bluuebunny/crossref_metadata_2025 huggingface dataset:
Perancangan Arsitektur Backend Microservice pada Startup Campaign.com
Authors: Virgiawan Zaky Riko , Harwikarya Harwikarya
Published: February 2022

Dalam memulai pengembangan perangkat lunak, salah satu poin terpenting

adalah menentukan arsitektur teknologi sesuai dengan analisa kebutuhan produk.

Sehingga nantinya dapat berjalan selaras bersamaan dengan visi produk tersebut.

Namun, seiring berjalannya waktu dengan user dan data yang semakin bertambah

perlu ada perombakan arsitektur kembali, dengan membangun pondasi yang lebih

kokoh. Hal ini dialami oleh perusahaan startup sosial Campaign.com.

Campaign.com merupakan sebuah aplikasi untuk mengambil aksi sosial yang dapat

menyalurkan donasi dari sponsor. Desain sistem yang dibangun di campaign.com

masih menggunakan arsitektur monolitik. Antarmuka pengguna, pemrosesan

logika, dan akses data digabungkan menjadi satu program dan ditempatkan dalam

satu basis data. Namun hal ini membuat aplikasi sering mengalami bugs dan server

downtime. Dengan masalah yang sedang dihadapi ini penulis mencoba melakukan

eksperimen dengan merancang dan menganalisa sistem arsitektur backend. Tujuan

yang ingin dicapai dari perancangan arsitektur ini adalah mendeskripsikan proses

penyederhanaan dari sebuah sistem arsitektur backend microservice agar mudah

dalam pemeliharaan sistem dan penggunaan algoritma Docker yang akan membuat

sistem menjadi efisien terhadap penulisan kode.
Price Factor Analysis, Word Of Mouth And Experiential Marketing On Customer Loyalty During The Covid-19 Pandemic (Case Study On The Tebing Tinggi Family Bakery)
Authors: Jayanti Suci Etri , Siahaan Rumiris
Published: February 2022

This study aims to determine how the influence of price, word of mouth and experiential marketing on customer loyalty during the Covid-19 pandemic. This study uses a quantitative research type with the help of the IBM SPSS 25.00 application. The results of hypothesis testing using multiple linear regression analysis with three independent variables and one dependent variable show that From Table 4.18 it is known: that tcount (2.865) > t table (1.986), as well as the significance value of 0.005 <0.05, it can be concluded that the first hypothesis is accepted, meaning Price variable (X1) has an effect to the Customer Loyalty variable (Y). From Table 4.18 it can be seen that tcount (4,914) > t table (1.986), as well as the significance value of 0.000 <0.05, it can be concluded that the second hypothesis is accepted, meaningvariable Word of Mouth (X2) has an effect to the Customer Loyalty variable (Y). From Table 4.18 it can be seen that tcount (1,993) > t table (1.986), as well as the significance value of 0.049 <0.05, it can be concluded that the third hypothesis is accepted, meaningvariable Experiential Marketing (X3) take effect to the Customer Loyalty variable (Y).
Національна безпека через призму розвитку космічної галузі
Authors: Кошова Світлана , Гбур Зоряна
Published: February 2022

У навчальному посібнику проаналізовано основні механізми державного регулювання космічної галузі, їх вплив на національну безпеку держави, основні аналітичні висновки та статистичний аналіз за останні 10 років, а також значення та роль розвитку космічної галузі в контексті європейської інтеграції України. Для фахівців – практиків сфери державного управління, публічного управління та адміністрування, національної безпеки та міжнародних відносин, науковців, студентів, аспірантів, викладачів, усіх, хто цікавиться розвитком наукової думки.
Politica delle alleanze, bipolarizzazione, frammentazione: le tre parole chiave delle elezioni regionali del 16 aprile 2000
Authors: Di Virgilio Aldo
Published: February 2022

La struttura dell'offerta: una variabile decisiva.

Il formarsi di coalizioni catch-all.

La partecipazione elettorale: meno votanti, più voti di preferenza.

La competizione maggioritaria: regioni "sicure"e regioni "marginali".

E i partiti? Rapporti di forza infracoalizionali e geografia del voto proporzionale catch-all.
Sacro-coccygeal Epidermoid Cyst: A Case Report from Tertiary Care Centre in India
Authors: Jain Dr. Amit , Singhal Dr. Shubham , Damor Dr. Neeraj
Published: February 2022

Localization of primitive neoplasms the retrorectal or presacral space is rare in adults as most of these tumors are congenital. Developmental cysts are included within the group of retrorectal congenital cystic neoplasms and are slowly-progressive cystic neoplasms. Because of their localization, their manifestation is delayed, despite their congenital nature. Their form of presentation is varied and is caused by compression of the surrounding organs or infectious complications of the cyst. In the present case, we have 55 yr old female with complain of low back painand pus dyscharge from perineal region. Further examination reveal 84*54*49mm lesion in posterior perianal region on either side of natal cleft with cutaneous opening within natal cleft. Post operative biopsy suggestive of epidermoid cyst.
Functional Outcome of Patients Undergoing Volar Buttress Plate for Fixation in Volar Barton’s Fracture of the Distal Radius
Authors: MA Islam , N Kumar , R Haque , SC Barmon , M Shahidullah , S Forhad , S Alam , S Kundu
Published: February 2022

Introduction: Volar Barton’s fracture is a common problem among the distal radius fracture. Shearing fractures may involve the Volar articular margin is a displaced and inherently unstable fracture that may lead to pain, deformity, limited range of motion, and loss of hand function. In clinical practices, various methods are used for the management of Volar Barton’s fractures. The Volar buttress plate technique is now mostly chosen for the management of this type of fracture. The aim of the study was to observe the functional outcome of treating a Volar Barton’s fracture of the distal radius using a buttress plate. Methods: This prospective interventional study was carried out in the Department of Orthopaedic Surgery, BSMMU, Shahbag, Dhaka for the duration of 2 years 6 months (March 2014 to September 2016). Within this period 30 patients of Volar Barton’s fracture were selected as per inclusion and exclusion criteria who are admitted in this institution. After proper evaluation of these patients, open reduction and internal fixation were done with Volar locking buttress plate. Result: In this study, out of 30 patients 77% were male and 23%were female where the mean age was 32±9.3 and maximum incidence was between 18-39 years. Left side involvement was more 63% (19 patients) than right side involvement at 37% (11 patients). 7% of patients were found with superficial skin infections and treated non-operatively. In the final follow-up, 6.7% were obtained excellent scores, 73.3% were obtained good scores and 20% were obtained fair scores on the basis of anatomical outcome. Conclusion: The Volar buttress plate is found an effective technique of fixation. The Volar locking buttress plate maintained articular congruity, radial length, and alignment. The significant functional outcomes were observed at end of the final follow-up (24 weeks).
Management of Infected Non-union Tibia with Ilizarov External Fixator: Study on Tertiary Hospital in Bangladesh
Authors: Islam Dr. Md. Sofikul , Hossain Dr. Mohd. Alamgir , Sobhan Dr. Md. Abdus , Pramanik Dr. Subrata Kumar , Rahman Dr. Md. Mushidur , Rahman Dr. Md. Munzur , Haque Dr. Obaidul
Published: February 2022

Introduction: Infection is the most prominent cause of delayed or non-union in tibial fractures because of the bone's sensitive subcutaneous location. Ilizarov external fixator application is regarded as the best approach for treating them because of several benefits. Analysis of the role of Ilizarov fixation in infected tibial non-union was the goal of this investigation and evaluating clinical & functional outcomes of infected tibial non-union. Materials and Methods: A Multicenter based non-randomized quasi-experimental prospective study was performed in Rajshahi Medical College Hospital, Rajshahi, Bangladesh. From 1st January 2015 to 31st December 2020. The study comprised a total of 61 (n=61) Tibial non-union patients treated with the Ilizarov fixator who also had an infection. ASAMI score criteria were used to evaluate the outcome. Results: The most common organism for infection was identified to be at Staphylococcus Aureus. The final follow-up showed that all but one patient had achieved union; one patient had to amputate due to infection and non-union. ASAMI score rating methodology for bone and function results rated the majority of patients as outstanding. Pin tract infections were the most prevalent problem discovered in this research. Conclusion: The Ilizarov external fixator is safe and successful for treating infected non-union of the tibia since it can offer a stable mechanical environment, bone transfer, rectify deformities, eradicate the infection, and allow patients to bear weight. Therefore, we still suggest it despite its disadvantages.
Nebulized Ketamine: A Promising Approach for Managing Acute Pain in the Emergency Department
Authors: Amine Meskine , Hamza Najout , Mohamed Moutawakil , Mohamed Meziane , Mustapha Bensghir
Published: February 2022

Acute severe pain is the most common condition for emergency consultations. opioids are the cornerstone of the treatment. However, they expose to various adverse effects. We describe a case of a 22-year-old woman with severe pain to her right hand, after a domestic fall, successfully managed by nebulized ketamine. Ketamine administration via nebulized route might be an attractive and non-invasive alternative to opioids use in acute pain management.
Learned Helplessness and Cluster Headache – A Case Report
Authors: Pohl Heiko , Neumeier Maria Susanne
Published: February 2022

Spontaneous coronary artery dissection (SCAD) has long been recognized as a cause of acute coronary syndromes (ACS) with very low prevalence (3% in most cohorts). It predominantly occurs in young to middle-aged women. SCAD patients have fewer traditional cardiovascular risk factors for ischaemic heart disease than patients with atherosclerotic coronary artery disease, however, many patients do have some risk factors for ischaemic heart disease including hypertension, smoking, and dyslipidaemia, although there is no evidence these contribute directly to the risk of SCAD. We report in this case an observation of spontaneous coronary dissection, in order to discuss its pathogenesis, diagnosis and management.
Sustainable Agricultural and Entomological Approaches Towards Immunity for Defense System in Insects
Authors: Zafar Muhammad Irfan , Farooqi Mazher Hussain , Shah Sayyed Muhammad Muntizir , Ahmad Bilal , Khan Mukarram
Published: February 2022

Immunity in insects is the series of events by discretion of signal proteins as a part of memory cells. The most important role of defensive proteins and peptides in insects are against function, assigning immune responses distinctly to priming and basal. But insects are also a source of high quality protein, containing many essential amino acids required for human nutrition. One their host enters into the cells of targeting area, immediate onset of proteolytic cascades that causes the cleavage of protein molecules of the attacking organisms. Immune system of the insects enhances exhibit properties the of production of antibodies and phagocytic cells to clear microbes and damaged cells from an organism. The most different types of immunological responses arise as pathogens enter into the cells of insects and activate the machinery of metabolic pools. The main reason for genetic and biochemical evaluation lie behinds the diversity of natural ecosystem of insects. Sterile insect technique has been controlled for direct killing. It is used primarily to control or eradicate insect pests, usually crop pests or human and animal. Integrated pest management, the broad-based approach that integrates practices for economic control of pests that significantly improved the yields of agricultural crops.
Harmful and Beneficial Effect of Senna Makki in COVID-19
Authors: Naureen Irum , Saleem Aisha , Shahid Ayesha , Tasneem Qaisera , Tariq Ansa , Hassan Asia , Bibi Asia
Published: February 2022

The outbreak of the unconventional coronavirus (SARS-CoV-2) on account that December 2019 has created an extraordinary state. Senna is a type of plant in the tropics. Senna, the sienna’s, is a huge variety of blossoming plants in the vegetable family (Fabaceae, subfamily Caesalpinioideae, clan Cassia). As It is a brand new variation of a deadly disease remedy alternatives aren't simplest confined however require painstaking trials to verify theireffectiveness. Due to the lack of information in lots of growing international locations, humans have begun out the usage of herbalmedications, used for numerous different diseases, to fight COVID-19. Misleading data on social mediaregarding “Senna Makki” has gone microorganism in the Asian nation. However, consumption of bush Makki isn't suggested as atreatment possibility for COVID-19 thanks to its several harmful associated side-effects. Though its use in different diseases isevident, trials to verify its effectiveness against COVID-19 got to be prioritized because the public has startedconsuming bush Makki in high doses and while not monitoring prescript.
RESISTENSI TERHADAP KOLONIALISME DALAM NOVEL GERHANA MERAH KAJIAN POSTKOLONIAL
Authors: Danang Bagus Juliantono  , Nurhadi Taufik
Published: February 2022

This study aims to describe the form of resistance to colonialism in the Red Eclipse novel . The theory used in this study is postcolonialism to see the forms of resistance contained in the novel. In postcolonial theory there are elements of resistance, namely passive resistance and radical resistance, namely hybridity, ambivalence, decolonization and anticolonialism carried out by characters in novels who experience colonialism. The method used in this study, namely a qualitative approach. Data from this study are in the form of words, sentences and paragraphs that describe colonialism in the novel . The data source in this study is the Red Eclipse novel written by Muhammad Sholihin. Data collection in this study uses documentation techniques. The step of analyzing by reading, interpreting and concluding. The results of this study were postcolonial not as something that came after colonialism and signaled the death of colonialism, but more loosely regarded as a resistance to colonial domination, and in the Red Eclipse novel there were two forms of resistance to colonialism namely passive resistance and radical resistance. Passive resistance is shown by the natives with the manifestation of themselves to refuse, namely a resistance that uses other means to maintain cultural identity and ownership. While Radical Resistance acts like an army or combat army, the struggle to liberate the nation from colonialism. organized movement plans, which are carried out by attacking directly.
PENGARUH STRATEGI METAKOGNITIF TERHADAP SELF EFFICACY PADA PEMBELAJARAN BAHASA INDONESIA KELAS V SD
Authors: Lis Lestari
Published: February 2022

Pembelajaran Bahasa Indonesia merupakan salah satu ilmu yang mempunyai peranan penting dalam kehidupan manusia serta untuk menguasai ilmu dan teknologi. Sebagai masyarakat Indonesia, penting untuk kita mempelajari dan memahami Bahasa Indonesia secara baik dan benar. Kegiatan tersebut perlu adanya rasa kemandirian dan percaya diri dalam belajar.  Sehingga tujuan dari penelitian ini adalah untuk mengetahui adanya pengaruh dari strategi metakognitif terhadap self efficacy pada pembelajaran Bahasa Indonesia kelas 5 sekolah dasar. Jenis penelitian yang digunakan ini adalah penelitian eksperimen dengan pendekatan kuantitatif.  Subjek penelitian ini adalah siswa kelas 5  yang berjumlah 100 siswa. Jumlah ini akan terbagi menjadi dua kelas eksperimen dan dua kelas kontrol. Analisis data yang digunakan dalam penelitian ini membandingkan dua kelompok dengan menggunakan uji t.  Hasil dari penelitian ini menunjukkan bahwa terdapat terdapat perbedaan self efficacy antara siswa yang mengikuti pembelajaran dengan strategi metakognitif dan non metakognitif.
Analisis Potensi Sport Tourism di Pantai Indah Kemangi Kendal
Authors: Nofarizqi Hanidar  , Maftukin Hudah  , Danang Aji Setyawan
Published: February 2022

Tujuan penelitian ini adalah untuk menganalisis berbagai potensi pariwisata khususnya sektor pariwisata olahraga. Penelitian ini merupakan penelitian deskriptif dengan pendekatan kualitatif. Pengumpulan data menggunakan metode observasi, wawancara dan dokumentasi. Analisis data menggunakan metode yang dilakukan secara terus menerus dengan reduksi data, penyajian data dan penarik kesimpulan. Hasil penelitian ini menunjukan bahwa potensi pariwisata olahraga yang dapat dikembangkan di Pantai Indah Kemangi antara lain seperti paralayang dan speed boat. Pantai Indah Kemangi memiliki banyak jenis wisata, dengan didukungnya fasilitas yang memadai, dan harga yang ekonomis. Namun, pantai ini juga memerlukan perawatan yang lebih karena seperti kebersihan, dan beberapa fasilitas tambahan perlu ditingkatkan. Pemanfaatan media informasi untuk sarana promosi sangat perlu ditingkatkan. Berdasarkan hasil penelitian, dapat disimpulkan bahwa adanya potensi pariwisata olahraga di Pantai Indah Kemangi. Saran kepada seluruh pelaku pariwisata untuk saling bekerja sama, membangun komunikasi dengan baik dan bertanggung jawab dalam setiap tugas dan wewenang. Perlunya evaluasi dan inovasi untuk bisa melahirkan ide-ide baru yang nantinya akan direalisasikan demi perkembangan dan kemajuan Pantai Indah Kemangi.
ANALISIS GURU NON PENJAS PADA KINERJA GURU PENJAS DALAM SISTEM PEMBELAJARAN DARING SAAT MASA PANDEMI DI SMA N 2 DEMAK DAN SMA N 1 DEMPET
Authors: Indah Kusuma Wardhani
Published: February 2022

Tujuan penelitian ini adalah untuk mendiskripsikan kinerja guru penjas dalam sistem pembelajaran daring saat pandemi di SMA N 2 Demak dan SMA N 1 Dempet.Jenis penelitian ini adalah penelitian deskriptif kuantitatif. pengambilan sampel dilakukan secara random sampling, populasi dalam penelitian ini adalah seluruh guru non penjas yang ada di SMAN 1 Dempet dan SMAN Instrumen berupa angket mengadopsi dari skripsi Nurochim (2009) dengan judul “Persepsi Guru NonPenjasorkes Terhadap Kinerja Guru Penjasorkes‟ Hasil penelitian ini di SMA N 1 Dempet Demak berada pada kategori “baik” sebesar 92,3% (24 guru), “sedang”sebesar 7,7% (2 guru), “rendah” sebesar 0% (0 guru) dan “sangat rendah” sebesar 0% (0 guru) sedangkan di SMA N 2 Demak Demak berada pada kategori “baik” sebesar 100% (26 guru), “sedang” sebesar 0% (0 guru), “rendah” sebesar 0% (0 guru) dan “sangat rendah” sebesar 0% (0 guru). Berdasarkan nilai rata-rata analisa guru non penjas dalam kinerja guru penjas pada proses pembelajaran daring saat masapandemi di SMA N 1 DempetDemak sebesar 92,3 % dan SMA N 2 Demak sebesar 100 % berada pada kategori baik.
MARTÍN GÓMEZ, M., Diario de una filósofa embarazada. Madrid: Tecnos,
Authors: Martín Lago Pedro
Published: February 2022

En la Historia de la Filosofía podemos encontrar todo tipo de temáticas y
problemáticas. Algunos dicen filosofemas. O sea, el tema como problema: qué es
la vida, qué es el alma, qué es lo que está bien o mal, etc., temas que, posteriormente, llevan su desarrollo o explanación. Son las filosofías. Porque la filosofía
no es –o no es sólo– un saber académico, sino una manera de entender nuestra
propia existencia. Y esto es clave para lo que viene después. No hay forma de
vivir una vida como seres humanos sin tener antes una filosofía de vida
أثر تطبيق معايير التعليم المحاسبي الدولية على جودة مهنة المحاسبة والمراجعة في ضوء متطلبات سوق العمل في ليبيا
Authors: شابون أبوبكر , العربي عائشة
Published: February 2022

تهدف الدراسة إلى التعرف على محددات جودة مهنة المحاسبة والمراجعة، واستكشاف مدى مواكبة التعليم المحاسبي في ليبيا لمتطلبات سوق العمل، ومن ثم تحديد مدى مساهمة تطبيق معايير تعليم المحاسبة الدولية في تحسين جودة مهنة المحاسبة والمراجعة. لذلك تم إجراء دراسة استطلاعية لآراء أعضاء هيئة التدريس بقسم المحاسبة بكلية الاقتصاد والعلوم السياسية بجامعة مصراتة، وأيضا تم تحليل الدارسات السابقة. تشير نتائج الدراسة إلى وجود فجوة بين الجانب التعليمية والأكاديمية لممارسي المحاسبة في ليبيا، وتدني جودة معايير المحاسبة والمراجعة المطبقة في ليبيا، وتدني الوعي بأهمية معايير التعليم المحاسبي. كما تظهر النتائج، من تحليل الأدبيات السابقة، أن هناك تأثير لتطبيق معايير التعليم المحاسبي في تحسين جودة مهنة المحاسبة والمراجعة إذا تم مراعاة تطبيقها في البيئة الليبية. توصي الدراسة بضرورة تحديث التشريعات الليبية المنظمة لمهنة المحاسبة والمراجعة، وإعادة النظر في مناهج التعليم المحاسبي لتواكب متطلبات سوق العمل في ليبيا.
القيم التنظيمية لدى القيادات وعلاقتها بجودة تطبيق معيار القيادة والحوكمة
Authors: شتوان خديجة , النعاجي أحمد
Published: February 2022

تهدف الدراسة إلى التعرف على العلاقة بين القيم التنظيمية لدى القيادات وجودة تطبيق معيار القيادة والحوكمة بكلية الآداب-جامعة مصراتة. وقد اعتمدت الدراسة على المنهج الوصفي، مستهدفة بذلك أعضاء هيئة التدريس بالكلية جميعهم. ولتحقيق أهداف الدراسة، تم تصميم الاستبانة بالاعتماد على مؤشرات دليل المركز الوطني لضمان الجودة لقياس معيـــار القيادة والحــــوكمة. ووزعت هذه الاستبانة على عينة مكونة من (108) من أعضاء هيئة تدريس. وقد أظهرت نتائج الدراسة أن درجة تبني القيادات للقيم (إدارة الإدارة، إدارة العلاقات، إدارة البيئة) بالكلية كانت منخفضة، أما درجة تبني القيادات لقيم إدارة المهمة فكانت متوسطة، بالإضافة لوجود علاقة طردية موجبة ذات دلالة إحصائية بين القيم التنظيمية لدى القيادات وجودة تطبيق معيار القيادة والحوكمة بكلية الآداب-جامعة مصراتة
Encouraging student motivation
Authors:   Xəzər Universiteti magistrant, Altay qızı Bəndəliyeva Gülgəz
Published: February 2022

Araşdırmada mövzuya aid müxtəlif ədəbiyyatlar nəzərdən keçirilərək motivasiya haqqında ümumi məlumat verilmişdir. Dörnyei (2001) araşdırmasına əsasən motivasiyanın necə yaradıldığı, necə artırılacağına aid üç mərhələsi haqqında danışılmışdır. Gorhan və Christopher (1992) araşdırmasına əsasən müəllimin motivasiyanı azaldan davranışları haqqında danışılmışdır. Sonda isə motivasiyanın növləri olan daxili, xarici və müvəffəqiyyət motivasiyası xarakterizə edilmişdir. Son illərə aid mövzu ilə əlaqəli çoxlu tədqiqatlar mövcuddur. Bir neçəsini misal göstərmək olar: Smith, Darves (2017). Encouraging student autonomy, through higher order thinking skills; Göğüş, Yetke. (2014). Öğretmen Yontemlerinin Çeşitlendirilmesi ile öğrenci motivasiyonunun artırılması; Vatansever Bayraktar, (2015), Sınıf yonetiminde öğrenci motivasiyonu ve motivasiyonu etkileyen etmenler; və başqaları. Bu çalışmanın əsas məqsədi: motivasiya haqqında müəyyən ədəbiyyatları nəzərdən keçirərək, müxtəlif təcrübələrlə tanış olaraq motivasiyaya aid bəzi məqamları qeyd etmək və müəllimlərə bu sahədə müəyyən qədər kömək etməkdir. Açar sözlər: motivasiya, şagird, davranış, müəllim, dərs Gulgaz Altay Bandaliyeva Encouraging student motivation Summary The study provides an overview of motivation by reviewing various literature on the subject. According to Dornyei’s (2001) study, there are three stages in how motivation is created and how it is increased. According to a study by Gorhan and Christopher (1992), teachers’ motivational behaviors are discussed. In the end, the tayps of motivation internal, external and motivation for success are characterized. There is a lot of research on the subject in recent years. Here are a few examples: Smith, Darves (2017). Encouraging student autonomy, through higher order thinking skills; Göğüş, Yetke. (2014). Increasing student motivation by Diversifying Teacher Methods; Vatansever Bayraktar, (2015), Student motivation and factors affecting motivation in classroom management; and others. The main purpose of this study: reviewing certain literature on motivation, getting acquainted with different experiences, noting some points related to motivation and helping teachers to some extent in this field. Key words: motivation, student, behavior, lesson
THE ROLE OF NT-PROBNP AND ST2 BIOMARKERS IN PATIENTS WITH ACUTE CORONARY SYNDROME
Authors: Barnett Olga , Halkevych Marta , Labinska Olha , Lutsiv Natalia , Kyyak Yulian
Published: February 2022

The aim: To determine the diagnostic value of serum levels of ST2 in patients with the acute coronary syndrome (ACS) and its correlation with NT-proBNP levels.
Materials and methods: NT-proBNP and ST2 concentration in serum of patients was measured on admission to the hospital and on the 10th day of the treatment using NT-proBNP ELISA (Biomedica, Slovakia) and Presage ST2 assay (Critical Diagnostics, USA), respectively.
Results: Statistically significant direct correlations (p<0.05). The simultaneous increase of ST2 and NT-proBNP serum levels above their threshold in patients with ACSelST (sensitivity – 92.5 %, specificity – 74.2 %, AUC – 0.893, р<0.05) indicated a significant risk of cardiovascular (CV) complications of acute myocardial infarction (AMI) during the inpatient period, e.g. acute heart failure, acute LV aneurysm, recurrent AMI, as well as rhythm and conductivity disturbances.
Conclusions: The data suggest that both ST2 and NT-proBNP may prove useful in predicting unfavorable prognosis during the inpatient care of AMI, as the simultaneous increase of these biomarkers above their threshold values indicates a significant risk of CV complications.
CURRENT ASPECTS OF THE CONTINUING MEDICAL EDUCATION OF DOCTORS ON MANAGEMENT OF PATIENTS WITH MULTIMORBIDITY AND COMORBIDITY
Authors: Diachuk Dmitro , Moroz Galina , Lasytsia Tatyana , Dzіzinska Olena
Published: February 2022

The aim: Тo assess the current approaches to training doctors to manage patients with multimorbidity or comorbidity and the awareness of physicians of the State Institution of Science “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department (SIS “RPC PCM” SAD) of this problem.
Materials and methods: 88 medical doctors of SIS “RPC PCM” SAD were interviewed anonymously, using the specially designed questionnaire. The age of respondents varied from 32 to 72 years; the average age was 53,1±1,2 year; the average length of service was 27,8±1,4 years. The doctors were divided into two groups: the 1st one included 56general practitioners, the 2nd group – 32 doctors – consisted of cardiologists, rheumatologists, neurologists and endocrinologists.
Results: The results of the sociological survey showed that 94,3±2,5% of SIS “RPC PCM” SAD medical doctors pay attention to the presence of comorbid pathology in patients with coronary artery disease (CAD) during the appointment of examination and treatment. Іntroduction of the module «Comorbidity in patients with coronary artery disease: current requirements for treatment» into the postgraduate medical education curriculum is considered necessary by 95,5 ± 2,2% of the interviewees. No statistical difference was found betweenthe 1st and the 2ndrespondent groups (р=0,55).
Conclusions: The results of the study substantiate the necessity of implementation of continuing medical education of doctors (general practitioners, cardiologists, rheumatologists, neurologists, endocrinologists) on management of patients with multimorbidity and comorbidityusing interactive live workshops and online case studies.
PROGNOSTICATION OF COMPLICATED COURSE OF ACUTE MYOCARDIAL INFARCTION WITH CONCOMITANT TYPE 2 DIABETES MELLITUS BASED ON USE OF ENDOTHELIAL MONOCYTE ACTIVATING POLYPEPTIDE-ІІ
Authors: Feldman Diana А. , Ryndina Nataliya G. , Kravchun Pavlo G. , Mykolayivna Dobrovolska I.
Published: February 2022

The aim: To determine the prognostic value of endothelial monocytic peptide ІІ in the course of AMI (acute myocardial infarction) in combination with type 2 diabetes mellitus (DM)
Materials and methods: The study involved 120 patients divided in 2 groups: Group 1 – patients with acute myocardial infarction (AMI) with concomitant type 2 DM (n=69); Group 2 – patients with AMI without concomitant type 2 DM (n=51). Control group was composed with 20 almost healthy persons.
Results: It was determined that in patients with AMI in combination with type 2 diabetes, the level of endothelial monocyte-activating polypeptide II (EMAP-II) was 1.65 times higher than in patients without concomitant type 2 DM (p <0.05). The patients with AMI and type 2 DM who were included in the group of the 3rd tertile according to level of EMAR-II had the complicated course compared to patients in the groups of the 1st and 2nd tertiles. Q-positive AMI was found in 100% of patients who belonged to the group of the 3rd tertile; recurrence of AMI occurred only in patients whose EMAR-II index was included in the 3rd tertile.
Conclusions: According to the results of endothelial function analysis with usу ща the marker of EMAP-II endothelial dysfunction in patients with AMI and concomitant type 2 DM, the increased level of this parameter was characteristic of pronounced violation of dilatation properties of the vascular wall and of the other indicators of complicated comorbid conditions.
EFFECT OF MECHANICAL STIMULI ON REMODELING AND MINERAL DENSITY OF THE SPINE
Authors: Kostyshyn Nazar , Tynitovska Oksana , Chornii Olesia , Gzhegotskyi Mechyslav , Kostyshyn Liubov
Published: February 2022

The aim: The aim of our study was to determine effect of whole body vibration on the bone tissue remodeling, determine the correlation between bone mineral density, markers of bone metabolism and level of vibration stimulus.
Materials and methods: Four experimental groups Wistar rats were exposed to vertical whole body vibration during 28 days. Blood intake and QCT-scanning of the lumbar spine was performed on the 28th and 56th day of study.
Results: The largest loss of trabecular bone was observed in experimental groups III (0.51g) and IV (1.15g), which was decreasing to 12% (p<0.05) and 14% (p<0.05), respectively, in comparison with the control group. After 56th day of the experiment, bone loss dynamics was the following: in the 1st group ≤ 10% (p <0.05), in the 2nd ≤ 12% (p <0.05), in the 3rd ≤ 17 % (p <0.05), and 4th ≤ 22% (p <0.05) compared with the control group. Changes in the level of hydroxyproline in the first experimental group were not statistically significant (p>0.05), in the second group – increased by 19.3% compared with the control rates, in the third – by 65.3%, and in the fourth – the level doubled (p<0.05). Increase of free hydroxyproline indicates violations in the balance between destruction and compensatory acceleration of collagen biosynthesis, which gradually decreases up to the 56th day. It has been determined that with the increase in vibration frequency, elevation of osteocalcin level in rats’ blood is observed.
Conclusions: Acceleration 0.51g increases the rate of bone metabolism, causes collagen metabolism disorders, loss of bone mineral mass, which further leads to osteoporosis.
GALANIN LEVELS IN HYPERTENSIVE PATIENTS WITH OBESITY
Authors: Kravchun Pavlo G. , Kadykova Olga I. , Herasymchuk Uliana S.
Published: February 2022

The aim: To study the level of Galanin concentration in hypertensive patients with obesity, and to identify how the degree of hypertension and the degree of obesity affect the level of Galanin in patients with this comorbid pathology.
Materials and methods: The study included 58 patients with hypertension. Grade 1 was diagnosed in 12 (20.69%), grade 2 – 16 (27.59%), grade 3 – 30 (51.72%) examined patients. Of the patients enrolled to study, 32 were women and 26 were men, 32 to 79 years old (mean age – 57,5±10.11 years).
Results: The level of Galanin in all groups of hypertensive patients was significantly increased compared to the control group (p < 0.001). The concentration of the latter in the blood serum gradually increases according to the degree of hypertension, while (p<0.01), and the maximum level of Galanin was observed in group of patients with grade 3 hypertension (Me 164.47 pg/mL). The level of Galanin concentration in all subgroups of patients, depending on the presence and degree of obesity, was significantly increased compared to the control group (p < 0.001), the maximum level of Galanin was in the group with hypertension and obesity of 3 degrees (Me = 166.48 pg/mL).
Conclusions: In hypertensive patients with obesity, a significant increase in the concentration of Galanin was detected; most pronounced in arterial hypertension grade 3 and obesity grade 3. Galanin is possibly a biomarker of cardiovascular risk in a cohort of patients with abdominal obesity.
PECULIARITIES OF ELECTRON MICROSCOPIC HIPPOCAMPAL FORMATION DEVELOPMENT CHARACTERISTICS IN POSTERITY OF RATS AFTER PGE2 INJECTION FOR LABOR INDUCTION
Authors: Hryhorieva Olena A. , Mamay Iryna Yu. , Tertyshniy Serhii , Dariy Volodymyr , Guminsky Yuriy Y.
Published: February 2022

The aim: To determine the peculiarities of electron microscopic hippocampal formation development characteristics in postetry of rats during two first weeks of postnatal life after intravaginal injection of prostaglandin E2 for labor induction.
Materials and methods: The ultrastructural changes of hippocampal formation in posterity of white syngenic rats at the 1st, 7th and 14th days of postnatal life were examined. In this study we used electron-microscopic method. Brain tissue from experimental animals underwent standart stages necessary for electron microscopy and poured into pure Epon. Epon polymerization was carried out in two stages at 36 ° C (12 h) and 56 ° C (24 h). Ultrathin (50-60 nm) sections were obtained on a PowerTome RMC Boeckeler ultratome and then contrasted according to the E. Reynolds method. Ultrathin sections were studied in a PEM-100 electron microscope with an accelerating voltage 60 kV.
Results: Based on the obtained data in the study of the hippocampal formation in postery of rats after induction of labor, analysis of the literature devoted to the electron microscopic study of the brain after ischemic injuries, it can be concluded that on the background of stimulation of labor by PgE2, changes corresponding to ischemic damage take place in the rat brain.
Conclusions: In posterity of rats after receiving PgE2 for labour induction it was revealed microcirculatory changes; edema of the presynaptic endings, synaptic vesicles aggregation in the center of the presynaptic processes, swelling and destruction of mitochondria; oligodendroglia changes; ultrastructural changes in neurons like edema and vacuolization of mitochondria.
EVALUATION OF RESULTS OF ERAS PROGRAM AFTER PANCREATODUODENECTOMY DEPENDING ON THE TYPE OF GASTROINTESTINAL RECONSTRUCTION
Authors: Skums Anatolii , Usenko Oleksandr
Published: February 2022

The aim: To assess the effect of gastrojejunostomy with Braun anastomosis during PD for prevention of DGE in ERAS protocol patients.
Materials and methods: A total of 92 patients from 28 to 75 years were included in this study, who underwent PD with ERAS program. Patients were divided into 2 groups, depending on type of reconstruction - PD with Child reconstruction and PD with gastrojejunostomy with Braun anastomosis.
Results: In non-Braun group nasogastric tube was removed on POD 1 in 56 (93.3%) patients and was reinserted later in 4 (6.7%) patients. DGE was observed in 8 (13,3%) patients, which required enteral feeding via nasojejunal tube. In 51 (85.0%) patients feeding was started according to ERAS program without the need for other methods of nutritional support. In Braun group nasogastric tube was removed on POD 1 in all patients after the X-ray control and oral feeding was started. Due to the development of DGE, a nasojejunal tube for enteral nutrition was placed in two cases. In 30 (93,7%) patients peroral feeding was started in accordance to enhanced recovery program. Thus, the frequency of DGE in group II was lower (6.3%), but the difference did not reach statistical significance (p = 0.299).
Conclusions: The formation of a Braun anastomosis in PD with the use of ERAS program can reduce the frequency of DGE and eliminate the consequences of technical errors. More studies are needed for stronger evidence.
PROGNOSIS AND PREVENTION OF UTERUS BLEEDINGS IN EARLY POSTPARTUM PERIOD FOR WOMEN WITH IDIOPATHIC ARTERIAL HYPOTENSION
Authors: Markin Leonid B. , Popovych Olena I. , Popovych Alla I.
Published: February 2022

The aim: To establish the effectiveness of thromboelastography (TEG) and tranexamic acid (TXA) for prognosis and prevention of early postpartum period bleedings (PPB) for postpartum women with idiopathic arterial hypotension (IAH).
Materials and methods: Coagulogical research was conducted (coaugologram screening, dynamic function of platelets under the influence of adenosine diphosphate (ADP) (visual assessment), measurement of soluble fibrin-monomer complexes (FMC) and TEG of 36 in parturient women during the I chilbirth period with arterial hypotension. 14 parturient women with normal fibrinolysis were included into the first observation group; The second group includes 22 parturient women with TEG results which show signs of hyperfibrinolysis. Further, in cases when stronger fibrinolysis was detected during the late pushing phase of childbirth period, the TXA by amount of 1,0 g IV (bolus) was injected due to bleeding prevention. TEG was repeated during early postpartum period.
Results: the inhibition of platelet aggregation activity with ADP was observed in every parturient woman with IAH in the first partum period. In 61,1% cases with TEG hyperfibrinolysis were shown, which was accompanied by significant increase in FMC levels in blood. The use of TXA as PPB prevention for parturient women with IAH and hyperfibrinolysis during TEG was fully oppressing the fibrinolytic activity and was not affecting the coagulation part of hemostasis.
Conclusions: hemostasis testing during childbirth based on TEG gives the ability to prognose the hemorrhagic complications in parturient women with IAH and administer their prophylaxy using TXA.
ANALYSIS OF THE EFFECTIVENESS OF DIFFERENT TREATMENT REGIMENS FOR DRUG-RESISTANT TUBERCULOSIS IN PRYKARPATTIA. CHALLENGES OF OUR TIME
Authors: Makoyda Iryna , Ostrovskyy Мykola , Ostrovska Ksenia , Todoriko Lidia , Babliuk Ludmila , Vepryk Tetiana , Melnyk-Sheremeta Olha
Published: February 2022

The aim: To study the structure of adverse drug reactions and the effectiveness of treatment among patients with drug-resistant tuberculosis who follow the modified short-term and individualized treatment regimens.
Materials and methods: The analysis of 138 inpatient medical records, outpatient health cards and electronic database of the patient register was conducted. Resistant strains of MTB were microbiologically verified in all the patients. All the patients underwent clinical-laboratory, instrumental microbiological, genetic-molecular (GeneXpert MTB / RIF) methods of examination, both for diagnosis and monitoring of the effectiveness of treatment. In order to prevent complications and control adverse reactions, all the patients were briefly screened for peripheral neuropathy, basic audiometry, the QTc interval was determined, visual acuity and color perception were checked.
Results: At individualized treatment regimen of tuberculosis, adverse reactions were 3.5 times more common than in patients with modified short-term therapy, in 65 (68.4%) cases and in 8 (18.6%) cases, respectively. Accordingly, the effectiveness of treatment differed in both groups. Prevailing in long-term treatment were: treatment interruption treatment gap, treatment failure, continued treatment. In patients receiving short-term regimens, the cured rate was almost twice as common as in the second group.
Conclusions: Timely detection cases of resistant tuberculosis and using linear probe analysis (LPA) - GenoType MTBDRplus for diagnosis of fluoroquinolone resistance, will allow the use of modified short-term treatment regimens for tuberculosis. Which in turn will reduce the number of side effects and improve the outcome of treatment.
ATRIAL FIBRILLATION IN PATIENTS WITH CONCOMITANT DIABETES MELLITUS – WHAT DO WE ALREADY KNOW AND WHAT DO WE NEED TO DISCOVER?
Authors: Gumprecht Jakub Janusz , Kalarus Zbigniew
Published: February 2022

Recently published data indicate the prevalence of atrial fibrillation, the most common cardiac arrhythmia worldwide, in up to 20% of the elderly population. This arrhythmia significantly impacts the quality of life by increasing the risk of stroke, thromboembolism, dementia or heart failure, resulting in a substantial increase in the risk of adverse events and all-cause death. On the other hand, diabetes mellitus is the most predominant metabolic disorder on the globe, which incidence is surging annually, currently affecting over 500 million individuals. Patients with coexisting diabetes have a relevantly elevated risk of atrial fibrillation development. This association have not yet been comprehensively elucidated. Nonetheless, it seems to be a multifactorial, complex relationship comprising mechanisms such as oxidative stress, insulin resistance, hemostasis and fibrinolysis disturbances or endothelium dysfunction, which lead to mechanical and electrical left atrial remodeling. Therefore, this study aims to summarize the evidence regarding the relationship linking diabetes mellitus and atrial fibrillation.
A HUGE PERICARDIAL CYST MIMICKING A FALSE LEFT DIAPHRAGMATIC PARALYSIS
Authors: Shaprinskiy Volodymyr , Kryvetskyi Volodymyr , Suleimanova Vasylysa , Dombrovskyi Vadym
Published: February 2022

Pericardial cysts are infrequent mediastinal entities. They can mimic cardiac chamber enlargement, phrenic hernia, malignancy, bronchogenic cysts, pleurisy, dextrocardia. Diaphragmatic elevation can also be misdiagnosed in some cases.
The reports about huge pericardial cyst mimicking the left diaphragmatic elevation (paralysis) are not common. The correct diagnosis of pericardial cyst can be difficult due to unremarkable complains and non-specific findings on chest radiography. In this report we have presented a rare clinical case described as the huge pericardial cyst mimicking a false left diaphragmatic paralysis. The combination of different radiological technics (CT-scans, barium esophago-gastrography etc.) are useful to correct preoperative diagnosis. Transthoracic (intercostal) accesses are the dominant to operate on patients with huge pericardial cysts.
PREGNANCY OUTCOMES IN WOMEN WITH EXTREMELY HIGH SFLT-1/PIGF RATIO: CASE SERIES
Authors: Oshovskyy Viktor , Arbuzova Svitlana , Nikolenko Marharyta , Mylytsya Kostyantyn
Published: February 2022

Preeclampsia (PE) is a multisystem disorder, usually defined as the development of hypertension and proteinuria after 20 weeks of pregnancy. The sFlt-1/PlGF ratio has been widely studied as a diagnostic and prognostic marker of preeclampsia and other manifestations of placental dysfunction. A sFlt-1/PlGF ratio greater than 85 for early PE, <34 weeks of gestation suggests a high risk of PE requiring close clinical monitoring. Our main aim was to evaluate the maternal and perinatal outcomes of pregnancies with an extremely high sFlt-1/PlGF ratio.
The analysis included data on placental growth factor and soluble fms-like tyrosine kinase serum levels, measured during 2017–2020 in 128 pregnant women. Here we present 8 cases of women with a numerical ratio greater than 850.
In all 100% of cases, the signs of obstetric angiogenic catastrophe requiring imminent delivery developed soon.
We observed a trend for worsening perinatal outcomes in women with an extremely high sFlt-1/PlGF of ≥850.
Respiratory Monitoring in Pediatric Neuromuscular Disease
Authors: Andre Sugiyono  , Siti Chandra Widjanantie
Published: February 2022

ABSTRACTDuring the outbreak of Covid-19, the policy of working from home for employees and studying from Neuromuscular disease in childhood result in dysfunction of chest wall and lung movement that interfere ventilation function and gas exchange. Without vital respiratory pump, ventilation, gas exchange function and cough ability would be compromised and could result in complications such as pneumonia, atelectasis, and respiratory failure. Comorbid factors in cardiovascular, musculoskeletal, nutrition, and gastrointestinal could aggravate respiratory morbidity and mortality if not adequately treated. This paper was written to review anatomy and physiology of neurorespiratory system, pathophysiology of respiratory complication in neuromuscular disease, clinical assessment and respiratory monitoring of childhood neuromuscular disease from Physical Medicine and Rehabilitation point of view.Keywords: assessment, neuromuscular disease, pediatric, respiratory
Quality monitoring of well waters of Zhydachiv district of Lviv region
Authors: Hoivanovych Nataliia , Bryndzia Iryna
Published: February 2022

The article presents the results of the study for well water quality in Zhydachiv district on the following indicators: total microbial count, coli index, content of nitrites, nitrates, ammonium ions, phosphates and chlorides, mineralization and pH. Exceedance of regulatory values for the content of nitrates, chlorides and ammonium ions was established. Studies of the total microbial count in drinking water have shown that the average annual values correspond to the norm only in some settlements in the winter, and in some cases exceed 2.2-9.8 times. The same tendency for changes is inherent for the coli-index in the studied water, where exceedances of 2.3-6.9 times were observed. Seasonal biotesting of well waters was carried out. It was found that most of the tested samples do not meet the standard for sanitary and hygienic indicators. The phytotoxicity index varies from low (Vilkhivtsi, Zhyrova) to high (Zhydachiv) pollution level. As a result of the study, it was found that the toxicity rates are lowest in the autumn-winter period, while they are the highest during spring-summer.
Dimensional and time span dynamics of forest litter on track (for example NNP "Skolivski Beskydy")
Authors: Lenevych O.
Published: February 2022

The article analyzes the weak and excessive influence of recreational load on forest litter within the track and their roadside by seasons (summer → autumn → spring → summer). It was found that the Skoliv Beskydy region of forest litter in the summer are 2,1−2,4 kg·m⁻², while on the track of first category they are – 1.2 kg·m⁻², and on the trails of IV category – was not detected forest litter. In the autumn on the track litter stocks increase by more than 50% compared to the summer. Litter reserves increase due to the fraction of leaves, the share of which is about 40% of the total mass. In the spring, forest litter stocks decreased almost twice, while within the roadside recorded an increase in the proportion of detrytu. The reason for such a sharp decrease in forest litter stocks on track and increase within the roadside can be considered mechanical movement and shredding of leaves by people in the autumn, and in the spring - leaching and transfer of rain water to the side of the trails. It was found that by the end of the summer forest litter stocks on first category track decreased by about 23% and by 8% - within the roadside. In the summer, no forest litter was found on track IV category, within the boundaries of this track, stocks did not exceed 0,3 kg·m⁻². The accumulation of forest litter within the roadside is due to: slow processes of transformation of forest litter, leaching of forest litter by rain from the «upper trail» to the «lower», the width of the trail and its direction, recreational influence.