarhadi
Published: July 2020

Curiosity is one of the important characters that should be acquired by every elementary student in Indonesia. Currently, a standardized instrument to measure the student’s curiosity has not yet available. This study aims to test the construct validity and reliability of the developed curiosity scale. The research involved 300 random samples from 565 students of the fifth grade of elementary school in Ngaglik district of Sleman region, in Yogyakarta, Indonesia. The data was analyzed with the second order confirmatory factor analysis using LISREL 8.80 software. The results show that the developed curiosity scale had fulfilled the criteria of goodness of fit, convergent validity, discriminant validity, construct reliability and omega composite reliability. Therefore, the developed scale was feasible to use.
The Degree of Utilizing E-Assessment Techniques at Prince Sattam Bin Abdulaziz University: Faculty Perspectives
Authors: ALShaikh Asma A.
Published: July 2020

Accomplishing higher education development entails the use of the available technological means and innovative teaching and evaluation methods. Further, developing modern techniques for assessment is integral for achieving the intended learning outcomes and enhancing the alumnus’ capabilities for meeting the digital era requirements. The current study thus aims to identify the degree of utilizing the techniques of e-assessment from the perspective of faculty members in the College of Education at Prince Sattam Bin Abdulaziz University, Saudi Arabia. It also seeks to identify statistically significant differences in the participants’ responses due to gender, academic degree, and years of experience. The analytical descriptive approach was adopted and applied to a sample of 70 faculties at the College of Education, Prince Sattam Bin Abdulaziz University. A questionnaire was developed to include three domains: diagnostic e-assessment, formative e-assessment, and summative e-assessment. The findings demonstrated that there was a low degree of utilizing diagnostic e-assessment and a medium degree of utilizing both formative and summative e-assessments from faculty perspectives. In addition, there were no statistically significant differences in the participants’ responses due to gender, academic degree, and years of experience. The study recommends expanding the utilization of e-assessment techniques in Saudi universities and conducting scientific research to identify faculty members’ training needs in the field of e-assessment.
Storability as a varietal characteristic of sugar beet? – Results 2016–2018
Authors: Kenter Christine , Ladewig Erwin
Published: July 2020

The storability of sugar beet varieties grown in Germany has not been specified to date. In 2016–2018, nine storage trials were carried out in order to test the storability of 13 current varieties. The beet were stored in climate containers for approximately 480 °Cd. Root mass and the contents of sugar, invert sugar and marc were determined before and after storage. During storage, the sugar content decreased in all varieties while the invert sugar content increased. The observed sugar loss was most significant (about 10% of the amount before storage) in an environment where the syndrome „basses richesses“ had occurred. Differences among varieties were significant in six environments, but not for the mean of the eight trials without diseases. Variety recommendations concerning the storability of sugar beet are thus currently not possible.
PENGARUH BUDAYA KERJA DAN PROMOSI JABATAN DALAM MENINGKATKAN KINERJA KARYAWAN PADA PT. PERKEBUNAN NUSANTARA III LABUHAN HAJI LABUHANBATU UTARA
Authors: Zebua Yuniman
Published: July 2020

ABSTRAKPenelitian ini bertujuan untuk mengetahui pengaruh budaya kerja dan promosi jabatan pada PT. Perkebunan Nusantara III Labuhan Haji Labuhanbatu Utara dalam meningkatkan kinerja karyawan.            PT. Perkebunan Nusantara III Labuhan Haji adalah perusahaan negara yang bergerak dibidang perkebunan. Pengambilkan keputusan masih sulit diterapkan secara objektif karena adanya unsur subjektifitas dalam penilaian seperti faktor sosial dan faktor non sosial. Populasi dalam penelitian ini adalah karyawan PT. Perkebunan Nusantara III Labuhan Haji berjumlah 502 orang. Dengan sampel berjumlah 50 orang. Adapun analisis yang digunakan adalah analisis regresi liniear berganda dengan menggunakan bantuan software SPSS 20.00 for windows.            Hasil penelitian menunjukkan bahwa budaya kerja dan promosi jabatan baik secara parsial (sendiri-sendiri) maupun secara simultan (s) berpengaruh positif dan signifikan terhadap kepuasan kerja karyawan PT. Perkebunan Nusantara III Labuhan Haji. Hal ini terlihat dari Uji T menunjukkan nilai t-hitung untuk variabel budaya kerja (9.465) dengan nilai sig sebesar 0,000 dan promosi jabatan sebesar (2.583) nilai sig sebesar 0,002, sedangkan untuk nilai t tabel dicari pada tabel t dengan level of test α = 5% dan df1 = 50 sehingga diperoleh nilai t tabel sebesar 1.675. Dan dari hasil Uji F menunjukkan bahwa Budaya Kerja dan Promosi Jabatan secara simultan berpengaruh terhadap Peningkatan Kinerja Karyawan bedasarkan kriteria nilai Fhitung sebesar 50.119 dengan nilai signifikan 0,000a. maka Fhitung (50.119) > Ftabel (3,20) dengan signifikasi 0,000a < 0,05.            Dari nilai Asjusted R Square sebesar 0.667 yang  berarti bahwa peningkatan kinerja karyawan dapat dijelaskan oleh budaya kerja, promosi jabatan sebesar 66,7%. Sedangkan sisanya 33,3% dapat di jelaskan oleh variabel lain yang tidak diteliti dalam penelitian ini. Kata Kunci  : Budaya Kerja, Promosi Jabatan, Kinerja Karyawan.
Mitigating the effects of a road on amphibian migrations: a Scottish case study of road tunnels
Authors: Hill I.D.C. , Rossi C.A. , Petrovan S.O. , Hartup M. , Clark F. , Downie J.R.
Published: July 2020

The ever-growing pace of road construction worldwide has become a serious concern for wildlife and natural habitats, resulting in habitat fragmentation and increasing wildlife road fatalities. For amphibians, which are undergoing population declines worldwide, mitigation measures such as road under-passages linked to amphibian-proof fencing may be an effective conservation tool, aiming to reconnect natural habitats and reduce wildlife fatalities. This study assessed the efficacy of road tunnels in a recently developed area by Frankfield Loch, Stepps, North Lanarkshire. Three amphibian tunnels, plus fencing, were put in place during 2010 following the construction of a road in 2006 which separated the loch from a substantial area of marshland, including ponds. In 2015 and 2016, we used custom-made time-lapse cameras within the tunnels to automatically monitor amphibian movements and conducted frog spawn surveys. Numbers of common frogs (Rana temporaria), common toads (Bufo bufo) and newts (Lissotriton spp.) using the tunnels were substantial in both years, though the number of toads decreased significantly between years. We found many frog spawn clumps in the marsh ponds, but rather fewer in the loch. A period of road repair in 2015 was linked with both road mortalities and a change in the pattern of tunnel usage. Additionally, amphibians showed a daily cycle of activity, with nocturnal movements most common. These results indicate important connectivity and usage of both the marsh and the loch, and suggest that this can be effectively sustained through the proper maintenance of tunnels and fencing, which also minimises road mortalities. It remains unknown, however, what proportion of the population crosses the road via the tunnels and how that compares with movements prior to road construction.
Long-term monitoring for adders: an evolving methodology
Authors: Hodges R.J. , Seabrook C.
Published: July 2020

Currently, there is no recommended methodology for long-term population monitoring of European adders (Vipera berus). To open a debate on a preferred methodology, we describe an approach based on 10-years’ experience of monitoring in a chalk grassland reserve. The main elements are: 1) selection of a site with areas offering contrasting environmental conditions; 2) detection of adders along standard survey paths (transects) combined with paired artificial refuges of corrugated iron and roofing felt that are essential for detecting immature stages; 3) recognition of individual adders based on head-scale and neck patterns; 4) frequent site visits throughout the reptile active season; and 5) adoption of an Encounter Index (E.I.) that combines data from standard paths and refuges and normalises them for variations in survey effort and for shifts between years in the encounter rates along paths and at refuges. E.I. values correlate strongly with the numbers of known adders in the reserve but in some years E.I. values have been disproportionally high. Future objectives of the project are to explain variations in detectability and to estimate adder detectability associated with the current monitoring approach. Effective long-term monitoring is achievable by deploying “sufficient” refuges and, within practical limits, maximising path lengths and site visits. Future analysis of our own results will likely confirm our methodology as a “rule of thumb” for adder monitoring on, at least, chalk grassland.
Estudios de Hombres Gay en Puerto Rico: Consideraciones para el Avance Investigativo
Authors: Esteban Caleb , Díaz-Medero Luis , Irizarry-Rodríguez Astrid , Ramos-Negrón David
Published: July 2020

Los efectos de las experiencias de discriminación social hacia la comunidad LGB son insalubres. Investigaciones han encontrado que la homofobia es un factor clave para predecir síntomas psicológicos y disparidades en salud en la comunidad LGB tales como: ansiedad, depresión, uso de alcohol y sustancias, ideación suicida, entre otras. En Puerto Rico se han realizado revisiones de literatura sobre estudios en mujeres lesbianas, sin embargo, no ha sido el caso en estudios sobre hombres gay. Por tanto, se llevó a cabo una revisión de literatura de tipo bibliográfica/descriptiva en búsqueda de tesis, disertaciones y publicaciones en el campo de la psicología en Puerto Rico sobre este tema. Esta búsqueda fue en línea y presencial, y se limitó al periodo del 2000 al 2019, en diversas universidades del país. La pregunta de investigación fue: ¿Qué datos tenemos en cuanto a la salud de los hombres gay desde la psicología en Puerto Rico que nos pueda guiar hacia futuras investigaciones? Los criterios de inclusión fueron: 1) ser un estudio cuantitativo o mixto realizado en Puerto Rico, y, 2) que la muestra incluyera hombres gay. Los resultados siguieren que un 41% de los estudios generados durante este periodo de tiempo, se enfocan en estigma, prejuicios, distancia social y discrimen. Otros temas estudiados fueron: identidad sexual y de género, religión/espiritualidad, violencia, alcohol y sustancias y satisfacción de vida. Se concluye que, aunque se ha observado un crecimiento en las últimas décadas en los trabajos realizados, aún nos queda vasto camino por recorrer.
Desarrollo de una Escala de Interés en Animales
Authors: Cirino Gerena Gabriel , Mariani Escalante Kelvin
Published: July 2020

Los psicólogos, particularmente en Puerto Rico, no han realizado suficientes investigaciones sobre las relaciones de los humanos y los animales a pesar de que hay un incremento de actividades terapéuticas que involucran animales y del uso de estos en actividades recreativas y de empleo. Por otro lado, los inventarios de intereses principales generalmente no incluyen escalas relacionadas con animales. Debido a esta situación decidimos desarrollar una escala de interés en animales para incluirla en el Inventario Cirino de Intereses (ICI). Redactamos una escala experimental con una sub-escala de orientación afectiva (6 ítems) y otra de orientación utilitaria (6) ítems hacia los animales.  El ICI se administró en línea a 1,858 participantes, de los cuales el 48.2% (n=895) son mujeres y el 51.8% (n = 963) hombres. Ambas sub-escalas resultaron confiables. Las sub-escalas correlacionaron r = 0.789 entre sí, por lo que entendimos que no hay evidencia de dos orientaciones distintas hacia los animales. Correlacionamos la escala final de interés en animales (10 ítems) con las escalas de Interés en Personas (r = 0.43) e Interés en Objetos (r = 0.44) del ICI-PR.  Finalmente incluimos la escala de interés en animales como parte de las escalas básicas de Interés en Objetos.
Short-Term and Mid-Term Load Forecasting in Distribution System Using Copula
Authors: Ahmadi Taha , Cristancho Rivera Carlos Alberto
Published: July 2020

Short-term and (Mid\Long)-term load prediction are needed for the efficient management of distribution system. An accurate load forecasting could help distribution operators to achieve a great control and flexibility on energy. In addition, a reliable prediction would have significant impact on load power flow problems, operation management, planning, automation, and search market. This paper proposes a new method based on copula for Short-term, and (Mid/Long)-term load forecasting. Proposed method was used less historical data to predict the load consumption then the other methods, so it is useful in distribution system due to scarce installed meters. Copula is a recently developed statistical theory for multivariate probability analysis that has been proposed by Sklar in 1958. Copulas are used in popularity for financial and reliability application. Numerical tests results using database of Iran system’s operation (ISO) shows that this method provides a much better prediction performance in comparison with other methods employing the same data.
MULTIAKAD MURABAHAH DAN RAHN PADA PRODUK LOGAM MULIA PERSPEKTIF HUKUM EKONOMI SYARIAH
Authors: Hatoli Hatoli , Parwanti Weni
Published: July 2020

Operasional setiap lembaga keuangan yang berbasis syariah secara yuridis harus merujuk kepada fatwa DSN-MUI, tidak terkecuali masalah multiakad atau lebih dikenal dengan hybrid contract. Dimana hal ini telah diamanatkan oleh UU No.21 Tahun 2008 tentang Perbankan Syariah Pasal 26 ayat (2). Di dalam fatwanya, terdapat dua multiakad yang diperbolehkan oleh DSN-MUI, yaitu Fatwa No. 71 Tahun 2008 tentang Sale and Lease Back dan Fatwa No. 72 Tahun. 2008 tentang Ijarah Sale and Back. Namun PT. Pegadaian (Persero) Unit Pelayanan Syariah Alianyang Singkawang telah melaksanakan multiakad (murabahah dan rahn) sejak 6 (enam) tahun terakhir  pada produk Murabahah Logam Mulia Investasi Abadi (MULIA) pembiayaan emas secara tidak tunai, dimana hal ini belum ada fatwanya dari DSN-MUI, sehingga memunculkan keraguan akan jaminan kesyariahan dari produk tersebut. Maka menjadi penting dikaji tentang bagaimana  sistem akad produk MULIA yang menggunakan akad murabahah dan rahn dari perspektif hukum ekonomi syariah. Penelitian ini merupakan penelitian kualitatif yang bercorak deskriptif yang diperdalam dengan cara melakukan wawancara secara langsung kepada pihak yang terlibat dalam penerapan multiakad murabahah dan rahn ini. Hasil penelitian menyimpulkan bahwa penerapan multiakad murabahah dan rahn pada produk logam mulia di PT. Pegadaian (Persero) Unit Pelayanan Syariah Alianyang Singkawang sebagaimana yang tertuang dalam Undang-undang No. 21 Tahun 2008 tentang perbankan syariah sudah dijalankan pada produk tersebut, serta dalam pandangan hukum ekonomi syariah adalah boleh dan dibenarkan, karena sistemnya merujuk kepada fatwa DSN-MUI No. 92 tahun 2014 tentang pembiayaan yang disertai rahn dan menjadi dasar dalam penggunaan multiakad.
Synthesis of Streptococcus pneumoniae serotype 9V oligosaccharide antigens
Authors: Parameswarappa Sharavathi G , Pereira Claney L , Seeberger Peter H
Published: July 2020

Streptococcus pneumoniae (SP) bacteria cause serious invasive diseases. SP bacteria are covered by a capsular polysaccharide (CPS) that is a virulence factor and the basis for SP polysaccharide and glycoconjugate vaccines. The serotype 9V is part of the currently marketed conjugate vaccine and contains an acetate modification. To better understand the importance of glycan modifications in general and acetylation in particular, defined oligosaccharide antigens are needed for serological and immunological studies. Here, we demonstrate a convergent [2 + 3] synthetic strategy to prepare the pentasaccharide repeating unit of 9V with and without an acetate group at the C-6 position of mannosamine.
Investigation of Solder Joint Encapsulant Materials for Defect Mitigation
Authors: Teng Sue , Guirguis Cherif , Ramakrishna Gnyaneshwar , Ly Hien
Published: July 2020

As Cisco’s next-generation products continue to push the trends of higher signal speeds and increased functional density, the need for advanced PCB structures, such as Via-in-Pad Plated Over (VIPPO) and backdrill, and high-speed memory is becoming more mainstream across product platforms.  Furthermore, as these high-speed memory technologies are being driven by consumer applications, the form factor and interconnect pitches continue to shrink to meet the demands of the mobile device market.  The use of these advanced PCB structures, like VIPPO and VIPPO with backdrill, within the BGA footprints, particularly for the fine pitch patterns, have been found to result in BGA solder separation defects at the bulk solder to IMC interface upon a 2nd reflow, e.g. during top-side reflow for bottom-side components or during rework of an adjacent BGA.1  In some cases, this solder separation failure mode has also been identified with buried vias under the BGA pad or even without the presence of VIPPO or any vias under the BGA pad. 2.3 Additionally, these small memory components have been experiencing high occurrences of head-in-pillow (HIP) defects even though the overall package warpage over the reflow profile is < ~3mils.

This paper will therefore focus on the mitigation of these solder joint defects resulting from SMT assembly with the use of solder joint encapsulant materials to provide enhanced adhesion strength for the solder joints.  Leveraging existing test vehicles that are known to induce the aforementioned solder joint defects, 2 different solder joint encapsulant or epoxy flux materials are evaluated in terms of the application process, assembly integrity and compatibility with Cisco’s production solder paste materials and SMT processes.
ARMANDO PALACIO VALDÉS Y EL ROMANTICISMO
Authors: Dendle Brien
Published: July 2020

Sin información.
PECULIARITIES OF TREATING PATIENTS WITH CARDIAC SURGICAL PROFILE WITH INFECTIOUS COMPLICATIONS AFTER STERNOTOMY BY VAC THERAPY
Authors: Boyko V. V. , Shafer Ya. V. , Buchneva O. V.
Published: July 2020

Summary. Infectious complications from the sternotomic wound in patients with a cardiac surgical profile are a very threatening factor that prolongs hospitalization, disability, and sometimes leads to death

The aim. Improving the results of treatment of patients with cardiac surgical profile with on infectious complications of sternotomy wounds using by VAC-therapy.

Materials and methods. The treatment results are analyzed with the help of VAC-therapy in 14 patients from 2015 to 2018 year inclusive, where there were complications after performing longitudinal median sternotomy.

Results and discussion. In 100% of patients, a positive result was achieved. The average length of stay of patients in the clinic who used VAC-therapy was 15 ± 6.5 days, which is half that when treating identical wounds with standard methods.

Conclusions. Treatment of infectious complications of longitudinal median sternotomy with the help of VAC-therapy is a safe, effective and cost-effective method in patients with cardiac surgery.
SURGICAL TREATMENT OF PATIENTS WITH CHRONIC HEMORRHOIDS
Authors: Vasilyuk S. M. , Shevchuk A. G. , Gudyvok V. I. , Labiak I. R. , Sidoruk S. S.
Published: July 2020

Symmary. About 300 surgical treatments for hemorrhoids are known now. The most common method in the world remains the Milligan-Morgan operation and its numerous modifications. These surgical interventions are essential in the choice of surgical treatment for chronic hemorrhoids. However, both open and closed hemorrhoidectomy have their disadvantages.

Purpose. To study the effectiveness of various surgical treatments for patients with chronic hemorrhoids using a laser coagulator.

Materials and methods. We conducted a clinical examination and treatment of 140 patients with chronic grade III-IV hemorrhoids by Goligher. All patients were presentably divided into three groups. The first group included 60 patients who had classic open hemorrhoidectomy - the Milligan-Morgan operation. The second group included 40 patients in whom had surgical treatment with a laser coagulator - laser open hemorrhoidectomy. The third group consisted of 40 patients who underwent laser open hemorrhoidectomy, supplemented with laser transcutaneous submucosal mucopexia.

Results and discussion. Analyzing the indicators of pain in different groups of patients at different postoperative period, we found that on the first postoperative day the classic Milligan-Morgan surgery, the was most uncomfortable procedure (the first group of patients). Among the patients in the second and third groups there were no people who rated pain above 7 points. In the first group, the median period of first defecation was in 5.0 days. As for in patients of the second group, the first defecation was observed in terms of the 3-5 days with a median of 4.0 days. A similar indicator was observed in patients of the third group. Patients in the second and third groups did not indicate severe pain during the first act of defecation. The anal hematoma was found only in patients of the first group (p<0.01). Anal infiltration occurred in 12.5±5.23 % in the third group (p<0.01). Infections of wounds were not found in any group.

Conclusion. Laser open hemorrhoidectomy is an effective method of surgical treatment of patients with chronic hemorrhoids. However, like the classic open hemorrhoidectomy Milligan-Morgan, it allows to eliminate only pathological substrate (cavernous bodies). To prevent recurrence of the disease, it should be supplemented with laser transcutaneous submucosal mucopexia. Analysis of cases of early postoperative complications showed that the classic Milligan-Morgan hemorrhoidectomy, compared with intraoperative laser coagulation, had a significantly higher frequency (p<0.001).
ANALYSIS OF CASES OF DIAGNOSTIC DIFFICULTIES WITH RUPTURE OF THE SPLEEN
Authors: Yefimov D. S.
Published: July 2020

Summary. Objective: to describe two cases of clinical observation of undiagnosed preoperative rupture of the spleen, in order to analyze errors.

Material and methods. Two cases of undiagnosed preoperative spleen rupture are analyzed. Patients were treated in general surgical departments of the Kharkiv City Clinical Hospital for Emergency and Emergency Medicine, named after Professor Alexander Ivanovich Meshchaninov, in 2016 and 2019.

Results: two almost identical patients, both in history and in the course of disease, as well as the volume of surgical intervention and treatment results, were treated at the hospital in 2016 and 2019, respectively. It was revealed that the causes of diagnostic errors were primarily the lack of a history of trauma and the erroneous interpretation of ultrasound data in favor of acute pancreatitis.

Conclusions: the absence of a history of trauma and an erroneous interpretation of the causes of the appearance of free fluid in the abdominal cavity recorded during ultrasound examination are the main causes of diagnostic errors in this pathology. The presence of free fluid in the abdominal cavity, shown during ultrasound examination, is the reason for questioning the patient concerning incidence of injury.
THE CHOICE OF TREATMENT FOR LIVER ABSCESSES
Authors: Boyko V. V. , Lihman V. N. , Myroshnychenko D. A. , Osmanov R. R. , Tkach S. V. , Shevchenko A. N. , Volchenko I. V. , Merkulov A. A. , Bilodid E. A.
Published: July 2020

Summary. Improving the results of treatment in patients with liver abscesses by treatment using minimally invasive interventions.

Materials and methods. We examined and treated 87 patients with liver abscesses aged 21 to 80 years. Of these, 82 patients underwent 102 surgeries. Abscess drainage was performed 95 times in 82 patients in four ways: under ultrasound guidance — to 45 (54.88 %) patients, laparoscopic - to 20 (24.4 %), under the control by angiography — 2 (2.44 %) and laparotomic access — 15 (18.28 %) to patients. 7 patients underwent resection operations.

Results. So, in our analysis of the clinical picture of liver abscesses, specific symptoms were not noted. Therefore, the combination of the results of ultrasound and CT (the sensitivity of which was 98 % and 100 %, respectively) was decisive in the diagnosis and differential diagnosis of liver formations. Most often strains were sown from the abscess cavity E. coli and Kl. Pneumoniae in 43.91 % of cases. A positive effect was noted after the first minimally invasive intervention occurred in 76 (92.68 %) patients. In operated patients with laparotomic access, the main indications were, first of all: the inefficiency of external drainage under ultrasound control or the inability to use the puncture drainage method itself due to the localization of the abscess; the presence of concomitant surgical pathology, which requires surgical treatment, choledocholithiasis with complications, peritonitis

Conclusions. The main task in the treatment of purulent diseases of the hepatobiliary system is the decompression and rehabilitation of the biliary tract, further antibiotic therapy, taking into account sensitivity with the active use of ultrasound-controlled drainage methods. Laparoscopic and open interventions are indicated for multiple and giant multi-chamber abscesses.
FEATURES OF THE EARLY PROCESS IN DIABETIC FOOT SYNDROME
Authors: Polyovyy V. P. , Khorshani B. , Petrynych V. V. , Kyfyak P. V. , Tkachuk O. V. , Sydorchuk R. I.
Published: July 2020

Summary. Diabetic foot syndrome (DFS) is one of the most common surgical diseases.

The aim of the study: to determine the features of the wound process in the DFS.

Materials and methods. Multimodal pathomorphological study of biopsy material in 120 cases of surgical treatment of DFS was performed.

Results and discussion. During the development of the wound process in the DFS, histologically determined reduction of edema, cellular infiltration, microcirculatory disorders in the marginal area of the wound in the dynamics of treatment. It is found in granulation tissue and in the dermis adjacent to intact skin, a large number of hairy cells. Microcirculatory disorders are expressed in the form of venular plethora, the phenomena of stasis in the capillaries, hemolysis of erythrocytes and the marginal standing of the formed elements in the venules and capillaries. The DFS is characterized by the appearance of foci of destruction and lysis of the newly formed epithelium, which is not observed in the normal wound process.

Conclusions. The formation of granulation tissue is slow, mainly in the form of unformed connective tissue without the formation of classic granulations.
SPEAKING OF PREVENTION OF ACUTE PANCREATITIS AFTER ENDOSCOPIC CHOLANGIOPANCREATO-GRAPHY
Authors: Lupaltsov V. I. , Skalii N. N. , Yagnyuk A. I. , Kotovshchіkov V. S.
Published: July 2020

Summary. Purpose. To study the manometric control of pressure in the pancreatic ducts when performing ERCP and to determine its capabilities in the early diagnosis of postmanipulative pancreatitis.

Materials and methods. The study was conducted to identify postmanipulative pancreatitis in 122 patients with impaired patency of the terminal part of the common bile duct who underwent ERCP. Patients were divided into two groups: the main – 58 patients and the comparison group – 64 patients. In 58 patients of the main group, the pressure in the pancreatic duct was studied by the device we developed. One makes it possible to register early signs of acute postmanipulative pancreatitis with conducting timely preventive measures for its development.

Results. Using the proposed device that records the pressure in the pancreatic ducts, acute postmanipulative pancreatitis was diagnosed in 6.9 % of patients in the main group, while in the comparison group it developed in 21.9 % of cases. Mild forms of APMP in the comparison group were noted in 11 patients and in 4 patients in the main group. Severe APMP caused by focal pancreatic necrosis occurred in three cases of the comparison group.

Conclusions. 1. ERCP is a highly effective method for diagnosing diseases of the pancreatobiliary zone, at the same time, sometimes fraught with the danger of developing serious complications, one of which is acute postmanipulative pancreatitis. 2. Monometric control during ERCP is a highly effective method for the diagnosis of early forms of acute postmanipulative pancreatitis, which can be recommended in the clinical practice of endoscopic surgeries.
POSSIBILITIES OF EARLY DIAGNOSIS AND PROPHYLAXIS OF INTRAOPERATIVE BILE DUCT LESIONS IN MIRIZZY SYNDROME
Authors: Zaporozhchenko B. S. , Bondarets D. A. , Borodaev I. E. , Sharapov I. V. , Sharapova A. Yu.
Published: July 2020

Summary. Goal. To analyze the possibilities of early diagnosis and prevention of intraoperative injuries of the bile duct in the Mirizzy syndrome.

Materials and research methods. The study is based on an analysis of 968 case histories of patients with acute calculous cholecystitis. The ratio of patients with Mirizzy syndrome to patients with calculous cholecystitis was 38 (3.9 %). There were 716 women (74 %), and 252 men (26 %). The age of patients ranged from 25 to 92 years.

All patients with Mirizzy syndrome were divided into 4 groups (according to the classification of A. Csendes). The number of patients with type 1 SM was 27 (72 %); 2 types — 6 (18 %); 3 types — 2 (6 %); 4 types — 1 (3 %).

Result. The treatment outcome of 35 patients with Mirizzy syndrome was evaluated. In type 1, LCE was performed in 27 (72 %) patients. In type 2, open surgery was performed. In 4 (12 %) patients of this group, a laparotomy was performed for cholecystectomy with plastic surgery of the common bile duct on Keru drainage. In 2 (6 %), subtotal cholecystectomy was performed with subsequent installation of drainage into the lumen of the remaining part of the bladder with fistula. In the presence of types 3 and 4 of Mirizzy’s syndrome, an “open” surgical intervention was performed, followed by hepaticojejunoanastomosis on the Loop-off loop in 3 (9 %) patients. The most informative non-invasive method of preoperative diagnosis of Mirrisi syndrome is MRI in cholangiography, which allows you to diagnose all types of this syndrome with a high degree of probability.
CORONARY INTERVENTIONS ON LEFT MAIN CORONARY ARTERY — SHORT-TERM RESULTS OF ROUTINE CLINICAL PRACTICE
Authors: Polivenok I. V. , Belimenko M. S.
Published: July 2020

Summary. Left main (LM) coronary artery lesions occurring in 4.8-9 % of patients on coronary angiography, represent a serious clinical problem with a quite aggressive revascularization strategy. Despite the growing evidence of the efficacy and safety of percutaneous coronary interventions (PCI) on LM, coronary bypass surgery remains the dominant method of revascularization in many hospitals.

Material and methods. The authors presented short-term results of LM PCI in 66 consecutive patients in one center.

Results. LM PCI accounted for 4.9 % of the total number of percutaneous coronary interventions. 67.2 % of PCI were performed by radial access, two-stent strategies were used in 10.8 %, mechanical circulatory support — in 7.5 %, and intracoronary imaging – in 1.5 % of cases. Hospital mortality was 4.5 %, the complications rate — 13.6 %. There was no significant difference in access, technical aspects of the procedure, the number of complications and mortality rate between elective patients and patients with an acute coronary syndrome.

Conlusion. LM PCI can be performed routinely in experienced coronary programs with acceptable short-term outcomes. Additional efforts are needed from the hospital administrations and professional societies to increase the use of coronary imaging in order to improve the long-term outcomes of LM PCI.
COMPARATIVE ANALYSIS OF INTERNATIONAL STANDARDS AND OUR EXPERIENCE IN TREATMENT OF PATIENTS WITH CHRONIC HEMORRHOID A BASE FOR EVIDENTIAL MEDICINE
Authors: Bojko V. V. , Makarov V. V. , Tsodikov V. V. , Tarasenko L. G.
Published: July 2020

Summary. Aim. Decrease the amount of postoperative complications and improve quality of life for patients by a chronic hemorrhoid (CH).

Materials and methods. Both international and national foreign clinical protocols are analysed. The obtained data are confronted with our clinical experience.

Results and their discussion. Materials and methods. In the looks of foreign colleagues to tactics of treatment of patients with CH are analysed. The obtained data are confronted from positions of the best medical practice of providing of medicaid to the patients with a CH. Results and their discussion. In spite of insignificant differences in the volume of operative treatment of patients of CH, international practice adheres to single approach on tactics of surgical decision of this problem. Among the radical methods of treatment recommend next methodologies as an operation of choice: hemorrhoidectomy Milligan - Morgan, Ferguson and Parks, that in all researches were marked as high-efficiency. Clinical experience of our clinic, that Milligan–Morgan hemorrhoidectomy is the operation of choice for patients with 3-4 degrees of fall of knots, and applications of modern methodologies allows to bring down lacks of this operation and to attain the level of complications less than 1 %.

Conclusions. The necessity of development of compatible clinical protocol of medicare to the patients takes place with CH. Introduction of single home standards of providing of medicare to the patients with CH will allow to bring down the risk of development of complications and improve the results of treatment. The got results of own researches on providing of medicare to the patients with CH are comparable with the results of foreign colleagues.
ТHE PLACE OF ENDOVASCULAR SURGICAL INTERVENTIONS IN PATIENTS WITH CRITICAL ISCHEMIA OF THE LOWER EXTREMITIES
Authors: Goshchynsky V. B. , Lugovyj O. B. , Lugovyj S. O. , Herasimets U. M.
Published: July 2020

Summary. The purpose of the study. To determine the possibility of endovascular surgical interventions and their effectiveness in patients with critical ischemia of the limbs.

Materials and methods. The object of research was 209 patients with critical ischemia of the limbs, ages 53 to 71 years, which made endovascular surgical interventions.

The results. Analysis of results of endovascular surgery witness that balloon angìoplasty with stenting zone for reconstruction and balloon angìoplasty with paclitaxel give the smallest percentage of reocclusion and restenosis in the early and late postoperative period than balloon angìoplasty.

Conclusions. 1. The use of endovascular surgical interventions is a promising method of treatment of critical ischemia of the lower extremities, especially in the elderly and senile. 2. In case of critical ischemia of the limbs should be used balloon angìoplasty with stenting or balloon angìoplasty with paclitaxel, based on the results of early and late postoperative period.
PREDICTION AND PREVENTION OF COMPLICATIONS IN PATIENTS WITH PRIMARY AND POSTOPERATIVE VENTRAL HERNIA UNDER CONDITIONS OF COMORBIDITY
Authors: Piatnochka V. I. , Dzyubanovsky I. Ya. , Selsky P. G. , Svistun G. V.
Published: July 2020

Summary. Purpose of the study. Conduct a retrospective and prospective analysis of complications in patients operated on for primary and postoperative ventral hernia based on the use of multi-parameter neural network clustering.

Materials and research methods. The object of the study was 1419 patients who underwent surgical interventions on the anterior abdominal wall for primary ventral and postoperative ventral hernias.

Results. An analysis of cluster portraits during neural network clustering in 1419 patients with primary and postoperative ventral hernias revealed that multimorbidity, allogeneioplasty of the onlay type, especially when using heavy polypropylene nets, morbid obesity of the II-III degree, as well as the presence of undifferentiated dysplasia syndrome connective tissue creates the highest risk group for the development of local and general postoperative complications.

Conclusions. 1. The comorbidity index significantly increases the operational-anesthetic risk and affects the incidence of postoperative complications. 2. The introduction of a comprehensive program (Enhanced Recovery After Surgery) in the perioperative period, which we used in 28.96 % of patients with primary and postoperative ventral hernias under conditions of comorbidity, reduced the number of postoperative complications by 2.08 times and reduced the duration of inpatient treatment by 2-3 days.
ТREATMENT OF STENOSIS OF THE PYLORIC BULBAR ZONE OF ULCERATIVE GENESIS USING MINIMALLY INVASIVE SURGERY
Authors: Babii O. M. , Tarabarov S. A. , Prolom N. V. , Shevchenko B. F. , Galinsky A. A.
Published: July 2020

Summary. Purpose: to improve the results of surgical treatment of stenosis of the pyloroduodenal zone of ulcerative origin through the use of minimally invasive laparoendoscopic interventions.

Material and methods. In the Department of Surgery of the Digestive Organs of the State Institution “Institute of Gastroenterology of the NAMS of Ukraine” for 2014-2019, 114 patients with stenosis of the pyloroduodenal zone of ulcerative origin were examined. Of these, 35 — with compensated stenosis, 57 — with subcompensated, 22 — with decompensated stenosis. The average age (45.3±5.2) years. The control group consisted of 20 healthy individuals. All patients underwent surgical treatment using minimally invasive and traditional surgical interventions.

Results and discussion. During the study, known indications were clarified and new indications for performing endoscopic balloon pyloroduodenoplasty and combined laparoendoscopic intervention were clarified. Complications in the immediate postoperative period occurred in 1 patient (1.04%) in the form of perforation of the dilated zone. In patients after the traditional laparotomy surgery, the average postoperative period was (15 ± 2) days. Complications in the immediate postoperative period occurred in 2 patients (11.1 %) in the form of bleeding and leaks in the pyloroplasty zone, which required repeated surgical treatment. Тhere were no fatal cases. The remote observation period was 7-22 months. Endoscopic, radiological and clinical signs of recurrence of peptic ulcer and stenosis were not detected.

Conclusions. The method of minimally invasive endoscopic and combined laparoendoscopic interventions in the treatment of stenosis of the pyloroduodenal zone of ulcerative genesis is characterized by a minimal number of complications, has good efficacy indicators and the absence of disease recurrence in the long-term period.