bluuebunny/crossref_metadata_2025 huggingface dataset:
The Last Planner® System and Building Information Modeling in Construction Execution: From an Integrative Review to a Conceptual Model for Integration
Authors: Schimanski Christoph Paul , Marcher Carmen , Monizza Gabriele Pasetti , Matt Dominik T.
Published: January 2020

Many researchers have stated that lean and building information modeling (BIM) have positive synergies. This integrative literature review aims at exploring this body of knowledge within the scope of combinations of BIM and the Last Planner® System, as an important Lean construction method, in the phase of construction execution. The research motivation is to find out whether a comprehensive understanding of how to take advantage of these synergies exists. Eventually, the question arises of how to condense this understanding—if existing—into a robust conceptual model for integration. As a theoretical backbone, we will make use of the original BIM-Lean interaction matrix. The hypothesis is that new BIM functionalities have been evolved since the first formulation of this interaction matrix almost 10 years ago. These new BIM functionalities cause new interactions with existing lean principles. We will focus on interactions that refer directly or indirectly to production planning and control and use them to find the most relevant literature for this review. Within the content analysis, as a part of this review, we focus on existing conceptual models and frameworks for integration of BIM and the Last Planner® System and reveal their shortcomings. Eventually, we will propose a new conceptual model.
Experimental Study on the Flexural Behavior of over Reinforced Concrete Beams Bolted with Compression Steel Plate: Part I
Authors: Alasadi Shatha , Shafigh Payam , Ibrahim Zainah
Published: January 2020

The purpose of this paper is to investigate the flexural behavior of over-reinforced concrete beam enhancement by bolted-compression steel plate (BCSP) with normal reinforced concrete beams under laboratory experimental condition. Three beams developed with steel plates were tested until they failed in compression compared with one beam without a steel plate. The thicknesses of the steel plates used were 6 mm, 10 mm, and 15 mm. The beams were simply supported and loaded monotonically with two-point loads. Load-deflection behaviors of the beams were observed, analyzed, and evaluated in terms of spall-off concrete loading, peak loading, displacement at mid-span, flexural stiffness (service and post-peak), and energy dissipation. The outcome of the experiment shows that the use of a steel plate can improve the failure modes of the beams and also increases the peak load and flexural stiffness. The steel development beams dissipated much higher energies with an increase in plate thicknesses than the conventional beam.
Characterization of Fresh and Cured Properties of Polymer Concretes Based on Two Metallurgical Wastes
Authors: Seco Andres , Echeverría Angel Maria , Marcelino Sara , García Benat , Espuelas Sandra
Published: January 2020

Polyester polymer concretes can substitute conventional concretes based on their usually good mechanical strength, adequate physical properties, and high resistance against aggressive chemical environments. They also show a high potential for using recycled targets in their manufacturing. This paper analyzes the fresh and cured properties of polyester polymer concretes containing two metallurgical wastes, namely: ladle slag and alumina filler. Both targets require a higher resin dosage than sand. The standard consistency test showed a low representativeness of the recycled fresh mixes’ workability. The ladle slag and alumina filler samples showed a higher length plastic shrinkage than those containing sand. All of the targets obtained cured density values in the range of 1.589–1.912 g/cm3. From a mechanical point of view, the sand and alumina filler containing polyester polymer concretes reached 11.02 and 10.93 kN, respectively, of flexural strength, while the ladle slag samples showed the best result with 19.31 kN. In the compressive strength test, the sand and alumina filler combinations reached 106.16 and 104.21 MPa, respectively, while the ladle slag achieved 160.48 MPa. The flexural and compressive elasticity modulus showed similar trends related to the resin content.
An Issue of Scale: The Challenge of Time, Space and Multitude in Sustainability and Geography Education
Authors: Skarstein Frode , Wolff Lili-Ann
Published: January 2020

The field of geography is important for any sustainability education. The aim of geography education is to enable students to understand the environment, its influence on human activity, and how humans influence the environment. In this article we present a study on how the interplay between the three pillars of sustainability thinking (environment, society and economy) play out on smaller and larger scales of time, space and multitude in geography education. In this paper, we argue that central issues in high quality sustainability education in geography relates to students’ deeper grasp of how to shift between magnitudes of time, space and multitude patterns. We show how an appreciation of many core issues in sustainability education require students to understand and traverse different magnitudes of the scalable concepts of time, space and multitude. Furthermore, we argue and exemplify how common sustainability misconceptions arise due to an inability to make the cognitive shift between relevant magnitudes on these scalable concepts. Finally, we briefly discuss useful educational approaches to mediating this problem, including the use of digital tools in order to allow geography teachers to facilitate the students’ better understanding of different magnitudes of slow, fast, small and large scale entities and processes.
Acknowledgement to Reviewers of Fractal Fract in 2019
Authors: Fractal and Fractional Editorial Office
Published: January 2020

The editorial team greatly appreciates the reviewers who have dedicated their considerable time and expertise to the journal’s rigorous editorial process over the past 12 months, regardless of whether the papers are finally published or not [...]
Special Issue: Integrated Pest Management in Arable and Open Field Horticultural Crops
Authors: Cuthbertson Andrew G. S.
Published: January 2020

Invertebrate pest control within both agricultural and horticultural production systems continues to present many challenges. Over the past decades the commonly used method for pest control has been the direct application of chemical products. However, in response to environmental, economic, and other problems associated with the over-reliance on chemical insecticides there has been an increasing drive towards the development of Integrated Pest Management (IPM) approaches. Many IPM strategies are now well developed under protected environments. However, within the open field in many situations targeted success is yet to be achieved. This special issue will seek to showcase original articles and reviews by leading research entomologists and associated experts. Articles presented will focus on the development and implementation of IPM strategies against various major arable and horticultural invertebrate pests (both indigenous and invasive species).
Role of Impurity Sulphur in the Ductility Trough of Austenitic Iron–Nickel Alloys
Authors: Christien Frédéric
Published: January 2020

The role of impurity sulphur in the ductility trough of iron–nickel (Fe–Ni) alloys is investigated using hot tensile tests. A strong detrimental effect of some ppm levels of sulphur is demonstrated. In addition, it is shown that, in the ductility trough, material failure occurs through subcritical grain boundary crack propagation, involving dynamic embrittlement at the crack tip, due to the sulphur. Very high intergranular crack growth rates are observed. This is possible because plastic deformation accelerates the transport of sulphur to the crack tip, by several orders of magnitude, compared to normal bulk diffusion. The ductility is recovered at high strain rates, which correlates with a decrease in the sulphur concentration measured on the fracture surface. It is suggested that the main mechanism of sulphur transport is dragging by moving dislocations.
The Quality of Rainwater Collected from Roofs and the Possibility of Its Economic Use
Authors: Zdeb Monika , Zamorska Justyna , Papciak Dorota , Słyś Daniel
Published: January 2020

The large temporal and spatial variability of rainwater quality, as well as the relatively small number of tests, makes the preliminary assessment of its economic exploitation difficult. Determining the relationship between the conditions and location of rainwater collection and rainwater quality would help indicate the range of options for rainwater use, as well as the parameters that require improvement. The aim of the presented article is to establish the physical, chemical, and microbiological parameters of different rainwater sources and, from the results obtained, determine the possibilities for its safe use in households. The research was carried out for two years. Samples of rainfall were collected from spring to fall from the following roofing materials: Concrete roof tiles, ceramic roof tiles, galvanized steel sheet, and epoxy-coated terrace. The physical, chemical, and microbiological quality were assessed on the basis of the pH, turbidity, electrical conductivity, the concentration of biogenic compounds, the concentration of chosen elements, the number of Escherichia coli, and the number of fecal streptococci. Significant bacterial contamination, decreased pH, and increased turbidity were identified in the water, depending on the parameters of the roofing washed by the rainfall and the intensity and frequency of precipitation.
COMPOSICIÓN Y TAXONOMIA DE LA FAMILIA BAETIDAE (INSECTA: EPHEMEROPTERA) PARA LA CUENCA DEL RÍO LA VIEJA, ALTO CAUCA, COLOMBIA.
Authors: Salinas Luis , Villegas-A Paola , Román-Valencia César
Published: January 2020

Baetidae es una de las familias de insectos más abundantes y diversas del orden Ephemeroptera. En Colombia se registran 38 especies en 19 géneros, de las cuales cinco especies se localizan en la cuenca del Río La Vieja: Andesiops peruvianus, Camelobaetidius edmunsi, Mayobaetis ellenae, Nanomis galera y Prebaetodes sitesi. En este trabajo, se examinaron un total de 7226 ninfas de baetidos, colectadas en el Río La Vieja, pertenecientes a 23 especies en 11 géneros. Se encontró que el género más abundante y con mayor riqueza es Baetodes seguido por Camelobaetidius (10 individuos y tres especies determinadas respectivamente), las especies más abundantes fueron Baetodes awa y Camelobaetidius edmunsi (con 3563 y 1282 individuos respectivamente). En el presente trabajo se registra por primera vez, para el Río La Vieja, dos géneros (Cloeodes y Varipes) y ocho especies (Baetodes awa, Baetodes diasae, Baetodes pseudospinae, Camelobaetidius mathuriae, Camelobaetidius patricki, Nanomis rasmusseni, Prebaetodes meridinensis y Zelusia principales). Lo anterior establece que el rio La Vieja registra alrededor del 61 % de las especies de baetidos reconocidas para Colombia (23 de las 38 especies).
Alevi-Bektaşi Şiir Geleneğinin Bilinmeyen Bir Temsilcisi: Samsunlu Âşık Hulusî
Authors: ÖZDEMİR Cafer , GÜL İbrahim
Published: January 2020

Samsunlu
Âşık Hulusî, Alevi toplumunun bir temsilcisi olarak hem mürşitlik makamında
oturmakta hem de irticalen söylediği şiirlerle Âşık edebiyatı geleneğini
yaşatmaktadır. Ayrıca badeli bir âşık olması onu geleneğe sıkıca bağlamaktadır.
Fakat şiirlerinde kullandığı hece vezninde bazı tutarsızlıklar göze
çarpmaktadır. Saz çalmayı bilmemesi gelenek açısından büyük bir kayıptır. Fakat
kendisinden önce yaşamış Alevi şairlerin şiirlerinden ilham alarak orijinal
şiirler söylemesi, kendi inanç sistemine büyük bir aşkla bağlılığı, diğer Alevi
şairlere göre Ehlibeyt, Hz. Ali ve Hz. Hüseyin hakkında yoğun olarak şiirler
ortaya koyması, onun geleneği yaşatan bir âşık olarak değerlendirilebileceği
izlenimi vermektedir.

Çalışmamızda
şiirlerinin neşriyatından başka hakkında daha önce bir çalışma yapılmayan Âşık
Hulusî konu edilecektir. Âşığın hayatı, sanatı ve şiirlerindeki temalar
örneklerle açıklandıktan sonra bazı şiirlerine yer verilecektir.
Türkiye’de Sanal Para Değerinin Belirleyicileri: Bitcoin Üzerine Bir Uygulama
Authors: ÇOLAK Yusuf , SANDALCILAR Ali Rıza
Published: January 2020

Çalışmada Türkiye’deki seçili bir takım finansal değişkenlerle (USD, EURO, POUND, SDR, BİST 100, Cumhuriyet Altını, M1 ve M2 para arzları) sanal para birimi Bitcoin (BTC) arasındaki ilişki incelenmiştir. Bu kapsamda 2013-2019 dönemine ait aylık veriler kullanılmıştır. Analizler sonucunda değişkenlerin birinci farklarının durağan olduğu tespit edilmiş, diğer taraftan Bitcoin ile diğer finansal değişkenler arasında uzun dönemli bir eşbütünleşmenin varlığı belirlenmiştir. Değişkenler arasında nedenselliğin araştırıldığı Granger Nedensellik testi ile de Bitcoin’in bağımlı değişken olduğu denklemde SDR ve USD ‘den BTC’ye doğru %5 anlamlılık düzeyinde; Euro ve BIST 100 değişkeninden BTC’ye doğru ise %10 anlamlılık seviyesinde bir nedenselliğin varlığı tespit edilmiştir.
Motivasyonel Dil Kullanımının Örgütsel Bağlılık Üzerindeki Etkisi: ÇAYKUR’da Bir Uygulama
Authors: LATİFOĞLU Neslihan , SAKLI Ali Rıza
Published: January 2020

Bu araştırmada yöneticilerin motivasyonel dil kullanımının çalışanların örgütsel bağlılığı üzerindeki etkisi incelenmiştir. Araştırma Rize’de bulunan Çay İşletmeleri Genel Müdürlüğü (ÇAYKUR) ve bağlı dokuz çay fabrikasının idari binalarında çalışan 254 kişi üzerinde yapılmıştır. Araştırmanın temel amacını pozitif bir algı olan motivasyonel dil kullanımının örgütsel bağlılık üzerindeki pozitif etkisini ortaya çıkarma oluşturmaktadır. Bu bağlamda basit tesadüfi örnekleme yöntemi ile elde edilen veri, SPSS programı ile analiz edilmiştir. Elde edilen bulgular göstermektedir ki, motivasyonel dil kullanımı (empatik dil) örgütsel bağlılığı artırıcı pozitif yordayıcılardan biridir.
STUDI EKSPERIMEN PENGARUH MEDAN MAGNET 800 GAUSS PADA ALIRAN BAHAN BAKAR PERTAMAX TERHADAP UNJUK KERJA MESIN BENSIN 150 CC
Authors: Harianto Agus , Hariyadi Muhammad Arif , Prasetyo Edi Kurniawan
Published: January 2020

Medan magnet dapat membantu proses ionisasi pada bahan bakar, sehingga bahan bakar saat proses pembakaran dapat mudah mengikat oksigen. Pengikatan oksigen pada bahan bakar secara stoikiometri menyebabkan pembakaran lebih sempurna, sehingga torsi dan daya pada mesin dapat meningkat. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh pemasangan magnet 800 gauss terhadap torsi, daya, dan konsumsi bahan bakar spesifik motor bensin 150 CC. Penelitian ini dilakukan dengan membandingkan prestasi mesin motor bensin merk Honda Verza CW 150 CC yang dipasang magnet 800 Gauss merk X-Power pada saluran bahan bakar dengan tanpa dipasang magnet 800 Gauss merk X-Power. Setiap pengujian dilakukan pada putaran mesin 3000 rpm, 4000 rpm, 5000 rpm, 6000 rpm, dan 7000 rpm. Metode yang digunakan adalah secara eksperimen di Laboratorium Efisiensi dan Konversi Energi. Hasil penelitian menunjukkan bahwa dengan menggunakan magnet 800 gauss terjadi peningkatan torsi maksimal sebesar 0,59%, dan peningkatan daya maksimal sebesar 1%.
PENGEMBANGAN SISTEM AKUISISI DATA UNTUK EVALUASI TINGKAT KESEHATAN MESIN DIESEL BERBASIS PADA ANALISA AKUSTIK
Authors: Firdaus Sukma , Adriana Marlia
Published: January 2020

Perawatan dan perbaikan dari sebuah mesin sangat erat hubungannya terhadap kinerja proses pembakaran. Proses pembakaran pada mesin memiliki implikasi timbulnya efek vibrasi yang memunculkan fenomena akustik. Dari penelitian ini, diperoleh alat akusisi data perekaman emisi akustik yang ditimbulkan oleh mesin diesel. Proses perubahan data time-series emisi akustik menjadi domain frekuensi menggunakan transformasi fourier (TF), dengan algoritma fast fourier transform (FFT). Dari hasil identifikasi, diperoleh nilai MPF untuk kondisi normal adalah 27.78 Hz dengan standar deviasi 0.19 Hz, pada kerusakan 1 sebesar 22.52 standar deviasi sebesar 0.27 Hz, kerusakan 2 sebesar 26.35 Hz standar deviasi sebesar 0.29, sedangkan pada kerusakan 3 nilai MPV adalah 30.04 dengan standar deviasi sebesar 0.95. Pada penelitian lanjutan dapat dilakukan analisis pada domain frekuensi dan domain waktu secara bersamaan. Sehingga setiap frekuensi dapat dihitung waktu kemunculannya dan akan memperoleh pola frekuensi dan waktu setiap kondisinya. Hal ini akan meningkatkan ekstraksi informasi yang terkandung didalam emisi akustik mesin diesel.
Technical Efficiency Assessment of Dairy Farm in the South-west Region of Bangladesh
Authors: Farjana Fariha , Khatun Afia
Published: January 2020

The paper concentrates on the measurement of the total factor productivity of dairy farms in the south-west region of Bangladesh. The study used stochastic frontier approach for analyzing the technical efficiency of the dairy farms. Here, seventy dairy farms are considered as a sample. The data reveals that the number of labor and the quantity of food are statistically significant at a 1 percent level of significance.The data also manifests that numerous farm-specific characteristics, i.e. farm size, farmer’s age, and amount of credit are statistically significant at 1 percent, 10 percent, and 10 percent respectively. The range of technical efficiency for the farms varies from 26 percent (minimum) to 95 percent (maximum) where the mean value is 68 percent for the dairy farms of the south-west region. This implies that an average output of milk production falls 32 percent short of maximum possible level. Hence, there is scope of improvement in this sector. Therefore, to improve the farm productivity government should provide proper training, and medical treatment facilities for the farms so that the animals become healthy. If it is possible to do so then the farm level production frontier will shift upward.
The quality life in patients with chronic obstructive pulmonary disease combined with arterial hypertension
Authors: Fushtey I. M. , Podsevahina S. L. , Tkachenko O. V. , Palamarchuk A. I. , Cabanna E. S.
Published: January 2020

Purpose of the study. Was to investigate life quality in patients with comorbidly pathology of chronic obstructive pulmonary disease in combination with arterial hypertension.

Materials and  methods.  77  subjects with a diagnosis of chronic obstructive pulmonary disease stage I–III (according to the GOLD criteria) in combination with arterial hypertension I–III stage. The comparison groups included 30 patients with essential hypertension and 45 patients with chronic obstructive pulmonary disease. All groups were completely comparable by the length and disease severity. All patients underwent general clinical examination, blood pressure measurement, spirometry, electrocardiography, and echocardiography. Study of the life quality in patients was carried out by means of self-questioning using General official Russian-language analogue of the MOS SF-36 questionnaire.

Results. It was determined, that life quality parameters of physical status and psychosocial status were reduced in all patients, but to a greater extent in patients with comorbidity than in patients of the comparison group. Disease duration influenced on life quality. In patients with newly diagnosed chronic obstructive pulmonary disease with a history of marked increase in blood pressure, changes in life quality were more expressed in comparison with the comparison group; at the same time there was tendency of it’s increasing over time. When assessing the relationship between quality of life and parameters of pulmonary ventilation, it was found that depending on the severity of respiratory function disturbances it is directly proportional to decreased quality of life, both physical and psychosocial status. Life quality of in patients with chronic obstructive pulmonary disease worsens due to addition and progression of essential hypertension.

Conclusions. Сomorbidly pathology has a negative impact on physical and psychosocial status of patients, which is significantly reduces life quality and depends on the severity of pulmonary ventilation disturbances, «length of the disease» and hypertension degree.
Polarization microscopic tomography of the polycrystalline structure of vitreous body preparations in diagnostics time of the since death
Authors: Sarkisova Yu. V. , Bachynskyy V. T. , Ushenko O. H. , Melnyk M. M.
Published: January 2020

Purpose of the study. Develop a complex of new forensic objective criteria to enhance the functionality of accurate definition time of the since death (TSD) estimation according to polarization microscopic tomography of the polycrystalline structure of human vitreous body (VB).

Materials and methods. The object of study is polycrystalline VB layers taken from 56 people who died from cardiovascular disease with known time of death ranged from 3 to 36 h. Measuring parameter distributions of birefringence of the polycrystalline component of VB preparations were carried out with a standard Stokes-polarimeter.

Results. The time dynamics of the magnitude of the set of statistical moments of the 1–4th order, which characterize the distributions of the birefringence of the polycrystalline component of the VB layers at different TSD values were investigated. The sensitivity range of the method of polarization tomography of the distributions of the birefringence of the polycrystalline component of the VB layers was determined (24 h), with the accuracy of TSD estimation – 20 min. The efficiency of wavelet analysis of the distribution of the magnitude of the birefringence layers of human VB layers at different TSD values is demonstrated. Scale-selective analysis has been shown to increase the sensitivity range up to 36 h while increasing the accuracy of TSD determination to 15 min.

Conclusion. The efficiency of the method of polarization microscopic tomography of the polycrystalline structure of human VB preparations in the determination of TSD is demonstrated.

Sensitivity ranges method up to 36 h was determined with an accuracy of up to 15 min.
Microflora of upper parts of gastrointestinal tract during acute necrotizing pancreatitis
Authors: Rotar O. V. , Khomiak I. V. , Rotar V. I. , Khomiak A. I. , Shafraniuk V. D. , Hrama O. V.
Published: January 2020

Analysis of results of treatment of 153 patients with acute necrotizing pancreatitis has been performed. Small intestinal content at admission, fluid and necrotic collections were gathered for microbiological investigation. At 57,4% of patients 8 strains of gramm negative microorgamisms were identified from small intestine before operation. Similar microflore were cultivated from pathological foci at 57,4% of patients after operation. Minimal inhibitory concentration of rifaximin from < 0,25 till 8 µg/ml and ciprofloxacin from 0,25 till 1 µg/ml suppressed growth of 100% of isolated microorganisms in vitro.
The achievements and perspective trends of electrically welded anastomosis
Authors: Podpriatov S. S. , Podpryatov S. E. , Marynskyy G. S. , Chernets O. V. , Tkachenko V. A. , Grabovsky D. A. , Lopatkina K. G. , Tkachenko S. V. , Buryak Y. Z. , Serdyuk V. K.
Published: January 2020

In result of previous studies, we found the superior qualities of electro-welded intestinal anastomoses had created by using tools and models are suitable for open surgery.

Purpose of the stady. Was to identify promising research trends according to laparoscopic instruments usage for creating electro-welded intestinal anastomoses inside abdomen.

Material and methods. Using a full-size porcine organo-complex, special laboratory tests at the bench, the 160 probes were provided. Initially the pressure of 1,0 to 2,0 N/mm2 (1,0–2,0 × 104 PA) was applied externally to the electrodes. The electrode surface sizes were: 75 mm2 mm for conventional and 30 mm2 for laparoscopic models. Then, using AC amplitude from 200 to 500 V, frequency 466 kHz, intestinal or colon walls’ anastomosis was created. Next the connection strength of the walls was studied by hydrostatic pressure.

Results. During the small intestine fragments welding, using the model of conventional electrodes, that’s peak temperature was 83,7 ± 8,7 °C, during the colon welding – 75,1 ± 11,1 °C. The burst pressure of anastomoses were 5,5 ± 1,1 kPa, 4,7 ± 0,9 kPa, respectively.

During the small intestine fragments welding, using the model of laparoscopic electrodes, that’s peak temperature was 83,1 ± 7,3 °C, during the colon welding – 78,8 ± 9,1 °C. Burst pressure of anastomoses were 6,1 ± 1,2 kPa, 5,0 ± 1,2 kPa, respectively.

Conclusions. The possible way to intracorporeal intestinal anastomosis creation, by using the modified Patonmed EKVZ-300 power source with laparoscopic instruments, is a reduction of electrode’s area and modifying the impulses’ parameters.
Mapping of azimuths of polarization of laser microscopic images of histological sections of human organs in the differentiation of poisoning by ethanol and carbon monoxide
Authors: Ivaskevych I. B. , Bachynskyy V. T. , Vanchulyak O. Y. , Palyvoda O. H.
Published: January 2020

Purpose of the study. This work is aimed at research and substantiation of information possibilities of objective method of polarization mapping of microscopic images of histological sections of human biological tissues for the establishment and differentiation of С2Н5ОН and CO poisoning.

Materisls and methods. Native histological sections of the brain, myocardium and adrenal glands from ethanol poisoning (n = 30) and CO (n = 20) were investigated using a laser polarimeter of standard scheme. Subsequently, statistical processing of the obtained results was conducted.

Results. Statistical moments of 1–4th order were determined by the method of polarization mapping of microscopic images of histological sections of human biological tissues. The values of the statistical moments of the 1–4th order for brain tissue for С2Н5ОН and CO poisoning reach differences by 2–2,5 times, for myocardial tissue – 2,2–2,9 times, the adrenal glands – 1,4–1,8 times. Accordingly, the statistical moments of the 3rd and 4th order are more sensitive to the detection and differentiation of poisons, whereby the accuracy of the method of differential diagnosis of poisoning С2Н5ОН and CO reaches an adequate level (~ 90%) in the study of histological sections of the myocardium and brain.

Conclusion. The obtained results show that the method of polarization mapping of microscopic images of human biological tissues gives an objective possibility of reliable establishment and differentiation of С2Н5ОН and СО poisoning.
Assessment of severity in patients with acute peritonitis, complicated by abdominal sepsis
Authors: Sydorchuk R. I. , Khomko O. Y. , Plehutsa I. M. , Knut R. P. , Plehutsa O. M.
Published: January 2020

Abdominal sepsis (AS) is one of the most important problems in modern abdominal surgery. Prediction of AS and complications remains a challenge for modern surgery. The aim of the study is to evaluate the prognostic and diagnostic value of clinical and laboratory parameters in order to substantiate the prognostic complex for patients with AS and to improve existing systems for assessing the severity of patients by modification aimed on adapting to the capabilities of clinics.

The proposed modification of the severity scoring scale APACHE II, based on the analysis of clinical and laboratory data obtained in 183 patients with acute peritonitis and abdominal sepsis. The complex of physiological parameters and their prognostic significance in AS was determined by in-depth statistical analysis and determination of predicting values.

Most of the analyzed indicators had a likely positive prognostic value in the diagnosis and prognosis of AS. At the same time, the predictive value of the qSOFA scale at low values is negligible. Statistically insufficient prognostic value was obtained for increased temperature above 38,0 °C. The data obtained formed the basis for the development of a digital AS and complications prediction system by modifying the APACHE II scale.

The proposed patient' severity scale is accessible and sufficiently informative for use in patients with peritonitis and AS. It is recommended that at least two systems for assessing the severity of a patient's condition be combined.
Methodical approaches self-assessment of quality management system in healthcare facilities
Authors: Krut A. G. , Horachuk V. V.
Published: January 2020

The international standard for quality management systems and its analogue for healthcare institutions contain a requirement to analyze the quality management system. In order to fulfil, the head of the healthcare institution must carry out periodic checks of the compliance of the quality management system with the requirements of the standard and determine the level of its development. This requires an effective tool for self assessment and the development of methodological approaches to its implementation.

Purpose of the study. Methodological approaches should be justified and developed for self assessment of the institution's quality management system of a healthcare institution in accordance with the requirements of the standard «Quality management systems – EN ISO 9001:2015 for healthcare».

Materials and methods. Quality management system standards international and domestic, scientific sources on the topic, the systematic approach methods, content analysis, descriptive and graphical modeling.

Results. Methodological approaches to selfassessment of a quality management system are disclosed through the development of a selfassessment questionnaire, structured according to the main sections of the standard. Work with the questionnaire provides for the application of the method of comparative analysis of requirements and actual data and a rating scale from 1 to 5 points. The procedure and frequency of self-assessment is proposed.

Conclusion. The proposed methodological approaches can be used in conducting a self-assessment of a quality management system to obtain reliable input for management analysis.
Features of lethal cases in patients with TB/HIV co-infection depending on the resistance to antituberculosis agents in the conditions of the antituberculosis dispensary
Authors: Sahaidak Т. К. , Skorokhodova N. О. , Akhtyrskyi О. І. , Fedorets А. V. , Yanovskyi А. V.
Published: January 2020

Purpose of the study. Analyze lethal cases in patients with the TB/HIV co-infection depending in resistance to anti-TB drugs in the conditions of the antituberculosis dispensary.

Materials and methods. Retrospective analysis was conducted 80 histories and autopsy reports of patients with TB /HIV infection who died in the MI «Zaporizhzhya Regional Anti Tuberculosis Clinical Dispensary» from 2012–2017.

Results. In patients with chemoresistant forms, disseminated tuberculosis was in 36 patients (90%), infiltrative tuberculosis was noted in 2 cases, focal and fibrosis and cavernous – one person each. In the disseminated processes, in addition to the lungs, intranuclear lymph nodes were more often affected – 19 (47,5%), meningoencephalitis – 9 (22,5%), pleurisy –

9 (22,5%), retroperitoneal lymphnodes 2 (5,0%), peripheral lymphnodes – 2 (5,0%), lesions of the spleen – 2 (5,0%), kidneys – 2 (5,0), intestine – 1 (2,5%). In patients with susceptible tuberculosis, pulmonary and extrapulmonary lymph nodes are found in 36 (90.0%), only extrapulmonary – 4 (10,0%). These were pulmonary disseminated processes, including miliary forms. In addition to the lungs, intrathoracic lymph nodes were more often affected in 16 patients (40,0%), in 14 (35,0%) cases there was TB meningoencephalitis, Objective mesenteric lymphnodes – 4 (10,0%), spleen – 3 (7,5%), kidneys – 3 (7,5%), liver – 3 (7,5%), brain tuberculoma –1(2,5%).

Conclusions. Inconducting a comparative analysis of clinical and pathoanatomical diagnoses in patients with susceptible tuberculosis there was only one case in which a patient with brain tuberculoma had not been diagnosed with purulentnecrotizing pneumonia of the upper lobe of the right lung. In patients with resistant forms of tuberculosis in all cases there was a coincidence of diagnoses. The main secondary diagnosis was cryptococcal meningoencephalitis – 8 (20,0%), oncopathology – 2 (5,0%).
BANDS NEUTROPHILS LEVELS CHARACTERIZATION AND THEIR DYNAMICS AT TREATMENT OF ACUTE ALIMENTARY PANCREATITIS PATIENTS
Authors: Avdosiev Y. V. , Pankiv K. M. , Khimich S. D. , Belozоrov I. V. , Kudrevych O. M. , Khytruk S. V. , Ustymenko O. S. , Iaremchuk P. V.
Published: January 2020

Purpose of the study. To evaluate changes of bands nuclear neutrophils level and their dynamics parameters during treatment in patients with acute alimentary pancreatitis based on repeated measurements and taking into account the severity of the course.

Materials and methods. Seventy patients with acute alimentary pancreatitis were examined, who treated in Surgical Department of Vinnitsa Regional M. I. Pirogov Clinical Hospital. Average age was 45,4 ± 13,87 years. Severe pancreatitis was found in 34 (48,57%) people, in 25 (35,72%) – moderate, 11 (15,71%) persons had mild forms. The severity of the disease was assessed using the Atlanta classification (2012). To achieve aim of study the repeated measurements of the stabs neutrophils levels were performed for all patients. Statistical analysis was performed using STATISTICA 13.

Results. The significant difference between the stabs neutrophils values identified in patients with acute alimentary pancreatitis was proved, taking into account the severity of the course, both during the primary measured (p = 0,04), during treatment (p = 0,004), and after its completion (p < 0,00001). The significant increase of stabs neutrophils level associated with increasing severity of acute pancreatitis, as in the primary treatment of patients (τ = 0,23, p = 0,005), with determination during treatment (τ = 0,31, p = 0,0001) and after its termination (τ = 0,49, p  0,00001) was determined. When comparing the indexes of stabs neutrophils determined by repeated measurements, a rapid and continuous decrease of their values was found, as a whole in the group – by 3,76 times, and in the groups with a mild course of the inflammatory process – 6,75 times, the average degree of severity – in 5,11 times and severe forms – 3,05 times.

Conclusions. Highinformativenessofevaluation stabs neutrophils level and their dynamic during repeated measurements in patients with acute alimentary pancreatitis taking into account the severity of the course has been proved.
THE INCREASED KINETICS OF H2O2-INDUCED CHEMILUMINESCENCE IN THE PATIENTS WITH LONG-TERM CONSEQUENCES AFTER CEREBRAL CONTUSION
Authors: Lekomtseva Y. V.
Published: January 2020

Purpose of the study. The aim was to study in the patients with long-term consequences after cerebral contusion the intensity of spontaneous and H2O2-induced chemiluminescence in order to evaluate the early fast-flowing reactions caused by oxidative stress and associated with the formation of primary radicals such as free radical oxidations.

Materials and Methods. Forty-two patients with long-term consequences after cerebral contusion were investigated (39,04 ± 12,84 years mean age; mean onset years 32,56 ± 6,4) where both spontaneous and H2O2-induced chemiluminescences were measured directly by HPLC-chemiluminescence assay.

Results. The study have showed that sera of the investigated patients with long-term consequences after cerebral contusion have the increased H2O2-induced chemiluminescence associated with the high amplitude of «fast» burst and the tendency to increase of spontaneous chemiluminescence (p = 0,039 and p = 0,58, accordingly). Thus, the patients with longterm consequences after cerebral contusion showed the abnormal high kinetics of H2O2-induced chemiluminescence (p < 0,05). The statistically significant increase serum Н2О2-induced chemiluminescence intensity detected in examined patients (3085,6 ± 114,2 vs 669,1 ± 214,83 controls) have showed the development of certain oxidative stress processes in this category of patients associated with the increasing of primary free radical reactions and their activity were getting increased with the progression of the disease duration (p < 0,05).

Conclusions. The study provides the novel data revealing the increased kinetics of H2O2-induced chemiluminescence in the patients with long-term consequences after cerebral contusion accompanied by the tendency to increase of spontaneous chemiluminescence that may play the certain pathogenetic role.
Nitric oxide role in development of the endothelial dysfunction in diabetic foot syndrome
Authors: Bilyayeva O. O. , Kozynets H. P. , Osadcha O. I. , Kryzhevskyy Ye. Ye. , Knivets M. A.
Published: January 2020

Introduction. Diabetes mellitus causes many acute and chronic complications, including diabetic foot syndrome (DFS) – a serious complication that can be a test for patients and directly affect their quality of life.

One of the most effective treatments for DFS is the use of nitric oxide (NO). The main advantage of using NO-therapy is the effect of polyfunctional nitrogen monoxide on all phases of purulent-inflammatory process.

Purpose of the study. The nitric oxide effect features on the development of endothelial dysfunctions in patients with diabetic foot syndrome are explored.

Materials and methods. In the department of purulent surgery at Kyiv City Clinical Hospital No. 6 in 2019 from January to June, 76 patients with DFS in stages II–V were treated by F. Wagner. In 47 (61.8%) patients the neuropathic form of DFS was observed, and 29 (38,2%) were neuroichemic form. According to the DFS rates of F. Wagner patients were distributed: II – 24 (31,7%) patient, III – 29 (38,1%) patient, IV – 15 (19,7%) and V stages – 8 (10,5%). All patients were studied in the capillary zone of necrotic lesions of the content of NO, the activity of superoxide dismutase (SOD).

Results and discussion. The signaling role of NO in cells is highly dependent on the level of superoxide. The balance between systems that synthesize NO and superoxide determines the regulatory orientation of the signals, and its disruption contributes significantly to inflammation in diabetes.

Conclusions. The use of NO-therapy helps to optimize the processes of regulation of the induction of nitric oxide and to improve the clinical results in the treatment of diabetic foot syndrome.
Capabilities and limitations of antibacterial and complex surgical treatment of inflammation-purulent limb lesion
Authors: Podpryatov S. E. , Podpriiatov S. S. , Korchak V. P. , Simonova Z. E. , Korbut O. M. , Mazurok L. M. , Satsyuk I. V.
Published: January 2020

Purpose of the study. The effectiveness of limb inflammation-purulent lesions (LIPL) treatment on the base of own experience was estimate.Material and methods. 190 patients were treated for LIPL, including:1. Acute LIPL – 142 cases, namely: acute complication of diabetes mellitus (phlegmon, arthrosteopathy, tissue necrosis) was found in 119, acute thrombophlebitis against the background of post-thrombophlebitis syndrome 5, lymphangitis against the background of a chronic limb wound in 5, erysipelas in 4, inflammation after manicure/pedicure at 4, scratching a cat at 3, an injection of fish bone at 3, a bite of a parasite in 2 and a bite of a dog in 2 patients.2. Chronic LIPL was observed in 48 patients who were followed up for 4 months to 13 years. The cause of repeated visits was the formation of a chronic wound/ulcer of the foot or lower leg (35 cases), the re-occurrence of acute inflammation – 13 cases. The background disease was diabetes mellitus in18 post-thrombophlebitis syndrome complicated by lymphostasis in 17, cancer in 7, systemic collagenosis in 4, and HIV infection in 2 patients.Results and discussion. Complicated wound healing occurs in 39,5% cases of surgeries on acute inflammation and in 37% cases in chronic. Among 104 patients with foot surgery antibiotic treatment was ineffective in 48,1%, high amputation incidence estimates 3,8%. After primary high amputation complicated wound healing estimates 21,7%. By combination of aimed and prolonged antibacterial treatment and full-fledged fasciotomy it was possible to ceased anaerobic non gas producing infection and hand compartment-syndrome.Conclusions. 1. In the case of non-effective antibacterial treatment of the LIPL requires reassessment of the pathogen and the appointment of an appropriate antibiotic, while determining the need for surgical intervention.2. Dangerous to patient’s life are anaerobic non gas producing infection, which demands instant clindamycin treatment, and sepsis, which demands clindamycin or/and carbapenem treatment.In-time surgery, fasciotomy or limb amputation in the case of such infections needed beside of this.3. Slow wound cleansing and granulations formation, which lead to prolonged infection and its antibiotic resistance supposed to patient extra examination for revealing concomitant disease and it stabilization.
Informatively of histological study by method of mapping ellipticity of polarization of microscopic myocardial images
Authors: Vanchulyak O. Ya. , Lytvynenko O. Yu. , Ushenko O. H. , Andriychuk A. O.
Published: January 2020

Purpose of the study. To investigate the informational value of the histological examination of the human myocardium in case of sudden cardiac death and the possibility of a method of mapping ellipticity of polarization of microscopic images of the myocardium in the diagnosis and objective differentiation of acute coronary insufficiency (ACI) and chronic coronary heart disease (CIHD).

Materials and methods. Samples of human myocardium from 89 people who died as a result of ACI and CIHD were investigated, using traditional histological and laser polarization techniques, with a standard-scheme laser polarimeter. Subsequently, statistical processing of the obtained results was conducted.

Results. The results obtained show that the values of the statistical moments of the 3rd and 4th order, which characterize the coordinate distributions of the ellipticity of polarization of microscopic images of myocardial samples on the scale of optical magnification ×56, were the most informative for differential diagnosis of ACI and CIHD. Accuracy of ACI and CIHD detection by mapping the ellipticity of polarization of myocardial microscopic images at an optical magnification of ×56 reaches ~ 97%, as opposed to the traditional histological examination ~ 81%.

Conclusion. On the basis of the obtained data, we confirm the diagnostic efficiency and accuracy of the method of mapping the values of ellipticity polarization of microscopic images of histological sections of the myocardium in the problem of diagnosis and objective differentiation of ACI and CIHD.
Three-dimensional spatial reconstruction of the gunshot injuries in the practice of forensic medicine
Authors: Bachynskyy V. T. , Zmiyevska Y. H. , Savka I. H.
Published: January 2020

During the recent years the number of the wounded and killed due to firearms use both in Ukraine and in the majority of the world countries has increased. Therefore, examination of gunshot injuries is rather topical issue now in forensic medicine, and it is a considerable comprehensive question.Transience of incidences with the use of firearms in the majority of cases does not enable to find a real picture of circumstances when these incidences occur. Therefore, the issues of traumatic factor identification in these cases, especially with perforating and tangential injuries, are very important in forensic medicine, but remain elucidated insufficiently.

At the same time, a dynamic development of upto-date computer technologies enables to increase the level of visualization, forensic diagnostics of injuries and substantiation of expert conclusions in case of gunshot injuries.

Purpose of the study. To study diagnostic possibilities of three-dimensional spatial reconstruction method for forensic identification of the main traumatic factor in case of gunshot injuries.

Materials and methods. Ballistic plasticine and gel, fragments of pig skin with subcutaneous fat, fragments of biological tissues with gunshot injuries were used as the material for the study. The obtained experimental gunshot injuries (45 cases) and cases of injuries from the expert practice (30 cases) were subjected to photogrammetric with possibility to obtain a three-dimensional spatial model of every injury by means of the computer program Agisoft Photoscan.

Results. The studies conducted differ from the existing ones by their novelty, higher inventive and scientific-practical level. Three-dimensional spatial digital models of the injured biological tissues and their imitators will be designed, examined and analyzed for the first time, and the diagnostic criteria for forensic identification of the main traumatic factor of gunshot body injuries will be developed. The obtained textured models of gunshot injuries in «Obj» format can be imported into the program 3dsMax, which enables to examine linear sizes of every fragment of a wound canal with higher accuracy (to 0,001 cm) in comparison with classical methods of examination.

The results obtained while conducting the study enable not only to develop computer threedimensional digital models of gunshot body injuries, but examine their character and morphologic peculiarities in forensic practice on an up-to-date scientific level. All the mentioned above enables to formulate and substantiate new, more accurate forensic diagnostic identification criteria of the main traumatic factor of gunshot body injuries.

Conclusion. Introduction of up-to date computer technologies into the practice of forensic medicine will enable to determine identifying peculiarities of the main traumatic factor in case of gunshot injuries with a higher accuracy.
Traumatic disease peculiarities course, its diagnostics and treatment at polytrauma in suffer obese patients
Authors: Khimich S. D. , Chemerys O. M.
Published: January 2020

Introduction. It’s known that the issue of polytrauma is one of the most urgent problems of surgery, and among injured patients a special approach is required for patients with overweight and obesity of varying degrees.

Purpose of the study. To study prognostic features of traumatic disease course and to improve the results of diagnostics and surgical treatment of patients with polytrauma suffer obesity.

Materials and methods. Clinical material was made up of 106 patients with combined body trauma, which were divided into three groups according to body mass index.

Results. The results of the research showed a significant difference in the course of traumatic disease in patients with normal body weight and obesity. In particular, in the process of diagnostics of blunt chest and abdominal trauma the frequency of application of interventional methods of diagnostics was directly proportional to the increase of body mass index. The course of traumatic disease in the obese patients had a number of characteristic features that formed the basis for the development of diagnostics and differential program of treatment.

Conclusions. The results of the research showed that the course of traumatic disease in combined injury obese patients is directly proportional to the body mass index and has certain features that differentiate them from patients with normal body weight.