bluuebunny/crossref_metadata_2025 huggingface dataset:
Postpartum clinical evaluation of omission of bladder flap during cesarean section
Authors: UZUN Asiye , AYDIN Emrah , ERSAN Fatma , ELÇİ ATILGAN Adeviye , LEYLA ALTUNTAŞ Şükriye
Published: April 2021

Objective: Cesarean section (C/S) is one of the most common operation performed by the gynecologist throughout the world. The aim of this study is to present our experience in this particular group of patients and compare the early and late outcomes of the patients with and without a bladder flap after a C/S procedure.

Materials and Method: All cases admitted between October 2018 and January 2019 due to C/S were retrieved from hospital electronic medical records. Data were collected on demographics, perioperative test results, operative characteristics, postoperative complications and outcomes. The C/S decision was given by the surgeon per fetal or maternal problems such as placenta previa, ablatio placenta, malpresentation, fetal distress, macrosomia and prolapses of the umbilical cord. Patients were grouped into two as Group 1 comprised patients who had C/S with bladder flap while Group 2 included the patients without bladder flap.

Results: There were 63 patients included in the study with a mean age of 27.87 ± 4. None of the patients in either group had bladder injury. The comparison of the groups demonstrated the group were statistically equal in maternal age, weight, body mass index (BMI) and gestational week. The presence of microhematuria was significantly higher in Group 1 patients (p=0.000, OR 2.55, 95% CI 1.568-4.159) and there was statistically significant decrease in the hemoglobin levels (Group 1 0.91 ± 1.48 vs Group 2 0.13 ± 1.24, p=0.026). However, the decrease in the hematocrit values did not statistical significance (Group 1 1.78 ± 6.84 vs Group 2 0.63 ± 4.09, p=0.423). The postoperative residual urine, on the other hand, was slightly higher in patients with bladder flap.

Conclusion: Bladder flap during C/S has adverse effects on the blood loss, surgical time and postoperative symptoms. Hence, omitting the flap will improve the postoperative comfort both for the patient and the surgeon.
Economic Growth, CO2 Emissions, Electricity Production, and Consumption Nexus in Bangladesh
Authors: Islam Nazrul
Published: April 2021

This paper seeks to find the causal relationship between economic growth, electricity consumption, carbon emissions, electricity production from oil, and electricity production from gas. The data were taken from World Development Index (WDI) for the period of 1972-2014. For stationarity checking, visualization and some econometrics techniques like ADF and Phillips-Perron test have been adopted. For testing the long-run relationships among the variables, the Johansen cointegration testing procedure has been considered. This test ensured that there are long-run relationships among the variables. To capture the short-run dynamics, a VECM test has been done, and to find the direction of causation, the Granger causality approach has been tested. The results find that there was a bidirectional causality from CO2 emissions to gross domestic product (GDP) and from electricity production from gas to GDP where unidirectional causality was found from GDP to electricity consumption and electricity production from oil to GDP. CUMSUM and CUSUM approaches have also been considered to test the stability of the parameters. Policy implications of the research indicate that Bangladesh should give importance to low carbon emission technologies to reduce the CO2 emissions level with a view to keeping Bangladesh safe from natural calamities along with economic growth.

JEL Classifications: C32, O13, Q43
Aprendizaje cooperativo y habilidades sociales en niños de tres años
Authors: Ramón Calderón Rosa , Novoa Castillo Pedro Félix , Ramirez Maldonado Yenncy Petronila , Uribe Hernández Yrene Cecilia , Cancino Verde Rosalinn Francisca
Published: April 2021

La investigación tuvo como objetivo general determinar la relación entre aprendizaje cooperativo y habilidades sociales en niños de tres años de una Institución Educativa, el tipo de investigación fue descriptivo correlacional, la muestra fue de 80 niños de nivel inicial, la técnica de recojo de datos fue la ficha de observación. Se llega a la conclusión de que existe relación entre Aprendizaje cooperativo y Habilidades sociales en la muestra de estudio.
Evaluación del desempeño docente en Instituciones Educativas Públicas
Authors: Alvarez-Andrade Guiliana Tessy Estrella
Published: April 2021

La presente investigación tiene como objetivo general identificar diferencias significativas respecto a la evaluación del desempeño docente entre los participantes y no participantes del Programa de Segunda Especialidad en Didáctica de la Educación Primaria en las en las instituciones educativas públicas pertenecientes a la UGEL N° 01, año 2019, es de nivel descriptivo comparativo, cuyo diseño es no experimental y de naturaleza transversal, ex post facto. Para ello, se diseñó una ficha de observación de clase, instrumento de recogida de datos, la cual estuvo conformada por 26 ítems de respuesta única en una escala de Likert, su diseño se hizo teniendo en cuenta el Marco de Buen Desempeño Docente (MBDD). La muestra no probabilística intencional estuvo conformada por 72 docentes del nivel primaria en instituciones públicas, pertenecientes a la UGEL Nº 01 de Lima Metropolitana, Perú. Los resultados encontrados evidencian diferencias significativas en el desempeño docente en ambos grupos comparados. Asimismo, se demuestra que existen diferencias entre los dos dominios: a) Preparación para el aprendizaje de los estudiantes, y, b) Enseñanza para el aprendizaje de los estudiantes.
Competencias matemáticas en preescolares de cinco años según género
Authors: Limas Bravo Lourdes Marivel , Novoa Castillo Pedro Félix , Uribe Hernández Yrene Cecilia , Ramirez Maldonado Yenncy Petronila , Cancino Verde Rosalinn Francisca
Published: April 2021

La investigación tiene como propósito establecer la diferencia por género en las competencias matemáticas en preescolares de cinco años en una institución educativa de Independencia. Para lograrlo, se han evaluado las diferentes habilidades en el manejo de los elementos básicos de la matemática. Los cuales contribuyen al desarrollo adecuado de los procesos de razonamiento. La metodología empleada corresponde al enfoque cuantitativo, nivel comparativo, básica y transversal. Se trabajó con 80 estudiantes de preescolar evaluados con el Test de Evaluación Matemática Temprana (TEMT). Los resultados señalaron que existen diferencias significativas entre niños y niñas de cinco años. Con evidente ventaja a favor de los niños en comparación de las niñas.
Las redes sociales y las habilidades de enseñanza - Aprendizaje del siglo XXI
Authors: Sánchez-Pacheco Carlos Luis
Published: April 2021

La educación en el siglo XXI destaca la globalización y la internacionalización. Se percibe que los docentes en el siglo XXI son expertos en tecnología, involucran y enseñan de manera efectiva a los alumnos de la generación Z. Las instituciones educativas deben estar equipadas con un requisito previo de recursos de TIC, tanto en hardware como software, y los planes de estudio son diseñados para promover un entorno de colaboración centrado en el alumno. Este estudio determina las habilidades del siglo 21 que poseen los docentes en términos de redes sociales recordando que aún necesitan orientación para usar la tecnología de manera segura y eficaz.
Niveles de competencias ciudadanas en estudiantes universitarios de Ciencias de la Salud
Authors: Mescua Figueroa Augusto César , Ramos Vera Rosario Pilar , Ramos Vera Patricia , Ramírez Maldonado Yenncy Petronila , Cruz Llerena Blanca Silvia , Caycho Valencia Felix Alberto
Published: April 2021

La formación profesional debe propender a integrar procesos educativos que comprendan el desarrollo de habilidades técnicas y competencias ciudadanas en la perspectiva del ejercicio profesional que conlleve a actuar en favor del bien común y bien público, desde los deberes y derechos ciudadanos. La investigación se propuso determinar los niveles y predominancia de las competencias ciudadanas en estudiantes universitarios de ciencias de la salud. Comprendió el nivel descriptivo, de diseño no experimental y de corte transversal. La muestra fue de 210 estudiantes peruanos de ciencias de la salud de Lima Metropolitana. Se aplicó un cuestionario de preguntas múltiples y escala tipo Likert. Como resultado se identificó que más de la mitad de los estudiantes se ubican en un nivel medio y los demás entre alto y bajo. Se concluyó que las competencias emocionales son las que tienen mayor predominancia y las competencias comunicativas, cognitivas (pensamiento crítico) y de conocimiento de la ciudadanía (conocimiento de deberes y derechos ciudadanos) requieren mayor desarrollo y tratamiento en las programaciones curriculares de la formación profesional.
Could Fampridine Attenuate the Severity of COVID-19 in Patients with Multiple Sclerosis?
Authors: Moghadasi Abdorreza Naser , Anjidani Nassim , Rashvand Fereshteh
Published: April 2021

The article's abstract is not available.
The Role of Respiratory System Surface Area and Ventilation Volume in Severity and Mortality of COVID-19 Infection
Authors: Tahsini Tekantapeh Sepideh , Mikaeili Haleh , Soleimanpour Hassan
Published: April 2021

The article's abstract is not available.
Seven Criteria of Severe COVID-19 (SCSC): A New Pre-Hospital Prognostic Scoring Tool Suggested for Screening of Probable/Confirmed COVID-19 Patients with Severe Outcomes
Authors: Saberian Peyman , Tavakoli Nader , Hasani-Sharamin Parisa , Kheyrati Leila , Younesian Somaye , Rafiemanesh Hosein
Published: April 2021

Introduction: COVID-19 pandemic led to various consequences in medical care that had been long provided for the patients referred to the hospitals.
Objective: We conducted this study to derive and validate a new scoring system that can accurately differentiate COVID-19 patients who may have a worse outcome from others at the prehospital stage.
Methods: This study was performed on probable/confirmed COVID-19 patients, who were transferred to the hospitals by Tehran emergency medical services (EMS). Occurrence of one of the items including: in-hospital death, intensive care unit (ICU) admission, or hospitalization for more than 20 days was considered to indicate a “severe disease”. Univariate and multivariate logistic regression were used for assessment of the relationship between all independent variables and the outcome. In the validity assessment step, area under the receiver operating characteristic (ROC) curve was calculated for a data set independent from the data based on which the model was designed. The sensitivity and specificity were also presented based on the best suggested cutoff point.
Results: In this study, the data of 557 cases were analyzed in the derivation step and 356 cases were assessed in the validation step. The univariate logistic regression showed that age, weakness and fatigue, disease history, systolic blood pressure, SpO2, respiratory rate, and Glasgow coma scale (GCS) were statistically significant in severe disease group. The area under the ROC curve (AUC-ROC) of the tool was 0.808 (95% CI: 0.779, 0.834). The best cut-off point for screening was the score of ≥4, in which the sensitivity and specificity of the tool for the best cut-off point were 71.87% and 78.06%, respectively. In the validation step, the AUCROC of the tool was 0.723.
Conclusions: Seven criteria of severe COVID-19 (SCSC) tool could properly differentiate probable/confirmed COVID-19 patients with severe outcomes in the pre-hospital stage.
Left Ventricular Pseudoaneurysm as a Complication of Myocardial Infarction; A Case Series and Review of the Literature
Authors: Ashraf Haleh , Sadatnaseri Azadeh , Aminorroaya Arya , Kuhi Zahra , Zandi Nadia , Karbalai Saleh Shahrokh
Published: April 2021

Introduction: Pseudoaneurysm may occur as a rare complication of myocardial infarction (MI) when a hemorrhagic process is covered by adherence of the visceral or parietal pericardium or of both, preventing the formation of cardiac tamponade. Pseudoaneurysm is prone to rupture because they are not easy to diagnose.
Case presentation: Here, we report three cases of left ventricular pseudo-aneurysm (LVP) that all were related to MI. Two patients were managed conservatively, one of them was lost to follow-up, and the other one expired one month later. One patient underwent surgery, but he expired during post-operation period.
Conclusions: High mortality rate of LVP emphasizes the importance of looking for it in cardiac evaluation of patients with history of MI. Due to available non-invasive modalities, the ability to differentiate LVP from other cardiac pathologies is improving. Still, the most recommended management of LVP is early surgery.
The Relationship between the Results of Coagulation Profile and Severity of Pulmonary Involvement in COVID-19 Patients
Authors: Ebrahimi Mohsen , Abiri Samaneh , Rayat Dost Esmaeal , Rahmanian Fatemeh , Foroughian Mahdi , Abbasi Alireza , Hashem Abdi Mohammad , Keshavarz Poyan , Hatami Naser , Kalani Navid , Haghbeen Marzieh
Published: April 2021

ntroduction: COVID-19 is currently a global pandemic, and coagulation-related mortality has been widely reported in patients suffering from it.
Objective: this article aimed to investigate the coagulation profile of COVID-19 patients.
Methods: This was a cross-sectional study conducted using a retrospective research design. We recruited patients with COVID-19 admitted to a hospital from June 15th to July 7th, 2020. Upon patients’ entering a blood sample was drawn from each patient for assessing patient’s coagulation profile (PT, PTT, INR, Platelet count); and a chest high-resolution computed tomography (HRCT) scan was performed for each patient. The study patients were divided in to sever group (CO-RADS score 5) and non-sever group (CO-RADS score <5).
Results: Thirty-six patients (20 males and 16 females) with a mean age of 54.7±17.5 years were studied. Of them, 11 cases (30.56%) had severe pulmonary involvement. Also, the coagulation profiles were longer in the severe group than non-sever group. As well, the means of platelet count that were 232.440 per microliter in the non-severe group and 289.180 per microliter in the severe and non-sever groups, respectively; but still not statistically significant (p>0.05). The Area under the ROC Curve (AUC) for PT and INR was 0.615 and 0.611, respectively. The AUC for platelet count was 0.680 (95% CI: 0.501 to 0.859) and had an acceptable discriminating power.
Conclusions: In this study, we did not find any statistically significant relationship between the results of coagulation tests and the severity of pulmonary involvement according to HRCT scan findings in COVID-19 patients. But further analyses suggest that, except PTT, the other coagulation tests (PT, INR, and platelet count) may discriminate severe COVID-19 patients.
Outcomes of Catheter-Directed Thrombolysis in Patients with Acute Arterial Thrombotic Limb Ischemia: A Prospective Interventional Case Series
Authors: Salimi Javad , Rahimpour Ehsan , Zabihi Mahmoudabadi Hossein , Farshidmehr Pezhman
Published: April 2021

Introduction: Acute limb ischemia is a critical medical condition that can quickly become a life threat. Therapeutic modalities such as catheter-directed thrombolysis (CDT) have demonstrated various levels of efficacy in previous studies.
Objective: This study presents the descriptive findings of a series of cases who presented with acute arterial thrombotic limb ischemia and underwent CDT.
Methods: This was a cross-sectional single-hospital-based case series, in which all patients who were diagnosed with acute arterial thrombotic limb ischemia, and consequently underwent CDT during the oneyear study period were included. Detailed baseline characteristics and clinical findings of the studied patients on presentation, after intervention and at one-year follow-up are presented.
Results: A total of 21 patients with a mean age of 60.7±15.2 years, including 16 males (76.2%) were included. The initial technical and treatment success rates were 20 (95.2%) and 14 (66.7%), respectively. The amputation-free and the overall survival rates after the one-year follow-up were 15 (71.4%) and 17 (81%), respectively. Four patients (19%) developed complications, two (9.5%) of which were significant (pulmonary hemorrhage and intraventricular hemorrhage). Amputation was performed in 6 (28.6%) cases.
Conclusion: In this study, the treatment success rate and the technical success rate were satisfactory.
Divisão de números naturais: Um olhar para o resto
Authors: Sobrinho Jairomar de Araújo , Silveira Helves Belmiro , Albuquerque Orlando Dantona , Simas Tarciso Binoti
Published: April 2021

O objetivo deste trabalho é demonstrar a importância da análise dos dados obtidos no algoritmo da divisão, para que haja uma interpretação correta, principalmente no que se refere ao resto dessa divisão. Propõe-se que investigue o mesmo no processo da divisão de números naturais com o objetivo de aprofundar o seu conceito. Foca-se também a relevância e o significado dos demais tratados no tema. Para tanto, foi realizada uma revisão bibliográfica e pesquisa de campo com alunos do Ensino Fundamental da Escola Municipal Cordulina Costa Rêgo da cidade de Couto Magalhães, Tocantins. A pesquisa de campo foi realizada por meio de questionários aplicados aos alunos, a fim de captar informações sobre a temática em questão. Esta pesquisa buscou identificar os diferentes tipos de interpretações que os demais podem dar ao resultado obtido, em diferentes situações-problema que possuem o mesmo algoritmo. Portanto, verificou-se que parte dos alunos tem dificuldade em perceber a existência, não conseguindo interpretar o sentido do resto da divisão, o que impõe a observação de que o professor deve dar a importância que o resto merece, sem dar destaque apenas para o quociente dentro do algoritmo de divisão.
Cidades saudáveis: o acesso equitativo a parques urbanos como promoção da saúde
Authors: Meneses Ana Raquel Santos de , Monteiro Marcela Marçal Maciel , Lima Wirenilza do Nascimento , Barbosa Ricardo Victor Rodrigues
Published: April 2021

O artigo analisou parques urbanos em duas capitais brasileiras – Belém-PA e Recife-PE – a partir do padrão de distribuição e atendimento à população por meio da identificação, dimensões e estimativa de suas áreas de alcance. Quanto à localização, observou-se que a maioria dos parques urbanos, nas duas cidades, se concentra em áreas centrais, distantes de bairros periféricos com menor padrão de renda. Quanto ao percentual de área de atendimento, verificou-se que a quantidade de pontos de acesso aos parques teve maior influência do que a área total coberta por parques na cidade. Por fim, o estudo aponta para a importância de um planejamento eficiente para acesso da população, de forma equitativa, aos benefícios ecossistêmicos proporcionados por esses espaços com vistas à melhoria da qualidade de vida nas cidades.
Modelo Digital do Terreno obtido por RPA para cálculo de volume de terra em morros
Authors: Barbosa Leonardo Carlos , Azevedo Laízy de Santana , Silva José Rubens Scatimburgo , Ferreira Willian dos Santos , Simas Tarciso Binoti
Published: April 2021

O uso de RPAs (Remotely Piloted Aircraft) popularmente conhecidas como Drones, tem se destacado como uma das técnicas com amplo potencial de contribuição em diversos campos científicos. A possibilidade de geração de produtos cartográficos e Modelos Digitais do Terreno de maneira rápida em comparação com as técnicas de topografia tradicionais como estação total vem se mostrando bastante aplicável no diagnóstico e na prevenção de acidentes de ordem geológico-geotécnica. Este artigo avaliou a acurácia do cálculo de volume, realizado por meio de Modelos Digitais de Terreno (MDTs), gerados a partir das tecnologias RPAs, LiDAR (Light Detecting And Ranging) e GNSS (Global Navigation Satellite System) na localidade do Alto da Sé em Olinda. Os resultados foram classificados de acordo com o PEC(Padrão de Exatidão Cartográfica) obtendo erro planimétrico inferior a 0,5mm, obtendo a classificação A em escala de 1/2000. O levantamento com RPA apresentou melhor acurácia no cálculo do volume.
Raciocínio Matemático: um estudo realizado na Acta do EIEM 2013
Authors: Oliveira Beatriz de , Pires Magna Natalia Marin
Published: April 2021

Este artigo apresenta os resultados de uma pesquisa teórica referente a um projeto de Iniciação Científica a respeito do tema Raciocínio Matemático. O estudo teve como suporte teórico os artigos contidos na Acta do Encontro de Investigação em Educação Matemática - EIEM, realizado em 2013, promovido pela Sociedade Portuguesa de Investigação em Educação Matemática. O objetivo foi compreender o conceito de raciocínio matemático e suas principais características segundo os autores dos artigos presentes na acta do EIEM de 2013. Para isso, foram construídos quadros com os principais trechos dos textos que definem e caracterizam o raciocínio matemático. Os principais aspectos ressaltados no estudo foram as definições, os tipos e os processos associados ao raciocínio matemático. Os tipos de raciocínio apresentados foram abdutivo, indutivo e dedutivo. Além disso, foram destacados os processos de representação, significação, generalização e argumentação e suas contribuições para o desenvolvimento do raciocínio. Com o intuito de organizar os conceitos estudados foi construído um mapa conceitual na tentativa de apresentar a composição do Raciocínio Matemático. A realização desse estudo propiciou uma experiência de pesquisa para a autora, licencianda em Matemática, e também trouxe contribuições teóricas a respeito do raciocínio matemático e suas implicações na construção do conhecimento matemático.
A caminhabilidade como indicador de qualidade de vida: Estudo de caso de Santana do Araguaia-PA
Authors: Araújo Andréa Nazaré Barata de , Monteiro Érica Corrêa , Costa Mateus Araújo , Monteiro Marcela Marçal Maciel , Costa Filho Galafre Guttemberg da , Oliveira Antonio Carlos Santos do Nascimento Passos de
Published: April 2021

O deslocamento é uma das principais formas de interação com o espaço público, e com a ideia mais recente de humanizar as cidades o conceito de caminhabilidade começou a ser amplamente pesquisado, na tentativa de minimizar os efeitos nocivos do excesso de veículos no meio urbano. Nesse sentido, o principal objetivo deste trabalho é diagnosticar a caminhabilidade do núcleo urbano de Santana do Araguaia, no Estado do Pará, assim como perceber como a população da cidade enxerga o espaço, como propício ou não para que a vida urbana aconteça. Para isto, foi aplicado questionário on-line para 406 respondentes, onde as respostas indicaram que falhas na infraestrutura pública são prejuízos em potencial para a acessibilidade, e consequentemente afetam outras condições como a segurança pública e viária, assim como as interações entre a comunidade.
Perfil operacional das concessões de serviços de abastecimento de água em três municípios do Sudeste do Pará
Authors: Oliveira Jefferson Martins , Souza Susane Maciel de , Araújo Adams Resplandes , Borges Karoline , Barbosa Leonardo Carlos , Carvalho Carlos Maviael de
Published: April 2021

A realidade das ações de implementação da universalização e de atendimento aos princípios fundamentais do saneamento básico não são iguais entre os municípios do país. Essa situação é evidenciada ao compararmos os indicadores dos serviços de abastecimento de água, disponíveis no Sistema Nacional de Informações Sobre o Saneamento Básico – SNIS. Ao fazer a comparação da quantidade de ligações, do consumo de água e, do volume de investimentos nas cidades de Redenção, Xinguara e Santana do Araguaia, todos, municípios da microrregião sudeste do Pará, foram encontrados diferentes cenários de universalização, os quais não alcançam o limite máximo estabelecido pela Lei 11.445/2007 e pelo Plano de Saneamento Básico Integrado do Estado do Pará. Assim, a análise, por indicadores, revelou um comportamento de preferência na prestação dos serviços àquelas cidades que apresentaram os melhores indicadores econômicos e de infraestrutura urbana.
Investigation of the Acquisition Conditions of Tl3AsS4 Compound in the Aquatic Environment
Authors: İMANOV Hüseyn , HUSEYNOV Qorxmaz
Published: April 2021

The condition for obtaining the Tl3AsS4 compound was investigated based on TlNO3 and As2S5 compounds in hydrothermal conditions in the aquatic environment. It was found that Tl3AsS4 compound has been obtained from a mixture of the primary components (As2S5 and TlNO3) in a ratio of 4:15 mol at 80 °C in the range of pH = 7 – 8. The individuality of the obtained Tl3AsS4 compound was confirmed by the XRD method and DTA, and TG analyses. The thermally processed Tl3AsS4 compound crystallizes in an orthorhombic structure at 220 °C. Based on the results of TG analysis, the temperatures of the phase transitions that occur during the oxidation of the compound were determined and the stoichiometric composition of the compound was specified. The SEM results of the compound showed that the Tl3AsS4 precipitate obtained from the solution at 80 °C is composed of aggregates of highly adherent nanoparticles and the size of the nanoparticles varies from ~60 to 120 nm. The effect of pH of the medium and the amount of the primary components on the yield of Tl3AsS4 was studied. It was determined that when T > 100 °C, (Tl2S)x(As2S3)1-x (x=0.1-0.9) – containing sediments are obtained from different molar ratios of the primary components (As2S5 and TlNO3).
Diretrizes para implantação de um sistema de saúde e segurança do trabalho em empresas produtoras de álcool em gel
Authors: Ippolito Pelufo Daniel , Cleonice Durante Luciane
Published: April 2021

O súbito aumento da demanda por higienizantes e sanitizantes, ocasionado pela pandemia de COVID-19, desencadeou um crescente aumento no número de empresas produtoras de sanitizantes para as mãos, principalmente, álcool em gel. Dificuldades na elaboração, desenvolvimento e operação do processo produtivo, aliado à insegurança dos colaboradores no desempenho de suas atividades podem ser desafios que interferem na capacidade destes empreendimentos em produzir processos, produtos e um ambiente de trabalho de qualidade. Dentro deste contexto, os sistemas de saúde e segurança do trabalho podem desempenhar um papel fundamental no posicionamento estratégico e no desenvolvimento sustentável de uma empresa, além de contribuir para motivação e bem estar de seus colaboradores, gerando bons resultados e competitividade. Este trabalho teve como objetivo elaborar diretrizes para implantação de um sistema de saúde e segurança do trabalho voltado para o processo produtivo de álcool em gel e para o manuseio das matérias primas utilizadas no processo. Para tanto, um estudo de caso foi realizado em uma fábrica deste sanitizante, utilizando-se da metodologia da Análise Preliminar de Risco. O estudo demonstrou que o álcool, o polímero e o neutralizante utilizados na produção devem receber atenção e o processo produtivo deve se adaptar à natureza destas substâncias. Além disto, a etapa do processo produtivo denominada elaboração do álcool em gel, deve obedecer a procedimentos quanto ao armazenamento e o manuseio das matérias primas, que são determinantes para gerar uma produção eficiente e segura.
Monitoramento da Integridade Estrutural de uma laje de concreto utilizando transformadas de wavelet
Authors: Faria Albert Willian , José Trindade Campos Pedro , Hideki Koroishi Edson
Published: April 2021

A presente contribuição utiliza uma metodologia para localizar danos em um sistema estrutural do tipo laje de concreto empregando transformadas de Wavelet. Esse sistema estrutural é modelado numericamente empregando o Método dos Elementos Finitos (MEF). O sinal da deflexão vertical da laje danificada é utilizado na localização da posição do dano empregando a transformada discreta de wavelet (TDW). As wavelets mães estudadas foram a: Daubechies, Symlets e ReverseBior. O tipo de dano implementado é dado sob a forma de perda localizada da rigidez do concreto da laje utilizando uma variável escalar de dano D. O sinal da deflexão, obtido na análise estática da laje, é interpolado e depois ampliado empregando a regularização de Tikhonov antes de ser transformado. O elemento finito utilizado na modelagem da laje apresenta quatro nós e seis graus de liberdade por nó, sendo três translações e três rotações. A calibração dos parâmetros bj da regularização de Tikhonov mostrou-se fundamental para amplificar e suavizar as perturbações nos gráficos dos coeficientes de wavelet. Além disso, todas as wavelets mães avaliadas foram capazes de identificar o dano proposto. Entretanto, quando a variável escalar de dano é maior ou igual a 0,20, somente o sinal da estrutura na condição danificada foi necessário para detectar a posição do dano. Já, para valores de dano menores que 0,20, foi necessário o emprego do sinal da diferença, obtido entre as condições da estrutura sem e com dano.
Dependence of pancreas resection volume on PET-tomography and express biopsy findings
Authors: Sukhotskaya A. A. , Bairov V. G. , Perminova A. A. , Mitrofanova L. B. , Nikitina I. L. , Ryzhkova D. V. , Amidhonova S. A.
Published: April 2021

Introduction. Recently, achievements in molecular genetics, imaging techniques (PET/CT), medicamentous therapy as well as in surgical treatment have promoted a better control of hypoglycemia and, consequently, better outcomes in children with congenital hyperinsulinism.Purpose. To specify indications, volume and outcomes of surgical treatment in patients with congenital hyperinsulinism depending on pathology form, differential diagnostics with PET / CT and intraoperative express biopsy.Material and methods. 41 children with congenital hyperinsulinism were operated in the department of pediatric surgery in Almazov National Medical Research Centre (Saint-Petersburg) during 2011 – September 2020. In Group 1, there were 6 children who had standard treatment with subtotal resection of the pancreas (95%). In Group 2, there were 35 patients who had PET tomography with 18-F-DOPA before surgery and intraoperative express biopsy of pancreas tissue. The analyzed patients were operated on in 2017-September 2020. PET tomography with 18-F-DOPA findings revealed that these children had 10 diffuse forms and 22 focal forms; the other 3 children had a disputable picture.Results. After surgery, diffuse form was confirmed in 10 (29%) children; focal form - in 21 (60%) children; 4 (11%) patients had the atypical form which was diagnosed intraoperatively. Of 35 children from Group 2, 33 (94%) had complete hyperinsulinism reversal, significant improvement in their psycho-motor function; however, 10 (29%) of them require insulin replacement therapy with minimal dosages - 8 children with the diffuse form of hyperinsulinism and 2 children with the atypical one. There were no intra- and postoperative complications. 20 (95%) out of 21 children with focal forms recovered completely. The authors also describe problems and peculiarities of urgent histological examination.Conclusion. Thus, partial pancreatectomy in focal forms, subtotal in atypical ones and almost total in diffuse forms allows to cope with hypoglycemia caused by congenital hyperinsulinism.
A combined application of extracorporal detoxification techniques in children at the acute stage of severe concomitant traumtic brain injury
Authors: Novikova T. A. , Yeletskaya E. V. , Ivanova T. F. , Amcheslavsky V. G.
Published: April 2021

Introduction. In modern literature, there is a limited information on the techniques of extracorporeal detoxification in children with severe concomitant injuries. Moreover, in fact there are no data on their application in children with severe concomitant traumatic brain injuries. It has defined the relevance of this research.Purpose. To improve outcomes of treatment in children with severe concomitant traumatic brain injuries who have manifestations of toxic-resorptive syndrome (TRS), septic complications, acute renal failure of mixed genesis using a combined application of extracorporeal detoxification techniques.Material and methods. The article describes authors’ experience in a combined application of extracorporeal detoxification techniques, including continuous veno-venous hemodiafiltration (CVVHDF) and membrane plasma separation (MPS) in ICU patients with severe concomitant traumatic brain injuries complicated by toxic-resorptive syndrome, sepsis and septic shock.Results. The combined application of extracorporeal detoxification techniques promoted the regression of toxic-resorptive syndrome, shock reversal, stabilization of hemodynamic parameters, parameters of internal homeostasis as well as the regression of multiple organ failure.Conclusion. Early extracorporeal detoxification improves clinical course at the acute stage of trauma. The authors underline that the key requirement for safety in extracorporeal detoxification in patients with severe concomitant traumatic brain injury is the invasive monitoring of intracranial pressure.
History and modern trends in the treatment of spleen injuries in children
Authors: Gorelik A. L. , Karaseva O. V. , Utkina K. E.
Published: April 2021

Introduction. Over the past 50 years, the concept of treating spleen injuries has undergone significant changes from no alternative to splenectomy to conservative treatment, and this concept is still being actively discussed. The present review shows evolution of views and approaches to the diagnostics and treatment of spleen injuries in children.Material and methods. The literature search was done using keywords in eLIBRARY, MEDLINE and GOOGLESCHOLAR. 65 sources have been selected.Results. The modern concept of spleen injury care has been formed under constantly improving techniques of non-invasive imaging of injuries (ultrasound, computed tomography), under constantly developing endoscopic and endovascular surgical techniques. Currently, conservative treatment of spleen injuries is close to 90-95%.Conclusion. The evolution of views as to the treatment of spleen injuries in children is demonstrating fundamental changes which take place in traditional surgical practice as well as in medical technologies.
Choledochal cysts – state of the art
Authors: Nguyen Thanh Liem , Cheremnov V. S. , Kozlov Yu. A.
Published: April 2021

Introduction. Choledochal cyst is enlargement of the external bile duct system that can lead to liver dysfunction and biliary cirrhosis in childhood and malignant degeneration of the liver and bile ducts in adulthood. There are many theories explaining the origin of the common bile duct cyst. However, none of them can explain the formation of all five different types. Most of them are congenital. However, some of them may be aquired. The theory of a long common biliopancreatic canal has become widespread and is still used to explain the formation of this type of cystic anomalies. If the common canal is long and its part is not surrounded by the sphincter of Oddi, the secret of the pancreas begins to be thrown into the choledochus. Proteolytic enzymes from the pancreas are quite active and can damage the epithelium and the wall of the bile ducts, which leads to their weakness and, as a result, dilatation of the choledochus. Ultrasound examination is the initial and main method for diagnosing choledochal cysts. In some cases, there is a need for endoscopic or magnetic resonance retrograde cholangiopancreatography, intraoperative cholangiography. Removal of the cyst and anastomosis of the common hepatic duct with the lumen of the jejunum or duodenum, performed through the subcostal approach, are standard procedures for the treatment of patients with a choledochal cyst. The advent of laparoscopy and the accumulation of experience in performing complex surgical interventions introduced a minimally invasive approach for the production of laparoscopic biliodigestive anastomoses. Intra- and postoperative complications include damage to the structures of the hepatic hilum, torsion of the abduction loop, incompetence and stricture of biliodigestive anastomosis, cholangitis, stone formation, adhesive intestinal obstruction, and malignancy of the cyst remnants.Conclusion. This literature review has demonstrated modern views on the origin, etiology, diagnosis and treatment of choledochal cysts. The scientific work discussed the versatile technical aspects of the surgical treatment of choledochal cysts in children and assessed its safety and effectiveness.
Bile duct reconstruction in choledochal malformations in children
Authors: Razumovskiy A. Yu. , Mitupov Z. B. , Kulikova N. V. , Stepanenko N. S. , Zadvernyuk A. S. , Adler A. V. , Shubin N. V.
Published: April 2021

Introduction. Currently, there is ongoing discussion regarding the method of biliary tract reconstruction in children with choledochal malformations (CM).Purpose. To make a comparative analysis of the techniques applied in bile duct reconstruction in children with CM.Material and methods. For 10 years we have admitted 99 patients with CM. 84 children with CM were operated on from January 2010 to May 2020. Group 1 - patients who had Roux-en-Y hepaticojejunostomy (RYHJ, n = 68, 81%); Group 2 - patients who had hepaticoduodenostomy (HD, n = 16, 19%). The surgical access varied depending on the biliodigestive anastomosis technique. It was mini-laparotomy and laparoscopy. Surgical time, short-term and long-term postoperative outcomes were analyzed.Results. Groups were comparable in gender, age, clinical manifestations, CM complications before surgery, accompanied comorbidity (p 0.05). It was found that CM types differ depending on the child’s age when the diagnosis was established ( p = 0.0493, Kruskal- Wallis test); there was also a statistically significant difference in the pair between CM 1C and CM 1F (p = 0.0164, paired post-test). It means that children with CM 1F were older, median age 49 months (Q1-Q3: 12-86 months), than children with CM 1C, median age 14 months (Q1-Q3: 5-30 months). In HD group, severe postoperative pancreatitis, which was not controlled with conservative therapy, developed more often (n = 2) (p 0.05) and required a number of repeated surgeries including re-hepatico and hepaticojejunostomoses, thus prolonging the length of stay in ICU and increasing much the number of bed days.Conclusion. In our study, RYHJ technique has some advantages over HD one. Therefore, at present we can recommend it as a basic one.
Minimally invasive correction of asymmetric chest deformity in children
Authors: El'nour A.A.I. , Razumovskiy A. Yu.
Published: April 2021

Purpose. To analyze literature data and to find out optimal techniques for surgical correction of asymmetrical chest wall deformity in children.Material and methods. The researchers studied data on surgical treatment of children with asymmetrical chest wall deformity who had thoracoplasty performed with well-known techniques developed by Bairov, Timoshchenko, Paltia, Ravitch, Kondrashin which included the resection of crooked cartilage and internal metal fixation with consideration of deformity shape, location and severity. For comparison, the authors analyzed the data on the minimally invasive Nuss technique and its modifications.Results. The researchers found that thoracoplasty by the Bairov method is less effective which gives the largest number of postoperative complications (16.5%) in the form of hemothorax, pneumothorax and hydrothorax what significantly increased the length of hospital stay and the following rehabilitation process. On the contrary, minimally invasive interventions were the most effective, if to compare with all applied techniques for chest wall deformity correction, having a low percentage of complications; though their drawback is long-term postoperative analgesia.Conclusion. At present, there is no any consensus on the top-priority technique for surgical correction of chest wall deformity in children. It necessitates further research in this direction as well as improvement of the existing techniques and development of new ones.
Surgical treatment of retroperitoneal neuroblastoma in a 14-month-old child
Authors: Sukhov M. N. , Narbutov A. G. , Lyvina I. P. , Bryzzheva I. A. , Isaeva M. V. , Komarova T. N.
Published: April 2021

Introduction. Neuroblastoma is the most common malignant embryonic extracranial solid tumor in childhood having a high mortality rate. While treating neuroblastoma, it is extremely important to follow international protocols with their staging systems and groups of risk. Surgical treatment is a compulsory approach, but in some cases it is extremely difficult, and it involves significant risks. However, in some cases, radical removal of the tumor can cure patients without chemotherapy.Material and methods. The article presents a clinical case of 14-month-old child with neuroblastoma of stage 3 and difficult anatomical location after 2 courses of polychemotherapy by NB-2004 protocol. The child had subradical resection of an extensive tumor in the retroperitoneal space and nephrectomy on the right. The authors also describe specific moments during surgery, problems which their faced during child’s treatment as well as follow-up examinations in the postoperative period.Results. Follow-up examinations did not reveal any signs of disease recurrence. Catamnesis lasted for 56 months. The child is in a good state; she is active, attends a nursery school.Conclusion. The discussed case demonstrates that a successful radical surgical removal of neuroblastoma of difficult anatomic location may have good outcomes without adjuvant postoperative therapy.
Experience in treating gastrointestinal tract perforations in newborns in the Republic of Uzbekistan
Authors: Salimov Sh. T. , Abdusamatov B. Z. , Vakhidov A. Sh. , Umarov K. M. , Berdiev E. A. , Elmuradov Sh. Kh.
Published: April 2021

Introduction. Despite of the fact that necrotic enterocolitis (NEC) is a common surgical disease in newborns, a significant breakthrough in its treatment has not been made yet.Purpose. To analyze outcomes of surgical treatment at the NEC surgical stage in newborns.Material and methods. Outcomes after surgical treatment of 71 newborns with necrotic enterocolitis at its surgical stage, who were admitted to the hospital in 2015-2020, have been analyzed.Results and discussion. Diagnostic laparoscopy (DL) was prescribed if the surgical stage of the disease was not complicated with pneumoperitonitis. 37 patients had DL; of them 11 (29.7%) had conversion to laparotomy. In 26 (70.3%) patients, diagnostic laparoscopy was ended with therapeutic laparoscopy and video-assisted mini-laparotomy; among them there were 7 (26.9%) patients in whom gastric perforation was sutured. Resection of the necrotic part of the intestine with followed end-to-end anastomosis was made in 8 (30.7%) patients; in 11 (42.3%) patients, an intestinal stoma was created. In 45 newborns with the NEC surgical stage, surgeons chose the traditional surgical tactics. 34 (75.5%) patients with diagnosed pneumoperitoneum had laparocentesis to achieve decompression; 8 (17.7%) patients out of them died. 37 (82.2%) patients had laparotomy; in 5 (11.1%) out of them stomach perforations were sutured. In 32 (71.1%) patients, intestinal stomas were created. If to compare the obtained results after video-assisted laparoscopic surgeries, the mortality rate was as follows: 6 (23.1%) patients after laparoscopic interventions and 64.4% after traditional ones.Conclusion. Diagnostic laparoscopy at the surgical stage of necrotizing enterocolitis allows to select tactics for radical surgical treatment, to transfer surgical treatment into non-surgical one, thus minimizing surgical trauma what impacts positively the postoperative survival of patients.
Development of the service sector in Poland compared to other European Union countries: an extended analysis
Authors:   University of Lodz, Szczukocka Agata
Published: April 2021

Introduction. In the recent years, many changes in the economic transformations that can be treated as evidences of the country’s economic development were observed in the European Union member states. The service sector also experienced many changes. The nature of services is constantly changing, new types of services keep appearing, but at the same time many of them suffer from lack of demand and disappear. The role of services is more and more significant in the socio-economic development as well as in individuals’ lives, hence, this is a relevant issue and should be studied extensively. The purpose of the paper is to discuss the transformations taking place in the services sector in Poland against other European Union countries and to analyze internal changes within the sector. Methods. Taken in this paper attempt to assess the development of the services sector is based on the analysis of the economic indicators, mainly the gross value added and employment rates. The study presents the results of the research on the development of the service sector in years 2009-2019. The directions and scope of changes taking place in particular services sector sections were analyzed. The results of the conducted research show that the determinant of the level of the service sector development is not only its high share in the three-sector structures, but also internal changes observed in the sector itself. The individual sections contribution to the creation of the gross value added and the level of employment vary greatly. The dominant activity among service entities in terms of value added is commercial activity. Moreover, the analysis of the service sector identifies which sections have the greatest impact on the service sector development. These sections include: wholesale and retail trade, transport and warehouse management, as well as professional, scientific and technical activities. Conclusion. Based on the research, it was found that the share of the service sector in the structures of economies of highly developed countries is prevailing. It is indicated by the increase in employment in this sector, the growing share in the creation of gross value added, as well as the number of service enterprises. The service sector stimulates the development of the economy, and its condition proves the dynamics of social and economic development.