bluuebunny/crossref_metadata_2025 huggingface dataset:
Pengembangan Model Bisnis Halal Logistik Transportasi Berbasiskan Business Model Canvass (BMC)
Authors: Irma Dwiputranti Made
Published: January 2021

The basic concept of general logistics and halal logistics are actually the same, the difference is that halal logistics is carried out by ensuring that processes in the supply chain separate halal cargo from non-halal cargo. This needs to be done to avoid cross-contamination and ensure that as long as the logistics system of the product is guaranteed halal, therefore halal logistics can be expressed as the application of the halal concept throughout the supply chain activities of suppliers, manufacturing, warehousing, transportation and product distribution to ensure the halal status of a product. If this is done, it will produce halal logistic output according to the standards of the customer's wishes.

               The research will be carried out through interviews and surveys, the results will be used to identify business processes and find out what business activities are carried out and who are the business actors involved, from the business process a business model is then created to develop ordinary logistics to halal logistics based on a Business Model. Canvass (BMC). The Business Model Canvass (BMC) consists of 9 elements, namely customer segments, value propositions, channels, customer relationships, revenue streams, key resources, key activities, key partnerships and cost structures.

The result of this research is to obtain a canvas-based halal logistics model that can be applied at PT Iron Bird, which is divided into 4 categories, namely: 1) Customers who have potential in halal logistics are industries engaged in fast moving, consumer goods, retail. , raw material and pharmacy 2) Value propositions, namely offers to customers regarding delivery that guarantees halal products, distribution to return goods or return, segregation for Less than Truck Load (LTL), re-packaging for contaminated goods, labels and documents halal, cleaning units according to standards, completeness of safety, transparency and trust, on time delivery, and costs in accordance with the services provided 3) Resources by managing main resources through a special team to handle contaminated goods, availability of vehicles, services provided , packaging for contaminated goods and labels and documents h alal 4) Financial through the services provided. Key Performance Indicators (KPI) in accordance with halal logistics standards which consist of: Quality, Time, Cost and Risk.
Degradation of Cultural Heritage Buildings
Authors: Prabowo Wahyu , Karsono Danarti
Published: January 2021

Preservation of cultural heritage buildings is an action in maintaining the sustainability of architectural diversity in Indonesia. Indonesia, which is a former colony of the European nation, certainly has cultural ties with European nations who have inhabited this country, where during these times, Europeans will experience a natural adaptation process which indirectly brings their culture into Indonesia, especially the city of Surakarta, one of which is in its architectural form. In the process of adaptation, a cultural assimilation occurred which caused European buildings in Indonesia to have different characteristics from European buildings in Europe. With the independence of the Indonesian nation, the ownership and function of these buildings were transferred, either to the Indonesian government or to private or individual property. Conservation means all the processes of looking after a place so as to retain its cultural significance. It includes maintenance and may according to circumstances include preservation, restoration, reconstruction and adaptation and will be commonly a combination of more that one of these (Burra Charter,1981). This research is designed to be used as a guide in maintaining cultural heritage buildings for the owners or users of cultural heritage buildings with European architectural characteristics, with the hope that it will help preserve the important value contained in a building and a sustainable architecture. The method used in this study is a descriptive analytical method of European-style cultural heritage buildings in Surakarta with a level of maintenance approach to these cultural heritage buildings.
The Product Quality, Impacts, and Implication of Solo Batik Carnival Event on Solo City’s Spatial Guidelines
Authors: Yulia Atika Candra
Published: January 2021

Solo Batik Carnival (SBC) is an annual carnival event which have vision to develop creative industry base on batik and reusable products to increase the value as artistic artwork masterpieces, held in Solo by Surakarta Tourism Office as the vice of regional goverment collaborate with Yayasan Solo Batik Carnival. The main purpose of this event are to introduce batik as a legacy of Java culture, and make Solo as one of tourist destination esspecially in fashion interest with the aims in educational development, art, culture, and economic increasing. Therefore, this study is so important and necessary to figure out about: (a) dependability of event quality and spatial in city’s space study, and (b) correlation between impact to the community and the city’s ability to coverage activities during event.

This research used sequential mixed methods theory with exploratory sequential strategy. Explorative method used for exploration on field and made a qualitative analysis to find the facts, and compare it with quantitative data from local and tourists respondents with two audiences: zone, tribune and runway. It takes event quality, economic, social and culture impact, and also open public space elements as indicators of research.

Thereby the results of this research: first, SBC has a potential ability as an attraction. Second, SBC has a value to increase and develop community economic conditions and also put the city on the national tourism position with creating image identity. And third, event quality and the event’s impacts have certainly been references to design guide-lines of the city’s space surrounding the event’s area.
Diaspora, Cultural Heritage and Tourism
Authors: Utomo Herry
Published: January 2021

A new perspective on the importance of preserving cultural heritage across the world has recently been emphasized both culturally and economically to benefit human civilization going forward. One of the arms of the United Nation, UNESCO has ratified its significance through its member nations. While the benefits can be foreseen, it is certainly a challenging undertaking that requires high levels of creativity mostly out the box approaches. One obvious reason is that cultural conservation and promotion will only make sense if it is economically sound and sustains. Surakarta City, better known as Solo, is one of the centers of Javanese culture that is rich in history dated back to the ancient Javanese kingdoms. It is an attractive tourist’s destination. It has seventy historic buildings, monuments, and urban sites of cultural significance. They are arranged into six category areas or districts that are composed of traditional, colonial, and religious buildings, gates, memorials, bridges, parks, and open public spaces as listed in the Provincial Decree and are protected under Cultural Property Law. Its cultural heritage also includes important urban areas. Surakarta's physical appearance is well defined and is its tangible cultural heritage. While it is important, the wealth of knowledge and skills that are transmitted from one generation to the next play very crucial roles. Intangible cultural heritage includes oral traditions, performing arts, social practices, rituals, festive events, knowledge, and skills needed to create traditional arts and crafts. This intangible cultural heritage must be nurtured in the social and daily life of its people and interwoven into the mainstream of social groups and will determine the survival and success of cultural heritage succession.

This paper will discuss potential roles of diaspora in cultural heritage preservation, promotion, and tourism in Surakarta based on the unique characteristics of diaspora, their needs, interests, views, and economic capabilities. By understanding the nature of diaspora, their potentials can be channeled to promote and safeguard cultural heritage and empower citizens to be actively engage in sustainable economic activities. Interlocking between economic and intangible cultural heritage of Surakarta is a step forward to economic and cultural prosperity.
Physical Therapy in Lumbosacral Discopathy
Authors: Kuliński Włodzisław , Smoleń Sebastian
Published: January 2021

Introduction: Back pain is one of the most common disorders of the 21st century. Back pain is usually associated with degenerative disease and discopathy and affects 50-70% of the population at some point in their lives. It leads to work absence in 20% of cases and is the fifth most common cause of hospitalisation.
Aim: To assess the condition of patients with lumbosacral discopathy before and after physical therapy.
Material and Methods: The study assessed 33 patients aged 25-58 years diagnosed with lumbosacral discopathy who were referred to the Rehabilitation Clinic in Połaniec. The following research tools were used: a questionnaire designed by the authors and the Quebec Back Pain Disability Scale. Patients were treated with the following physical therapy procedures: diadynamic currents, interferential current therapy, Trabert’s currents, ultrasound therapy, laser therapy, low-frequency alternating magnetic fields, and kinesiotherapy.
Results: Following 3-week physical therapy, elimination or considerable reduction of pain and improved physical fitness were found in study patients; the need for pharmacotherapy was eliminated.
Conclusions: 1. Lumbosacral discopathy is a difficult clinical and social problem. 2. The disorder restricts or prevents the ability to perform activities of daily living. 3. Physical therapy procedures reduce pain associated with discopathy, improve physical fitness, and eliminate the use of pharmacotherapy. 4. Physical therapy and rehabilitation are a basic part of treatment in this group of patients.
Biological Signs of Aging in the Elderly
Authors: Stachura Agata , Gierszon Patrycja , Paziewska Magdalena , Łagowska-Batyra Agnieszka
Published: January 2021

The aging process is one of the natural stages of human life, it is characterized by both changes in human appearance and the degenerative process of internal organs. It is considered natural to counteract this process and delay it gradually. It is possible with good knowledge of the pathophysiology of aging processes and the involution of individual systems and organs. Therefore, this work is a “small compendium of knowledge” reminding about the physiological aspects of aging in some systems, which should be the basis for the selection of a diagnostic and treatment method in accordance with current medical standards.
Creating of Image of the Thermal Treatment Institution
– Selected Elements
Authors: Paszkowska Małgorzata
Published: January 2021

The positive image is very important for the market activity of each healthcare institution. Shaping a positive image is also important for thermal treatment institutions, especially those wishing to increase the number of full-paid patients. The image of the thermal treatment institutions consists of many elements. Taking care of everyone, at least the most important of them, contributes to creating a positive image and, as a result, to maintaining or strengthening the market position. Nowadays, every thermal treatment institutions should plan and implement long-term public relations activities. The aim of the article is to present some of the important elements that influence the image of the thermal treatment institutions (sanatorium and hospital). Public relations in the operation of the thermal treatment institutions is an alternative to the statutory ban on advertising of medical activities.
The Effectiveness of Complex Non-Pharmacological Treatment
in Patients with Episodic Migraine and Neck Pain
Authors: Morozova Olga G. , Dubenko Olga E. , Chernenko Anna G.
Published: January 2021

Introduction: Comorbidities and co-occurring conditions contribute to the overall burden of migraine. Treatment co-occurring condition is an important part in providing optimal care.
Aim: To investigate the effectiveness of complex non-pharmacological treatment and impact it on daily activities and concomitant anxiety and depression in patients with episodic migraine and co-occurring neck pain.
Materials and Methods: We evaluated 56 patients with episodic migraine (with aura 18 and 38 without aura) and co-existing neck pain, 21 men, 35 women, age from 18 to 55 years. Examination including radiography of the cervical spine, visual analogue scale for the pain, “HIT-6”, Beck Depression Inventory and Spilberger-Hanin’s anxiety scale. The Kolmogorov-Smirnov test was used to compare the data.
Results: Patients were divided into two treatment groups: the first group of patients 28 patients received only the specified complex of manual therapy, second group - 28 patients underwent a set of manual therapy and acupuncture. After treatment in first group observed decrease of frequency and severity of migraine attacks and a reduce number of days with a headache, but level of anxiety and depressive manifestations less decreased. In second group was more significant reduce the intensity, duration and frequency of migraine, more significant dynamics of anxiety disorders and general well-being.
Conclusions: Non-pharmacological treatment neck-pain syndrome in patients with episodic migraine not only to be effective in symptomatic control of pericranial muscles tension but influence on decrease of frequency and severity migraine attacks. Adding acupuncture to manual techniques more significant reduce pain syndrome and psychological disorders that possible lead to reduce drug intake.
Climbing – From Extreme Sports to Therapy
Authors: Bibro Marta
Published: January 2021

Not so long ago climbing was perceived as an extremely demanding activity, intended only for an elite group, is now gaining new supporters year by year. The mass emergence of artificial (indoor) climbing walls with routes varied in different difficulty levels caused that nowadays it is a sport available for people of different ages, as well as those with disabilities. Comprehensive impact of climbing on the body aroused interest not only of trainers and teachers of physical education, but also physiotherapists, occupational therapists and psychotherapists. Therapeutic climbing is successfully used in the field of orthopaedics, psychotherapy, neurology and geriatrics, as well as an educational tool for the treatment of children and adolescents with hyperactivity, attention deficit or drug problems. It can also be used as a form of prevention of civilization diseases and a way of dealing with mental trauma caused by war and difficult living conditions.
UTILIZATION OF AIR SUPPORT IN THE POLISH EMERGENCY
MEDICAL SYSTE M FOR PATIENTS WITH OUT-OF-HOSPITAL
CARDIAC ARREST
Authors: Świeżewski Stanisław Paweł , Rabczenko Daniel , Wejnarski Arkadiusz , Leszczyński Piotr Konrad , Rzońca Patryk , Jarzębowska Marta , Michalak Grzegorz , Fronczak Adam , Gałązkowski Robert
Published: January 2021

The aim: This study aimed to evaluate the utilization of air support in cases of OHCA in the Polish emergency medical system, in particular to assess the prevalence of return of spontaneous circulation (ROSC) and to determine the 30-day
survival of patients.
Material and methods: A retrospective cohort study based on the analysis of aviation and medical records of all HEMS missions in 2014 was conducted. Patients’ follow-up was traced using information from nationwide databases.
The inclusion criterion for the study was both the disposal of HEMS to OHCA and the appearance of OHCA during the intervention.
Results: During the research period PMAR aircraft performed 8366 missions. The criteria for inclusion were met for 574 missions. Most often HEMS crews intervened in cases of OHCA in men and patients over 60 years old. In 58% of all
cases OHCA has a cardiological background and the most common first rhythm was asystole. ROSC was obtained in 237 (41.2%) cases and 30-day survival was observed in 10.4% of patients in the study population.
Conclusions: The utilization of air support in the Polish emergency medical system has a positive impact on the prehospital phase of the therapeutic process of OHCA patients. The cooperation between GEMS and HEMS in OHCA cases
in Poland allows obtaining ROSC and 30-day survival of patients at the level of countries with the well-developed emergency medical systems in the world.
The use of traction splints in the Emergency Medical Teams in Poland
Authors: Stachurski Jan , Sionek Andrzej , Gałązkowski Robert
Published: January 2021

The aim: Traction splints are part of the procedure recommended in the femoral shaft fractures and in many countries they are equipped with ambulances. The aim was to determine the availability of traction splints in the emergency medical teams in Poland.
Material and methods: The survey was conducted using a survey method, obtaining answers from 29% of administrators of emergency medical teams in Poland, representing 36% of all emergency medical teams.
Results: Traction splints are found only in 11% of examined emergency medical teams in Poland, more often in specialized teams (17%) than basic ones (less than 10%). There has been wide variation between models of traction splints. Only in two cases organized cooperation between emergency departments and emergency medical teams was found in the matter of replacing traction splints in the piece-by-piece mode.
Conclusions: There is low availability of traction splints at the pre-hospital stage in Poland. There is no organized cooperation between emergency departments and emergency medical teams in the matter of replacing the traction splints with the use of the piece-for-piece method.
TREATMENT OF SEVERE SPINAL DEFORMATIONS IN CHILDREN WITH IDIOPATHIC SCOLIOSIS USING HALO-GRAVITY TRACTION
Authors: Rohozynskyi Valentyn A. , Levytskyi Anatolii F. , Dolianytskyi Mykola M. , Benzar Irina M.
Published: January 2021

The aim: To chose the best way treatment and achievement of 3-dimensional spinal correction in order to maximize its parameters to the physiological norms is a choice of
the optimal surgical severe scoliotic spinal deformity correction technology.
Materials and methods: Performed surgical treatments to 60 children of two patient’s groups, that were under surgical treatment for severe scoliotic spinal deformations with preliminary used halo-gravity traction and one-step correction; to establish an effective and safe protocol of the treatment for children with severe scoliotic spinal deformations (>100°). The results comparative analysis of 60 patients with severe scoliotic spinal deformations, with a two-step surgery treatments (first step – halo-gravity traction and second step – correcting spinal instrumentation) and patients with one-step correction.
Patients were divided into 2 groups with 30 children in each of them. The first group treated with preoperatively HGT (halo-gravity traction) and after that a spinal instrumentation together with osteotomies (3-4 levels by Ponte; VCR (vertebral column resection) osteotomy 1 level) were performed. The second group – performed one-step spinal instrumentation with osteotomies (3-4 levels by Ponte; VCR osteotomy 1 level).
Results: One-step implanted construction in children with severe scoliotic spinal deformations, compare to HGT treatment that were carried out in stages – is increasing the danger of neurological deficiency by 17%, HGT allows to make more corrections and to adjust spinal cord for the next correction treatment. .
Conclusions: Halo-gravity traction as a first stage of severe scoliotic spinal deformations treatment allows to increase the mobility of the vertebral column and to adjust spinal cord step by step for the next correction treatment.
COMPARATIVE HYGIENIC ASSESSMENT OF PESTICIDES BEHAVIOR IN SOIL IN INTENSIVE GRAIN FARMING TECHNOLOGIES
Authors: Blagaia Anna V. , Kondratiuk Mykola V. , Omelchuk Sergii T. , Pelo Ihor M. , Kozak Nataliia D.
Published: January 2021

The aim: Was the comparative hygienic evaluation of the pesticide behavior in the soil after application on cereals.
Material and methods: Methods of full-scale in-field hygienic experiment, high-performance liquid (HPLC), gas-liquid (GLC), thin-layer chromatography, statistical, bibliography were used in the research.
Results: Data on the detailed conditions and land parcels treated with studied pesticide formulation and its a.i. are highlighted in the article. The actual levels of the different classes a.i. content in soil and its dynamics were determined, based on which the dissipation rate constants (K) were calculated, as well as quantitative parameters of stability (τ50, τ95, τ99).
Conclusions: Azoxystrobin, benzovindiflupyr, epoxiconazole, propiconazole, prochloraz, cyproconazole can be classified as of low hazardous substances, and trinexapac-ethyl, kresoxim-methyl, picoxystrobin, and tebuconazole are considered to be moderately hazardous. Among all pesticides studied, tebuconazole is the longest persists in the soil; epoxiconazole and propiconazole are most likely to disappear from the soil. Calculated values of half-lives of the studied substances in the agro-climatic conditions of Ukraine are slightly different from the results of in-field experiments that were conducted in other countries, namely: azoxystrobin, epoxiconazole, propiconazole, and cyproconazole disappear from the soil more quickly; the kresoxim-methyl and pinoxaden disappear more slowly. Meanwhile, the persistence of benzovindiflupyr, picoxystrobin, prochloraz, trinexapac-ethyl, and tebuconazole does not differ from the persistence in soils of European countries.
CONGENITAL ANOMALIES IN CHILDREN OF UKRAINE: 25-YEAR MONITORING OF MORBIDITY AND PREVALENCE
Authors: Volosovets Oleksandr P. , Kryuchko Tetyana O. , Veselskyi Viktor L. , Kryvopustov Sergii P. , Volosovets Tetiana M. , Shatilo Viktor Y. , Dudnik Veronyka M.
Published: January 2021

The aim: Of the work was to study 25-year trends in the incidence of congenital anomalies in the child population of Ukraine in order to determine the impact of ecotoxic environmental factors on their development, in particular radiation.
Materials and methods: Methods of statistical assessment, epidemiological analysis of materials at the Center for Medical Statistics of the MOH of Ukraine were used.
Results: The rate of congenital anomalies growth for the recent 25 years has exceeded the growth rate of the total incidence in the child population of Ukraine by 1.6 times,
occupying the leading place in Europe by the level of environment pollution. Over the last 25 years, the growth of the Ukrainian children’s congenital anomalies incidence
level by 59.5% is observed, mostly in children from large industrial regions of Ukraine, due to the significant ecotoxic effect of pollutants on the child’s body. Children living
permanently in the areas contaminated by the Chernobyl accident had significantly higher rates of congenital anomalies in 1986 than in the early 1990s, but over the recent 25 years the incidence in this contingent has decreased.
Conclusions: The results of such long-term studies performed by a group of leading Ukrainian scientists from different regions of Ukraine indicate that in children experiencing negative effects of ecotoxic factors, including radiation, an increase in the detection and prevalence of congenital defects is observed, which requires complex international and intersectoral measures to prevent and reduce child mortality.
CORRECTION OF AUTONOMIC AND COGNITIVE DISTURBANCES IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE
Authors: Sirchak Yelyzaveta S. , Griga Vasilij I. , Petrichko Oksana I.
Published: January 2021

The aim: To explore the features of the congnitive (CD) and neurovegetative dysfunctions (NVD) of patients with different forms of non-alcoholic fatty liver disease NAFLD (nonalcoholic fatty hepatosis (NAFH) and non-alcoholic steatohepatitis (NASH)) and type 2 diabetes mellitus (T2DM), as well as their dynamics against the background of complex therapy using armadin (2-ethyl-6-methyl-3-hydroxypyridine succinate).
Materials and methods: 50 patients with NAFLD (24 patients with NAFH and 26 patients with NASH) and T2DM were examined. Dysfunction of central and vegetative nervous
system was carried out with the help of neuro-psychometric testing.
Results: The analysis of the conducted research before treatments indicates the NVD in the surveyed patients. Cognitive dysfunctions (mostly mild and moderate) was
revealed in all of our patients in both groups. The most pronounced disturbances before treatments were determined in the areas of attention and concentration, memory, less pronounced – visually constructive area, especially among patients with NASH and T2DM. Stressful situations have a pronounced impact on the lives of these patients, but they are not critical enough to any issues. Patients of Group 2 before treatments had the lowest level of resistance to stress. They found a slight vulnerability even from minor impacts.
Conclusions: In patients with NAFLD and T2DM, congnitive and neurovegetative dysfunctions were found, according to neuro-psychometric testing. Complex therapy using 2-ethyl-6-methyl-3-hydroxypyridine succinate is an effective and safe method for the correction of congnitive and neurovegetative dysfunctions in patients with NAFLD and T2DM.
WAYS TO IMPROVE THE SYSTEM OF MEDICAL PROVIDING OF PUPILS IN UKRAINE
Authors: Peresypkina Tatiana V.
Published: January 2021

The aim: Of this article was analysis of the existing health care system for school-age children in Ukraine and the identification of ways to improve and develop the school
health care system like a topical issue of pediatrics.
Materials and methods: The analysis of the state of health of children in Ukraine, the questionnaire of the participants of the educational process regarding the expedient
and expected types of medical care, the WHO publications on the medical provision of schoolchildren were analyzed.
Conclusions: The analysis of the legal framework in Ukraine in the period of reforming the medical sector has allowed to identify the problematic issues, the solution of which
will contribute to ensuring the quality of the medical aid system for school-age children, improving the level of health, shaping the health behavior of health behavior. These include improving the legal framework on some issues, defining the functional authority and structure of the school health care system.
THE RESULTS OF MONITORING THE PSYCHOLOGICAL READINESS FOR PROFESSIONAL ACTIVITIES IN MEDICAL STUDENTS
Authors: Morokhovets Halyna Yu. , Bieliaieva Olena M. , Lysanets Yuliia V.
Published: January 2021

The aim was to analyze the psychological readiness of a future physician for professional activity, the attitude of the first-year medical students to their profession, the formation of positive motivation to study and professional activity in general.
Materials and methods: In the course of research, the following techniques have been used: bibliosemantic method for the analysis of scientific publications, methodology
for study the main motives for choosing a profession, suggested by Ye.M. Pavliutenkov, methodology for study the motives of academic activity, suggested by A.A. Rean and V.A. Yakunin to conduct a survey in the process of learning medical and biological physics by the students of Medical and Dental Faculties at the Ukrainian Medical Stomatological Academy in 2018/2019 academic year, the MS Excel software application.
Conclusions: Professional identity of medical students begins at the first course of studies and coincides with the heavy academic load of general scientific, medical and
biological disciplines, foreign languages, etc. In the period of professional identification, it is very important to create a positive motivation for learning, to acquire knowledge and skills that will be necessary in future professional activity. Therefore, the use of the state-of-the-art multimedia specialized means, involvement of students into self-research activity, etc., is crucial for its formation. Prospects for further research encompass the study of the issue of readiness for professional activity and motivation of international students at medical higher education institutions and the development of methodological support for teaching humanities at a medical university, taking into account the abovementioned recommendations.
BIOMARKERS OF DISEASE ACTIVITY IN SYSTEMIC SCLEROSIS
Authors: Pawlik Katarzyna Karina , Bohdziewicz Anna , Chrabąszcz Magdalena , Stochmal Anna , Sikora Mariusz , Alda-Malicka Rosanna , Czuwara Joanna , Rudnicka Lidia
Published: January 2021

Systemic sclerosis (SSc) is an autoimmune disease characterized by vasculopathy and uncontrolled cutaneous and internal organs fibrosis. Diagnosis of SSc in an early phase can be difficult because of a lack of typical symptoms. The delay in diagnosis and treatment of SSc may lead to uncontrolled progression of the disease, thus identification of possible early indicators of skin and organ involvement to prevent their further damage is necessary. The aim of this study is to review the latest biomarkers of organ involvement in SSc. In patients with lung fibrosis lung-epithelial-derived surfactant protein (SP-D), the glycoprotein Krebs von den Lungen-6 (KL-6), and chemokine ligands 2, 4 and 18 (CCL2, CXCL4, CCL18) are
elevated, while in patients with skin fibrosis serum levels of heat shock protein 27 (Hsp27), interleukin 16 (IL-16), and IgG–galactosylation ratio are increased. Adiponectin concentration is inversely correlated with the intensity of cutaneous fibrosis. Skin gene profiling also seems very promising. In patients with heart involvement increased serum levels of brain natriuretic peptide (BNP) are present, as well as raised Midkine and Follistatin-like 3 (FSTL3) proteins, ratios of Cu/Se and ceruloplasmin(CP) /Circulating selenoprotein P(SELENOP) and higher whole
blood viscosity level. Elevated calprotectin levels are found in individuals with gastrointestinal involvement. Increased levels of chemerin and ARA autoantibodies are associated with renal involvement, whereas high levels of adhesion molecules are found in patients with scleroderma renal crisis (SRC). Currently there are no biomarkers in use that can specifically identify the early involvement of organs.
STUDY OF THE STATE OF STRESS-IMPLEMENTING SYSTEMS IN ABDOMINAL DELIVERY DEPENDING ON ANESTHETIC TECHNIQUES
Authors: Georgiyants Marine A. , Vуsotska Olena V. , Seredenko Nataliia P. , Chernii Tatiana V. , Strashnenko Hanna N. , Haiduchyk Petro D.
Published: January 2021

The aim: Evaluation of stress-protective effects of various anesthetic techniques on Cesarean section (CS). Materials and methods: 127 pregnant women who delivered by cesarean section, were divided into 4 subgroups: 1a (n = 31) – general anesthesia (GA) with ketamine, 1b (n = 31) – GA with sodium thiopental, 2a (n = 31) – spinal anesthesia (SA), 2b (n = 34) – SA with intravenous administration of ondansetron at a dose of 8 mg. The assessment was performed at 5 stages: 1 – initial; 2 – infant extraction; 3 – 6 hours after surgery; 4 – 12 hours after surgery. Results: At stage 2, insulin levels in 1a and 1b subgroups decreased by 23.9% and 34.1%, while in 2a and 2b subgroups there were no significant changes. There was an increase in the levels of cortisol, prolactin and cortisol/insulin ratio at the 2 and 3 stages in the 1a and 1b subgroups. Pain intensity increased by the 3 stage in patients of all groups. It was the highest in the 1a and 1b subgroups. At the 4 stage, pain intensity was reduced in all groups, remaining significantly higher in patients of 1a and 1b subgroups. Conclusions: The dynamics of the content of stress hormones, the pain intensity in patients undergoing CS under SA give reason to consider this method as an optimal and adequate one for protection from surgery stress.
CURRENT ISSUES ON PROVISION OF SERVICES TO WOMEN DURING PREGNANCY AND POSTPARTUM PERIOD BY FAMILY DOCTORS
Authors: Shcherbinska Olena S. , Slabkiy Gennadiy O. , Bilak-Lukyanchuk Viktoria Y.
Published: January 2021

The aim is to determine the types of medical services that family doctors should provide to women during pregnancy and in the postpartum period and the competencies they should have to provide these services and the most acceptable ways to acquire them.
Materials and methods: During the study, the method of expert assessment, statistical method and method of structural and logical analysis were used. 50 obstetricians and gynaecologists who provide women with outpatient care and 50 family doctors acted as independent experts in the study.
Results: The types of medical services that family doctors should provide to women during pregnancy and in the postpartum period and the competencies that they should have to ensure the provision of these services were determined by experts. The most acceptable ways to acquire the necessary competencies, as well as the benefits and risks of providing these services at the primary level of health care were designated.
Conclusions: The implementation of the proposed types of medical care by family doctors will increase the availability and quality of medical care for women during pregnancy and in the postpartum period.
ALEXITHYMIA FORMATION AS AN ADAPTATION TO EVERYDAY STRESS IS DETERMINED BY THE PROPERTIES OF THE NERVOUS SYSTEM
Authors: Tukaiev Sergii V. , Vasheka Tetiana V. , Dolgova Olena M. , Fedorchuk Svitlana V. , Palamar Borys I.
Published: January 2021

The aim of the study was to determine the psychological nature and mechanisms of alexithymia formation by way of the analysis of its relation to the properties of the nervous system, mental states, and characteristics of the emotional sphere of the personality. Materials and methods: In the process of the study, for the diagnostics of alexithymia, we used the 26-item Toronto Alexithymia Scale (TAS-26) developed by G.J. Taylor and a block of psycho-diagnostic methods aimed at the diagnostics of properties of the nervous systems, the emotional sphere and mental states of respondents. The relationships were evaluated using Spearman’s rank correlation coefficient and Pearson’s correlation coefficient. Results: The main factors related to alexithymia were weak nervous system, low stress resistance and such characteristics of the emotional sphere as marked extraversion, high level of trait anxiety, neuroticism, indirect verbal aggression, low levels of aggressiveness. The emotional exhaustion and reduction of personal achievements, the Resistance Phase, chronic fatigue and depression were the most pronounced within the alexithymia group. The alexithymic personality type demonstrated less developed spatial anticipation. Conclusion: In accordance with our results, the weakness of the nervous system and high Trait Anxiety facilitate the adaption to stressful situations by avoiding and crowding out negative emotions, lead to the inability of verbal description and expression of emotions. A low level of stress resistance conduces to neurotization, chronic fatigue, and emotional burnout. The predominance of refractory and dysphoric reactions causes a negative vision of the situation and can provoke the development of psychosomatic disorders.
PATHOPHYSIOLOGICAL AND PATHOMORPHOLOGICAL ASPECTS OF RELAPSE OF VARICOSE VEINS AFTER ENDOVASCULAR LASER VEIN COAGULATION
Authors: Goshchynsky Volodymyr B. , Migenko Bogdan O. , Riabokon Svitlana S.
Published: January 2021

The aim: With the help of biochemical and morphological methods of investigation to identify the causes of a false postoperative recurrence of varicose veins after the EVLC.
Materials and methods: In 173 patients with varicose veins of the lower extremities, the level of markers of endothelial dysfunction was determined: P-selectin, E-selectin, tissue plasminogen activator, endothelin-1, adhesion molecules of type 1 vascular endothelium (sVCAM-1-soluble vascularcellularmolecula), circulating endothelial cells (CEC) before surgery (EVLC), on the 10th and 60th day of the postoperative period.At the same time, a morphological and electron microscopic examination of the state of the deep venous system in 31 patients with varicose vein disease of the lower extremities who died from acute heart failure, was performed.
Results: Increased values of markers of endothelial dysfunction in patients with varicose veins of the lower extremitiesbefore surgery of EVLC were established. We found that, despite the operation, the parameters of endothelial dysfunction decrease, but in the remote postoperative period do not come to the norm. Morphological and electron microscopic studies of the deep vein wall revealed pathomorphological changes in all of their layers, especially the endothelial layer. At the heart of the development of endothelial dysfunction in the postoperative period, the leading role belongs to changes in mitochondria.
Conclusions: 1. Based on our research, we can state that there are significant pathomorphological and pathophysiological changes in the deep venous system of the lower extremities in conditions of varicose vein disease. 2. The initiator of postoperative relapse of varicose veins are structural changes in the wall of deep veins with a violation of the integrity of the endothelial lining, contributing to the absorption of plasma and leukocyte contents from the blood stream in the interstitium, with the following pathological changes in the layers of deep veins.Such changes are the basis for the manifestations of endothelial dysfunction in the postoperative period.
ROLE OF PROINFLAMMATORY CYTOKINES IN PATHOGENESIS OF ARTHROPATHIES IN PATIENTS WITH DIABETES MELLITUS
Authors: Orlenko Valeriya L. , Kravchuk Maria H.
Published: January 2021

The aim: Of our work was to study the level of proinflammatory cytokines in patients with diabetic arthropathy and to investigate their possible effect on the development of this complication.
Materials and methods: 118 patients were examined, which were divided into groups by type of diabetes, the presence and severity of diabetic arthropathy. The content of IL-1, TNF-α, IL-6 and receptors to S IL-6-R in serum was determined by immunoassay.
Results: In patients with diabetic arthropathy, levels of TNF-α (with type 1 diabetes 44.5%, type 2 diabetes 42.9%) and IL-6 (with type 1 diabetes 52.1%, with diabetes 2 types by 64.4%) significantly increased. There is a direct correlation between the severity of joint damage and the level of TNF-α and IL-6. For IL -1, receptors for S IL-6-R have not been detected.
Conclusions: The chances of detecting arthropathy with type 1 diabetes with increasing TNF levels increase by 1.7 times, with an increase in IL-6 by 1.5 times. For type 2 diabetes, it is 1.8 and 1.3 times, respectively. Thus, TNF-α and IL-6 may be markers of the presence and progression of arthropathy in patients with diabetes mellitus
THE THEORETICAL AND LEGAL BASIS FOR ENVIRONMENTAL RISK AS A POSSIBLE MEASUREMENT OF HARM TO THE ENVIRONMENT AND HUMAN HEALTH
Authors: Pashkov Vitalii M. , Trotska Maryna V. , Harkusha Andrii O.
Published: January 2021

The aim: To inquire into a theoretical and legal basis that regulates relevant areas and processes; use of certain objects, associated with ecological risks, which association, in turn, indicates the likelihood of conditions that can have adverse effects on the environment, human life and well-being.
Materials and methods: In this work we study statutory regulations and scientific positions of scholars regarding the above-mentioned issue. The study analyses generalized information from scientific journals employing scientific methods from a medical and legal perspective. This article is based on dialectical, comparative, analytic, synthetic, and comprehensive research methods.
Conclusions: The importance of the issue of environmental risks reflects the need in solving the problem of coexistence between human beings and nature. The analysis of theoretical and legal basis within the outlined framework will allow detecting the gaps and will help to understand in what way they are surmountable while regulating the stressors associated with ecological risks, on one hand, and, on another hand – the possible consequences, in order to prevent and eliminate them as promptly as possible and, thus, minimize their adverse effects on the environment and the health of the population.
HEMATURIA AND OTHER KINDS OF BLEEDINGS ON NON-VITAMIN K ANTAGONIST ORAL ANTICOAGULANTS IN PATIENTS WITH ATRIAL FIBRILLATION: AN UPDATED OVERVIEW ON OCCURRENCE, PATHOMECHANISMS AND MANAGEMENT
Authors: Wojtowicz Dagmara , Tomaszuk-Kazberuk Anna , Małyszko Jolanta , Koziński Marek
Published: January 2021

Non-vitamin K antagonist oral anticoagulants (NOACs) are currently recommended for oral anticoagulation in patients with non-valvular atrial fibrillation. In the setting, NOACs effectively prevent from stroke and systemic embolic events. In spite of the favorable safety profile of NOACs when compared with vitamin K antagonists, the use of any kind of anticoagulation is associated with an increased risk of bleeding. However, there is still a lack of direct comparisons of effectiveness and safety among NOACs. The results of indirect comparisons and meta-analyses suggest that the risk of various types of hemorrhagic complications differ among the particular NOACs. Management of bleeding in patients under NOAC therapy can be challenging because of limited availability of antidotes and the lack of routine laboratory test monitoring the NOAC anticoagulant effect. In case of life-threatening or critical site bleeding, reversal of NOAC anticoagulant activity is essential together with immediate implementation of causative treatment. Moreover, some patients on chronic NOAC therapy may require urgent surgery or invasive procedures. Specific reversal agents for NOACs have been developed, i.e. more widely available idarucizumab for the factor IIa inhibitor (dabigatran) and andexanet alfa for the factor Xa inhibitors (rivaroxaban, apixaban, edoxaban) with limited availability. This review summarizes the occurrence and management of NOAC-related bleeding complications with a particular emphasis on hematuria.
INFORMATION AND COMMUNICATION TECHNOLOGIES IN PUBLIC MANAGEMENT OF THE HEALTHCARE INSTITUTIONS NETWORK DURING COVID-19 PANDEMICS
Authors: Samofalov Dmytro A. , Izhytska Nataliya V. , Dragomyretska Natalia M. , Lyashenko Artem V.
Published: January 2021

The aim was to study the structure, routes and algorithms of telemedical network in Odessa region and its impact on the spread of COVID-19 pandemics.
Materials and methods: We have analysed the data of the official reporting documentation provided by the Department of Healthcare of Odessa region. So the description of legislative acts and structure of telmedical network of Odessa region is given. In more detail, we described functions and capabilities of telmedical network COVID-19 pandemics.
Conclusions: Studies have shown that Telemedicine can be used in 5 main directions: Triage and decisions regarding hospitalization to hospitals designed for COVID-19 patients or to other hospitals. Outpatient consulting in COVID-19 patients who stay at home. Coordination of activities of different hospitals; provision of specialized consulting. Training of healthcare providers for counter-epidemic measures and management of COVID-19 patients. Routine consulting in patients with chronic disease and in palliative cases. In all this activities significant benefits were founded. But amount of telemedical consultations are quiet low. As in all viral pandemies remote consultations of patients leeds to lowering in amount of infection of COVID-19 patients.
RHABDOMYOLYSIS – INDUCED ACUTE KIDNEY INJURY – AN UNDERESTIMATED PROBLEM
Authors: Kwiatkowska Marlena , Chomicka Inga , Malyszko Jolanta
Published: January 2021

Rhabdomyolysis is a condition characterized by muscle damage and the release of intracellular muscle contents into the circulation. It leads to a lot of complications e.g. hyperkalemia, hyperphosphatemia, and calcium disorders. The etiology is multifactorial. Severity ranges from mildly muscle weakness without any systemic complications, to life-threatening multi-organ damage. The most common and serious systemic complication is acute kidney injury (AKI). In the review, we address the epidemiology, causes, and treatment. The ideal would be to predict and prevent rhabdomyolysis at all, but when it is impossible, the key to successful treatment is its rapid implementation. Therapy should be selected individually, adapting to the triggers, and closely monitoring the patient’s condition. Early implementation of fluid therapy appears to be crucial. Electrolyte disturbances should always be detected in the early stages and carefully treated. The use of bicarbonates or diuretics may also be helpful, but especially in the latter case, the indications should be well evaluated, remembering to avoid hypovolemia. Renal replacement therapy is often implemented due to water-electrolyte or acid-base disorders. Proper diagnosis and early therapy implementation improve patient outcomes, in particular in the face of new infectious dangers and global underestimating of the disease.
FEATURES OF CRIMINAL LIABILITY OF A MEDICAL PROFESSIONAL FOR FAILURE TO PERFORM OR IMPROPER PERFORMANCE OF THEIR PROFESSIONAL DUTIES IN UKRAINE
Authors: Bondarenko Olha S. , Reznik Oleg М. , Dumchikov Mykhailo O. , Horobets Nadiia S.
Published: January 2021

The aim: Research of features of criminal responsibility of the medical worker for failure to performe or imptoter perfomance of their professional duties in Ukraine.
Materials and methods: The article uses general scientific and special scientific methods of cognition, which provided an objective analysis of the research goal.
Conclusions: Criminal law, which provides for liability for improper performance of duties by a healthcare professional or pharmacist, must have a perfect design to ensure the rights and interests of both the patient and the medical worker.That is why, the existing construction of article 140 of the Criminal code of Ukraine requires a number of changes and additions.
A CASE OF MRI-NEGATIVE HERPES VIRUS ENCEPHALITIS
PRESENTED BY RAMSAY HUNT SYNDROME
Authors: Dyachenko Pavel A. , Dyachenko Anatoly G.
Published: January 2021

Ramsay Hunt syndrome (RHS) occurs due to reactivation of latent Varicella Zoster Virus (VZV) infection in the geniculate ganglion of the facial nerve. Major clinical symptoms include ipsilateral facial paralysis, otic pain, and herpetic vesicles (rashes) along the nerve with accompanying ear pain. Rarely clinical findings include retrograde transaxonal spread of the virus from the ganglion into the brain parenchyma with developing the encephalitis or multiple cranial nerve involvement. We describe here a patient with both RHS along with complicating brains