bluuebunny/crossref_metadata_2025 huggingface dataset:
How a Tourism City Responds to COVID-19: A CEE Perspective (Kraków Case Study)
Authors: Kowalczyk-Anioł Joanna , Grochowicz Marek , Pawlusiński Robert
Published: July 2021

Academic papers on the COVID-19 pandemic and tourism adopt the perspective of strengthening tourism resilience or recognize the ongoing crisis as an opportunity for reflection and the need to redefine tourism development strategies. This article examines these issues using the example of Kraków, a tourism city that, on the eve of the pandemic outbreak, was experiencing symptoms of overtourism. Using a case study approach, the authors illustrate the strategies applied at the city level, as well as the range of measures and actions used to support the tourism industry during the full pandemic year. The Kraków case shows that the pandemic time can be used to reorganize relations between local tourism stakeholders and to create a new formula for a tourism city in the so-called ‘new normal’. In addition, the exploratory case study allows for the formulation of research problems for further work on tourism cities responses to COVID-19. This can focus on a revision of the tourist offer and profile; the role of culture and the accompanying technology-facilitated innovations; the continuation of ‘being-a-tourist-in-your-own-city’, as promoted in the pandemic; tourists’ reactions to introduced changes; and shaping (new) relations between tourism stakeholders in the (post)pandemic city.
Sustainable Leadership: Philosophical and Practical Approach in Organizations
Authors: Hategan Vasile-Petru , Hategan Camelia-Daniela
Published: July 2021

The contemporary leadership concept manifests trends of continuous improvement, which is why this paper is an approach to the field from the perspective of philosophical counseling practices, different from current training and development programs for managers. Thus, the new opportunities are identified, which can join business education and personal development programs for leaders. The paper analyzes the characteristics of coaching studies compared to those of philosophical counseling applied in organizations, using the concept of philosophical leadership in order to identify the existence of interdisciplinary links between the two fields. The intensity of these links was studied through the bibliometric analysis performed on the concepts of leadership and philosophy, which were the subject of papers published in relevant journals indexed in the international database Clarivate Analytics–Web of Science Core Collection. The results of the analysis showed a close connection between concepts, which confirms their association. Through the practical applications of philosophy in the leadership, an innovation of the programs takes place of current specialization dedicated to leaders, which contain tools and methods that can be taken from philosophical practices, to achieve high-performance leadership programs. The concept of philosophical leadership can have a sustainable approach which can be included in personal development programs addressed to leaders, and will be delivered in the form of leader service packages, in which other specialists can participate, such as philosophical counseling, who can be successfully involved in the development of the leadership training program (LTP).
Indoor Thermal Comfort Analysis: A Case Study of Modern and Traditional Buildings in Hot-Arid Climatic Region of Ethiopia
Authors: Hailu Haven , Gelan Eshetu , Girma Yared
Published: July 2021

Indoor thermal comfort is an essential aspect of sustainable architecture and it is critical in maintaining a safe indoor environment. Expectations, acceptability, and preferences of traditional and modern buildings are different in terms of thermal comfort. This study, therefore, attempts to evaluate the indoor thermal comforts of modern and traditional buildings and identify the contributing factors that impede or facilitate indoor thermal comfort in Semera city, Ethiopia. This study employed subjective and objective measurements. The subjective measurement is based on the ASHRAE seven-point thermal sensation scale. An adaptive comfort model was employed according to the ASHRAE standard to evaluate indoor thermal comfort. The results revealed that with regards to thermal sensational votes between −1 and +1, 88% of the respondents are satisfied with the indoor environment in traditional houses, while in modern houses this figure is 22%. Likewise, 83% of occupants in traditional houses expressed a preference for their homes to remain the same or be only slightly cooler or warmer. Traditional houses were, on average, in compliance with the 80% acceptability band of the adaptive comfort standard. The study investigated that traditional building techniques and materials, in combination with consideration of microclimate, were found to play a significant role in regulating the indoor environment.
Інституційний аудит як інструмент підвищення інституційної спроможності органів виконавчої влади
Authors: Серняк О.
Published: July 2021

Розглянуто систему аудитів у публічному секторі та визначено роль інституційного аудиту в підвищенні інституційної спроможності органів виконавчої влади та формуванні засад доброго врядування. Виокремлено напрямки посилення інституційної спроможності органів виконавчої влади. Визначено об’єкт, результати та потенційні вигоди процесу оцінювання інституційної спроможності як складової інституційного аудиту. З метою підвищення ефективності інституційного аудиту запропоновано залучати громадські об’єднання до інституційного аудиту відповідних органів виконавчої влади чи їх структурних підрозділів.
Autoconsciência e autoconhecimento: sobre algumas dificuldades na redução da subjetividade
Authors: Frank Manfred
Published: July 2021

É uma descrição sóbria o fato de que nenhuma voz filosófica da filosofia alemã pós-fascista em todo o mundo, sobretudo nos Estados Unidos, é levada tão a sério, discutida tão profundamente e admirada por tantos quanto a habermasiana. Isto não se deve apenas ao espírito democrático fundamental (raro na tradição alemã) que respira a partir dela. Nenhuma outra posição filosófica hoje presente reagiu com comparável flexibilidade e amplitude às mudanças dos sistemas de crenças e sensibilidades contemporâneas quanto a habermasiana. O conceito de comunicação, em seu ponto central, também abre espaço para o defensor da subjetividade contra aquilo que é cultuado entre seus menosprezadores e, de fato, parece igualmente imune a uma série de tentativas reducionistas rejeitadas a seguir. Quando eu, no entanto, - após a apresentação das minhas próprias convicções – declaro haver um déficit filosófico sobre subjetividade na teoria de Habermas, faço com a consciência de que os argumentos nunca são “definitivos” ou “conclusivos” (cf. NOZICK, 1981, pp. 4), na verdade, as teorias nunca são definitivamente refutadas. Temos, diz David Lewis, de pagar um preço (LEWIS, 1983, p. X) por continuar a defendê-las contra os nossos adversários. Nas próximas quatro seções explicarei como concebo uma teoria consistente de subjetividade, e numa quinta justificarei porque é que o preço que esta teoria teria de pagar ainda me parece demasiado elevado se quisesse aderir ao paradigma da “razão comunicativa”.
ANALYSIS AND FORMATION OF THE STRUCTURE OF THE INTERNET OF THINGS NETWORK BASED ON LATTICE MODELS
Authors: БУШЕЛЕНКОВ С.Н. , ПАРАМОНОВ А.И.
Published: July 2021

Приведены результаты анализа и моделирования беспроводной сети интернета вещей в многоэтажном строении. Получено выражение для отношения сигнал/помеха (ОСП) при размещении узлов сети в виде регулярной структуры, представляющей простую кубическую решетку. Приведены зависимости ОСП от интенсивности трафика и количества узлов сети в строении. Рассмотрена возможность применения теории перколяции при описании функциональных возможностей сети.

The article presents the results of the analysis and modeling of a wireless network of the Internet of Things in a multi-story building. In the proposed model, an expression is obtained for the signal-to-noise ratio when locating network nodes in the form of a regular structure representing a simple cubic lattice. The dependences of the signal-to-interference ratio on the traffic intensity and the number of network nodes in the multistory building are obtained. The possibility of applying the theory of percolation in describing the functionality of the network is also considered.
UNIVERSAL INVARIANT ECHOCOMPENSATION METHOD IN DUPLEX COMMUNICATION SYSTEMS
Authors: ЛЕБЕДЯНЦЕВ В.В. , ПАВЛОВ И.И. , АБРАМОВ С.С. , ЛЕБЕДЯНЦЕВ М.В. , ПАВЛОВА М.С. , АБРАМОВА Е.С.
Published: July 2021

Предлагается универсальный метод эхокомпенсации в дуплексных системах связи, инвариантный относительно амплитудной характеристики паразитного эхотракта устройств разделения направлений передачи. Теоретическое обоснование метода базируется на отображении линейных и нелинейных измерений сигналов передатчика в эхотракте проективной группой преобразований и использовании инварианта этой группы для расчета копий сигналов передатчика на выходе эхотракта.

It is proposed the universal method of echocompensation in duplex communication systems, which is invariant with respect to the amplitude characteristic of the parasitic echo path of transmission direction separation devices. The theoretical justification of the method is based on the mapping of linear and nonlinear measurements of the transmitter signals in the echo path by a projective group of transformations and using the invariant of this group to calculate copies of the transmitter signals at the output of the echo path.
Grammatical Errors Made by English Department Students in Writing Analytical Exposition Essay
Authors: Annisha Dyuli Adha
Published: July 2021

This research was aimed to find out the students’ grammatical errors in writing analytical exposition essay. Besides, it is also to find out the processes of how the errors occur on the students’ writing and the causes of the errors. Sources of data were English department students of UNP in the fourth semester that were from four different classes, namely K1, K2, K3, and K4 in which each of the classes consisted of 30 students. So, total of the students was 120 students. However, only 30 students that were chosen randomly as samples of this research. The type of this research was a descriptive research. The data were collected by using writing test and interview. The findings of this research showed that the students’ grammatical errors in using simple present tense were in the use of subject, verb/ predicate, object, complement, and prepositional phrase. Besides, there were also the causes of the students’ errors, namely overgeneralization, ignorance of rule restriction, incomplete application of the rules, dan false concept hypothesized. From the data gotten, it could be concluded that the students made errors in six elements of grammar in analytical exposition essay.
Perancangan dan Pembuatan Teknologi Augmented Reality sebagai Media Pembelajaran Aksara Minang di SDN 01 Patamuan Berbasis Android
Authors: Andre Irawan  , Randy Permana  , Muhammad Reza Putra
Published: July 2021

Augmented reality merupakan sebuah teknologi yang dapat menggabungkan antara dunia nyata dengan dunia virtual. Seiiring berjalannya waktu augmented reality dikembangkan pada berbagai bidang contoh nya yaitu bidang pendidikan. Aksara minang merupakan sebuah kebudayaan tulisan yang berasal dari alam minangkabau yang ditemukan pada kitab tambo alam. Aksara minang sendiri terdapat 15 buah huruf aksara dan lima tanda untuk tanda baca. Dengan memanfaatkan teknologi augmented reality ini dapat menjadikan sebuah pembelajaran mengenai aksara minang
HUBUNGAN TENAGA MEDIS DALAM INFORMED CONSENT DAN PERJANJIAN TERAPEUTIK TERHADAP PERTANGGUNGJAWABAN RUMAH SAKIT
Authors: Junaidi Junaidi
Published: July 2021

Dalam hubungannya antara tenaga medis, rumah sakit dan pasien dikenal dengan perjanjian terapeutik, dimana perjanjian ini merupakan hubungan hukum yang menimbulkan hak dan kewajiban dalam bidang kesehatan. Hubungan terapeutik ini diawali dengan adanya persetujuan pasien dalam memberikan tindakan medik terhadap pasien setelah mendapatkan informasi yang jelas dari tenaga medis yang dikenal dengan informed consent. Hubungan hukum yang mendasari antara tenaga medis, pasien dan rumah sakit berdasarkan Pasal 1367 Kitab Undang-Undang Hukum Perdata. Hubungan hukum yang timbul ini menyebabkan adanya asas vicarious liability, dimana setiap kelalaian atau kesalahan tindakan medis yang dilakukan oleh tenaga medis di rumah sakit menjadi tanggungjawab Rumah Sakit. Berdasarkan Pasal 46 Undang-Undang Nomor 44 tahun 2009 tentang Rumah Sakit menentukan bahwa adanya tanggung jawab hukum yang terpusat untuk setiap kelalaian yang dilakukan oleh tenaga medis di Rumah Sakit
GAMBARAN PENGETAHUAN REMAJA MENGENAI BAHAYA HAMIL USIA DINI PADA SISWI DI SMA SEI PUTIH KECAMATAN TAPUNG KABUPATEN KAMPAR TAHUN 2021
Authors: Marlita Lora , Roza Andalia , Dewi Ariana
Published: July 2021

ABSTRAK

Kehamilan adalah fertilisasi atau penyatuan dari spermatozoa dan ovum dilanjutkan dengan nidasi atau implantasi. Bisa dihitung dari saat fertilisasi hingga lahirnya bayi, kehamilan normal akan berlangsung dalam waktu 40 minggu. Tujuan penelitian ini untuk mengetahui Gambaran Pengetahuan Remaja Mengenai Bahaya Hamil Usia Dini Di SMA Sei Putih Kecamatan Tapung Kabupaten Kampar Tahun 2021. Menggunakan jenis penelitian deskriptif kuantitatif. Populasi dalan penelitian ini yaitu siswi SMA Sei Putih sebanyak 52 orang. Teknik pengambilan sampel pada penelitian ini dengan menggunakan teknik quota sampling dimana peneliti mengambil sampel sesuai dengan yang ditargetkan atau diinginkan. Instrumen penelitian menggunakan kuesioner skala Guttman yang terdiri dari 20 pertanyaan. Analisa data menggunakan analisa univariat. Diketahui tingkat pengetahuan pada penelitian ini yaitu cukup dengan jumlah 28 responden (53,84%).

 

Kata Kunci : Kehamilan, Siswi, Bahaya Hamil Usia Dini
PENGARUH PENDIDIKAN KESEHATAN TERHADAP PERILAKU 3M PENCEGAHAN COVID-19 PADA IBU PKK DI DESA RAMBAH HILIR TIMUR TAHUN 2021
Authors: Wulandini Putri , Fitri Ainil , Ilham M. Raihan Riski
Published: July 2021

Health education is a way of supporting health programs that can produce changes and increase knowledge in a short time. This 3M behavior is said to prevent the transmission of covid-19. This study aims to find out the influence of health education on the behavior of 3M prevention of covid-19 in pkk mothers in the East Rambah Hilir Village in 2021. The design of this research uses a type of design one group pre-test post-test,Population in this study is the mother of pkk in the village of rambah downstream east. Sampling techniques in this study using sampling techniques so as to get a sample of 28 people. The research instrument uses questionnaires and observation sheets consisting of 23 questions. The results of this study showed the influence of health education on the behavior of 3M prevention covid-19 p value 0.000 < 0.05. health education can be used as a way of providing behavior for the community and it is expected that public concern and better understanding of the application of 3M behavior to the prevention of covid-19
FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KUNJUNGAN LANSIA KE POSYANDU DI PUSKESMAS SELALONG KECAMATAN SEKADAU HILIR TAHUN 2020
Authors: Ritayani Ritayani , Hariana Evy
Published: July 2021

Posyandu lansia merupakan program pelayanan kesehatan lansia tingkat dasar untuk menjaga kualitas hidup lansia menjadi lebih baik melalui kegiatan preventif, kuratif, dan rehabilitatif seperti pelayanan pemeriksaan kesehatan lansia. Penelitian ini bertujuan untuk mengetahui Faktor-Faktor yang Berhubungan dengan Kunjungan Lansia ke Posyandu di Puskesmas Selalong Kecamatan Sekadau Hilir. Penelitan ini merupakan penelitian kuantitatif dengan pendekatan cross sectional. Jumlah sampel 64 lansia. Teknik pengambilan Sampel total sampling. Instrumen penelitian menggunakan kuesioner. Hasil Penelitian dengan analisis bivariat  (uji Chi Square) diketahui ada hubungan antara pengetahuan  (p-value = 0,037), Sikap  (p-value = 0,023)  dan Dukungan keluarga  (p-value = 0,011) dengan Kunjungan Lansia ke Posyandu. Tidak ada hubungan antara pendidikan  (p-value = 0,605 dengan uji Fisher's Exact) dan tokoh masyarakat  (p-value = 0,118) dengan Kunjungan Lansia ke Posyandu di Puskesmas Selalong Kecamatan Sekadau Hilir. Faktor-Faktor yang berhubungan dengan kunjungan lansia ke Posyandu di Puskesmas Selalong Kecamatan Sekadau Hilir adalah pengetahuan, sikap dan dukungan keluarga lansia. Disarankan agar semua pihak dapat memberikan edukasi tentang Gizi sehat bagi lansia. Memberikan motivasi bagi lansia untuk lebih aktif dalam mengikuti posyandu lansia.
ANALISIS PENERAPAN KESELAMATAN RADIASI SINAR-X PADA PETUGAS RADIASI DI INSTALASI RADIOLOGI RUMAH SAKIT PEKANBARU MEDICAL CENTER (PMC)
Authors: Monita Rennyta , Rasyid Zulmeliza , Muhamadiah Muhamadiah , Edigan Firman , Masribut Masribut
Published: July 2021

ABSTRAK

Keselamatan radiasi adalah tindakan yang dilakukan untuk melindungi pasien, pekerja, masyarakat, dan lingkungan hidup dari bahaya radiasi. Mengingat potensi bahaya radiasi yang besar dalam pemanfaatan sinar-X, faktor keselamatan merupakan hal yang penting sehingga dapat memperkecil risiko akibat kerja di instalasi radiologi dan dampak radiasi terhadap pekerja radiasi. Jenis penelitian ini menggunakan metode diskriptif kualitatif dengan teknik pengambilan data observasi, wawancara, dan studi dokumentasi. Informan dalam penelitian ini berjumlah 6 orang diantaranya: satu kepala ruangan instalasi radiologi, dua radiografer, satu petugas proteksi radiasi, satu fisikawan medis, dan satu petugas K3 Rumah Sakit. Uji keabsahan data menggunakan teknik triangulasi sumber dan triangulasi teknik. Hasil analisis dari penelitian ini menunjukkan bahwa penerapan keselamatan radiasi belum dilakukan secara keseluruhan, dimana terdapat aspek yang tidak memenuhi standar peraturan BAPETEN seperti tidak dilakukannya pemantaun kesehatan sesuai ketetapan peraturan, tidak adanya pelatihan proteksi radiasi, kurangnya alat proteksi radiasi, tidak adanya surveymeter, kurang lengkapnya rekaman pelaksanaan kegiatan dan tidak adanya uji paparan potensial. Saran yang direkomendasikan adalah dilakukannya pemantauan kesehatan secara menyeluruh, diadakannya pelatihan proteksi radiasi bagi pekerja, penambahan alat proteksi radiasi, pengadaan surveymeter dan melengkapi rekaman pelaksanaan kegiatan di instalasi radiologi.

Kata Kunci :  Keselamatan, Radiasi Sinar-X, Radiologi, Rumah Sakit
ANALISIS INDEKS KEPUASAN MASYARAKAT DALAM PENERAPAN UNSUR-UNSUR PROGRAM INDONESIA SEHAT DI PUSKESMAS WILAYAH KERJA DINAS KESEHATAN KOTA PEKANBARU
Authors: Aisyah Yang Ma , Hartono Budi , Jepisah Doni
Published: July 2021

Program Indonesia Sehat dilaksanakan untuk meningkatkan derajat kesehatan masyarakat melalui upaya kesehatan dan pemberdayaan masyarakat yang didukung dengan perlindungan finansial dan pemerataan pelayanan kesehatan. Pelaksanaan program Indonesia Sehat diselenggarakan melalui pendekatan keluarga. Tujuan penelitian ini adalah untuk menganalisis kepuasan masyarakat dalam penerapan unsur-unsur program Indonesia sehat di Puskesmas Wilayah Kerja Dinas Kesehatan Kota Pekanbaru. Penelitian ini bersifat deskriptif korelasi dengan desain analytik cross sectional. Sampel penelitian sebanyak 346 responden dengan metode purposive sampling. Hasil analisis univariat menunjukkan nilai indeks kepuasan masyarakat dalam penerapan Program Indonesia Sehat di Puskesmas Wilayah Kerja Dinas Kesehatan Kota Pekanbaru  yaitu 3,014 dengan nilai konversi 75,36. Artinya Mutu Pelayanan yang diberikan pada pasien termasuk kategori B (baik). Secara statistic terdapat hubungan unsur-unsur pelayanan PISPK terhadap kepuasan masyarakat di wilayah kerja Puskesmas Kota Peknbaru Tahun 2019. Disarankan pada institusi perlunya peningkatan kualitas sumber daya manusia melalui program pelatihan dan seminar dalam rangkan peningkatan kompetensi dan kapasitas petugas.
Genetic Variance Components in Cotton by Generation Mean Analysis
Authors: Isong A. , Balu A. , Ahmed A. , Mbe J. O. , Mohammed I. G. , Isong C. , Vinothini N. , Gbadeyan S. T.
Published: July 2021

The mode of gene action for the expression of quantitative traits is decided by the predominance of variances due to additive, dominance and epistasis gene effects. In this experiment, involving four F1 crosses (TCH1716 x TCB37, TCH1705-101 x TCB209, KC2 x TCB26 and TSH0250 x DB3) of upland cotton, inheritance of major yield components by Generation Mean Analysis was investigated. The investigation revealed that both additive and dominance gene effects were involved in the expression of most of the yield contributing traits. One or more types of epistatic interaction effects were prevalent for all the characters and thus played a major role in the control of the characters. The inheritance of the traits was found to be complex in lieu of the low heritability estimates and genetic advance over mean. For seed cotton yield per plant, the dominance x dominance interaction effect was positively significant for all the crosses, the additive x dominance effect was positively significant only in cross 1 and the dominance main effect showed negative significant in all crosses. The dominance (h) and dominance x dominance (l) effects were of opposite signs in all the crosses indicating the presence of duplicate epistasis in all the crosses. To harness additive gene effects for improvement of some of the traits, breeding methods with postponement of selection to later generation should be adopted.
Gate Drives generating EMI in the absence of Power Converter loading
Authors: de Beer Arnold
Published: July 2021

This paper shows how
a power converter can generate electromagnetic interference (EMI) through the
operation of gate drives only - in the absence of any power conversion. This is
due to parasitic capacitances connecting the power semiconductor’s gate to the
main circuit. A half bridge converter is used to illustrate this concept.
Practical measurements are compared to simulations for an energized and
non-energized converter. Even without loading, a converter can exceed
regulatory conducted emission EMI limits. This effect is important to consider during
the design of converter EMI mitigation - especially for low power converters
where the load current is not dominant.
Voltage Controlled Domain Wall Motion based Neuron and Stochastic Magnetic Tunnel Junction Synapse for Neuromorphic Computing Applications
Authors: Lone Aijaz , Amara Selma , Fariborzi Hossein
Published: July 2021

The present work
discusses the proposal of a spintronic neuromorphic system with spin orbit
torque driven domain wall motion-based neuron and synapse. We propose a
voltage-controlled magnetic anisotropy domain wall motion based magnetic tunnel
junction neuron. We investigate how the electric field at the gate (pinning
site), generated by the voltage signals from pre-neurons, modulates the domain
wall motion, which reflects in the non-linear switching behaviour of neuron
magnetization. For the implementation of synaptic weights, we propose
3-terminal MTJ with stochastic domain wall motion in the free layer. We
incorporate intrinsic pinning effects by creating triangular notches on the
sides of the free layer. The pinning of domain wall and intrinsic thermal noise
of device lead to the stochastic behaviour of domain wall motion. The control
of this stochasticity
by the spin orbit torque is shown to realize the potentiation and depression of
the synaptic weight. The micromagnetics and spin transport studies in synapse
and neuron are carried out by developing a coupled micromagnetic
Non-Equilibrium Green’s Function (MuMag-NEGF) model. The minimization of
the writing current pulse width by leveraging the thermal noise and demagnetization
energy is also presented. Finally, we
discuss the implementation of digit recognition by the proposed system using a spike
time dependent algorithm.
How COVID-19 Lockdown Impacted on Mobility and Environmental data
Authors: Badii Claudio , Bellini Pierfrancesco , Bilotta Stefano , Daniele Bologna , Claudio Cenni , Difino Angelo , Ipsaro Palesi Alessandro , Mitolo Nicola , Nesi Paolo , Pantaleo Gianni , Paoli Irene , Paolucci Michela , Soderi Mirco
Published: July 2021

According to the COVID-19 lockdown and successive reopening a number of facts can be analysed. The main effects have been detected on: mobility and environment, and specifically on traffic, environmental data and parking. The mobility reduction has been assessed to be quite coherent with respect to what has been described by Google Global mobility report. On the other hand, in this paper a number of additional aspects have been put in evidence providing detailed aspects on mobility and parking that allowed us to better analyse the impact of the reopening on an eventual revamping of the infection, also taking into account of the Rt index. To this end, the collected data from the field have been compared from those of Google and some considerations with respect to the Imperial college Report 20 have been derived. For the pollutant aspects, a relevant reduction on most of them has been measured and rationales are reported. The solution has exploited the Snap4City IOT smart city infrastructure and data collector and Dashboard in place in Tuscany.
Analysis of the influence of risk factors on the development of complications after heart surgery
Authors:   Tyumen State Medical University, Tyumen, Sokolova V. V. , Shneider V. E. ,   Tyumen State Medical University, Tyumen, Burova T. E. ,   Tyumen State Medical University, Tyumen, Dorovikova A. V. ,   Tyumen State Medical University, Tyumen
Published: July 2021

Aim. To study the influence of risk factors on the development of complications in patients after heart surgery. Materials and methods. The study was carried out on the basis of the cardiac surgery department of the «OKB № 1», Tyumen. In the course of the work, a retrospective analysis of the results of cardiac surgery with sternotomy access was carried out on the basis of 469 case histories of patients in the period 2014-2020. Results. During the study, all patients were divided into 2 groups: patients with complications associated with access and without complications. As a result, a database of patients was created, on the basis of which a comparative analysis of 45 risk factors was carried out. Based on a comparative analysis, it was proved that in the development of postoperative complications, the leading risk factors among preoperative ones are diabetes mellitus, chronic obstructive pulmonary disease, obesity; among intraoperative risk factors, hemorrhage during surgery of more than 1000 ml is statistically significant. The number of resternotomies in history and the presence of risk factors affect the length of hospital stay and mortality after cardiac surgery. Conclusion. Timely diagnosis of concomitant diseases, their compensation and correction in the postoperative period affects and prevents the development of early postoperative complications. Careful hemostasis, a differentiated approach to osteosynthesis of the sternum after sternotomy reduce the risk of postoperative complications and the number of hospital stay days, which significantly reduces the economic costs of the hospital.
Clinical features of tuboovarial educations in the prepublic period (on the example of the clinical case)
Authors:   Tyumen State Medical University, Tyumen, Chernova A. L. , Lazarev I. P. ,   Novy Urengoy Central City Hospital, Novy Urengoy, Chernov I. A. ,   Tyumen State Medical University, Tyumen, Sazonova N. S. ,   Tyumen State Medical University, Tyumen, Makarsky O. V. ,   Novy Urengoy Central City Hospital, Novy Urengoy, Gudz M. E. ,   Novy Urengoy Central City Hospital, Novy Urengoy
Published: July 2021

Aim. To analyze the clinical features of subacute purulent salpingoophoritis, saktosalpinx, pyovar in a 9-year-old girl. Materials and methods. A retrospective analysis of the medical history of a patient born in 2001, who was treated in the gynecological department of the Novourengoy Central City Hospital, was carried out. Results. The article presents complaints, anamnesis of the disease and life, the results of a clinical, laboratory, and instrumental study of a 9-year-old girl who was admitted to the hospital in an emergency with a diagnosis of Tuboovarial formation of the left appendages. Mild anemia. According to urgent indications, diagnostic laparoscopy, ovariosalpingoviscerolysis on the left, salpingectomy on the left, drainage of the piovar on the left, and sanitation of the left ovarian cavity were performed. Postoperative diagnosis: Subacute purulent salpingoophoritis with the formation of sactosalpinx. Piovar on the left. Adhesive process of the small pelvis of the first degree. The analysis of the clinical features of the course of the disease, possible pathogenetic mechanisms of its development was carried out. Conclusion. The clinical picture of tubovarial formations in the prepubertal period can be characterized by an erased course and inconsistency of the clinical picture of the disease with the severity of the purulent-inflammatory process in the uterine appendages, which must be taken into account when conducting a diagnostic examination.
The prevalence of alexithymia among medical students. The relationship between alexithymia and somatic morbidity, the presence of bad habits and the level of academic performance
Authors:   Tyumen State Medical University, Tyumen, Kolpakova N. V. , Shestel A. I. ,   Tyumen State Medical University, Tyumen
Published: July 2021

Aim. To determine the prevalence and severity of alexithymia among medical university students. To assess the relationship between somatic pathology in students and academic performance. Material and methods. An anonymous standardized questionnaire survey of 130 students of the Tyumen State Medical University was conducted. The questionnaire is based on a Russian-language validated version of the 20-point Toronto Alexithymia Scale for quantifying alexithymia, including information about age, gender, concomitant psychosomatic diseases, unwanted habits, and self-assessment of academic performance. Results. Among the examined students, the frequency of alexithymia was 6,2%. The risk group for alexithymia included 12.3% of the surveyed students. Diseases of a psychosomatic nature (arterial hypertension, VSD, cephalgia, bronchial asthma, chronic skin diseases) were registered twice as often. Alexithymia is often combined with a number of undesirable habits, among which alcohol abuse, smoking, nail biting, and sweet drinking predominate. The relationship between the presence of alexithymia and reduced academic performance is determined. Conclusion. To reduce the negative impact of alexithymia on somatic and mental health, the effectiveness of training and personal development of students, it is necessary to conduct a systematic assessment of the level of alexithymia. When identifying alexithymia or its risk, use methods of psychotherapeutic correction.
Analysis of risk factors of falls and audit of fall prevention program in the multidisciplinary hospital
Authors:   Tyumen State Medical University, Tyumen, Lapik S. V.
Published: July 2021

Aim. To explore the organization of the activities of nurses in the prevention of falls and injuries of patients in the multidisciplinary hospital for compliance with the requirements of the quality management system. Materials and methods. Retrospective analysis of 1600 medical records of patients admitted to the surgical and therapeutic department of the multidisciplinary hospital, assessment of the risk of falls using the Morse scale, interviews of medical personnel, audit of the hospital using quality management system approaches. Results. Most of the patients in the hospital, despite of the profile, have a low and medium risk of falls, regardless of age, but due to the underlying disorders and concomitant diseases, as well as restrictions imposed by the disease, the presence of falls in the anamnesis. To assess the risk of falls in a medical organization for adult patients, it is advisable to use the Morse Fall Scale (MFS) in dynamics with fixation in the medical documentation in accordance with the adopted regulations. We have confirmed 70% compliance of the fall prevention program in the multidisciplinary hospital with the practical guidelines of Roszdravnadzor for the safety of medical care. Conclusions. In the context of limited resources, a differentiated approach to the prevention of falls in the medical organization will contribute to the decrease and absence of injuries.
Non-ST-segment elevation myocardial infarction: features of pathogenesis, diagnosis, interventions management
Authors:   Tyumen State Medical University, Tyumen, Kremneva L. V. ,   Regional Clinical Hospital No. 1, Tyumen, Stognii N. Y. ,   Tyumen State Medical University, Tyumen,   Regional Clinical Hospital No. 1, Tyumen, Suplotov S. N. ,   Tyumen State Medical University, Tyumen, Abaturova O. V. ,   Tyumen State Medical University, Tyumen, Shalaev S. V. ,   Tyumen State Medical University, Tyumen,   Regional Clinical Hospital No. 1, Tyumen
Published: July 2021

The literature review presents data about pathogenesis of non-ST-segment elevation myocardial infarction (non-STEMI), the characteristics of modern high-sensitivity troponin tests, invasive strategy management of patients with non-STEMI.
HIV epidemic situation in the penitentiary system of the Tyumen region
Authors:   Tyumen State Medical University, Tyumen, Kondratova S. E. , Marchenko A. N. ,   Tyumen State Medical University, Tyumen, Melnikova E. N. ,   Tyumen State Medical University, Tyumen
Published: July 2021

In the biggest Area of Ural Federal District with the high level of prevalence of HIV one of the leading roles in dynamics of epidemic is played by group of the population in which the consumers of injecting drugs, men having sexual contacts with men are most concentrated, workers of commercial sex is group of prisoners. Despite number of the held preventive actions, by the beginning of 2019 the prevalence HIV-infection among these special squads has reached the maximum indicator. Aims. Revealing the development of the epidemic process of HIV infection in the institution of the Federal Penitentiary Service of the Tyumen Region over a long period. Materials and methods. In work statistical data of GBUZ TO «The center for fight about AIDS» of Tyumen, Department of Rospotrebnadzor for the Tyumen region are used. Results. In the Tyumen region the number living with HIV has exceeded 1% of the population, and the prevalence rate infection was 1129.5 on 100 thousand population. Prisoners in places of detention enter into group of the increased risk of infection of HIV (cumulative share in structure of HIV-positive people – 24.4%). The maximum rate of gain of HIV infection among prisoners was +44.0%, minimum – 27.0%. Places of detention need to be considered as one of the main places with high probability of infection of HIV and its carrying out of limits of penal system. Conclusion. Intensity of epidemic process of HIV infection in places of detention are caused by conditions of restriction of freedom and prevalence of the population that demands optimization of system of preventive actions with participation of bodies of health care, services of execution of the punishment and social departments.
Ultramicroscopic structure of peyer’s patches in the rats’ small intestine after imunofan correction of experimental immunosuppression
Authors:   Belgorod State National Research University, Belgorod, Morozova Е. N. , Morozov V. N. ,   Belgorod State National Research University, Belgorod, Zabolotnaya S. V. ,   Belgorod State National Research University, Belgorod, Mikhailik T. A. ,   Belgorod State National Research University, Belgorod
Published: July 2021

Aim. To study the structure of Peyer’s patches at the ultramicroscopic level after the administration of imunofan against the background of experimentally modeled immunosuppression caused by the administration of cyclophosphamide. Materials and methods. The study was carried out on 36 white mature male rats, divided into 2 groups. The Group 1 included rats, which on the 1st day of the experiment were injected with cyclophosphamide at a dose of 200 mg/kg, and then imunofan according to the scheme on days 2, 4, 6, 8, 10 at a dose of 0.7 μg/kg of body weight. Group 2 was formed from rats, which were injected with an equivalent amount of isotonic sodium chloride solution. Animals of the Group 1 were Taken out from the experiment on the days 7 and 30 after the correction of cyclophosphamide-induced immunosuppression with imunofan. Pieces of Peyer’s patches were isolated and processed according to a standard technique. Ultrathin sections were contrasted in a solution of uranyl acetate and lead citrate according to E. Reynolds and studied under an electron microscope with further photographing. Results. It was found that lymphocytes, in most cases, are tightly adjacent to each other on the days 7 and 30 after the correction of cyclophosphamide-induced immunosuppression with imunofan; in the control group, the stroma is more often located between them. In the nucleus of these cells, heterochromatin is located in clumps and adjoins the nuclear membrane; in the control group, it fills two-thirds of the karyoplasm. The cells with patterns of mitosis, lymphoblasts are often found, macrophages contain large lysosomes on days 7 and 30 of experiment, compared with the control group of rats. In plasmocytes, the granular endoplasmic reticulum occupied up to 2/3 of the cell cytoplasm. The stromal component is well expressed in the control group of animals, compared with the experimental one, and is represented by reticulocytes, reticular fibers and vessels, and fibroblastic reticular cells are also found. Conclusion. In an ultramicroscopic study, the administration of the immunomodulator imunofan against the background of cyclophosphamide-induced immunosuppression promoted an increase in lysosomes in macrophages, lymphoblasts, cells with mitotic patterns, as well as the development of a granular endoplasmic reticulum on days 7 and 30 of the experiment, compared with the control group.
Implementation of distance education at a medical university: an analysis of student satisfaction
Authors:   Ural State Medical University, Yekaterinburg, Prokhorova O. V. , Lavrentyeva I. V. ,   Ural State Medical University, Yekaterinburg, Kovalev V. V. ,   Ural State Medical University, Yekaterinburg, Khramova M. D. ,   Ural State Medical University, Yekaterinburg
Published: July 2021

Aim. Assessment of satisfaction of students of a medical university with the quality of distance learning. Materials and methods. A comparative prospective non-interventional study was conducted in December 2020 – January 2021, which included 167 students of the medical and prophylactic and pediatric faculties of the Ural State Medical University. Anonymous survey, submitted using the Google Forms platform, included answers to 18 open-ended questions with a choice of one or more answer options. Statistical analysis of the survey results was carried out on the basis of a summary of responses from the Google Forms platform, and Fisher’s criterion was also determined for nonparametric data. Results. When comparing the results of the questionnaire survey of students of the Ural State Medical University, it was found that three quarters of the students as a whole quite effectively adapted to the new conditions of on-line education, there were no significant differences in these indicators. Conducting classes in the format of video lessons, on-line testing and individual assignments on specific topics turned out to be the most welcomed by students forms of communication with teachers. At the same time, among the additional advantages of distance learning, students noted the possibility of combining study and work, the flexibility of the educational process and conducting classes in a comfortable home environment.
Binary logistic regression is a model for prediction of pregnancy by the in vitro fertilization in women with tuboperitoneal infertility
Authors:   Tyumen State Medical University, Tyumen, Chekhova Yu. S. , Soloveva S. V. ,   Tyumen State Medical University, Tyumen, Antonova M. V. ,   Tyumen State Medical University, Tyumen, Lyubimceva O. A. ,   Tyumen State Medical University, Tyumen, Hanipova L. V. ,   Tyumen State Medical University, Tyumen, Ogoshkova N. V. ,   Tyumen State Medical University, Tyumen, Beltikova A. A. ,   Tyumen State Medical University, Tyumen
Published: July 2021

Predicting the onset of pregnancy by in vitro fertilization (IVF) in women with tuboperitoneal infertility is a pressing challenge of modern medicine. Aim: to develop a method for determining the chance of pregnancy by IVF in women with tuboperitoneal infertility, based on the analysis of physiological parameters, using the binary logistic regression. Materials and methods. The object of the study is clinically healthy women before pregnancy and in the first trimester after conception, women with tuboperitoneal infertility before entering the IVF and in the first trimester of gestation, and women with tuboperitoneal infertility and an unsuccessful IVF trial. We analyzed the state of the cardiovascular system and autonomic regulation, adaptive capabilities and height-weight indicators at the first stage of the study. The data were statistically processed using the Microsoft Office and Statistica10 software package. We used the binary logistic regression method to create a model for predicting pregnancy in the second stage. Results. Based on the physiological indicators obtained using logistic regression analysis a mathematical model was built – a formula for assessing the probability of non-pregnancy. Conclusion. The quality of prognosis of the binary logistic regression model was 97.2%. The model can serve as a method for predicting the onset of pregnancy by IVF in women with tuboperitoneal infertility. We recommend this method for use in the work of a practicing physician.
Incidence rate and specifics of the clinical course of herpesviral meningitis in children and adults according to regional clinical hospital for infectious diseases, city of Tyumen
Authors:   Tyumen State Medical University, Tyumen, Beltikova A. A. , Zasypkina A. A. ,   Tyumen State Medical University, Tyumen, Lyubimtseva O. A. ,   Tyumen State Medical University, Tyumen, Khanipova L. V. ,   Tyumen State Medical University, Tyumen, Orlov M. D. ,   Tyumen State Medical University, Tyumen, Ogoshkova N. V. ,   Tyumen State Medical University, Tyumen, Antonova M. V. ,   Tyumen State Medical University, Tyumen, Chekhova Y. S. ,   Tyumen State Medical University, Tyumen, Semenyuk E. N. ,   Regional Infectious Diseases Clinical Hospital, Tyumen, Antonyuk N. V. ,   Regional Infectious Diseases Clinical Hospital, Tyumen
Published: July 2021

Aim. The objective is to explore the incidence rate and the specifics of the clinical course of herpesviral meningitis in children and adults. Materials and methods. The post-hoc analysis of 23 patients’ records has been carried out. The patients were admitted to State Budgetary Healthcare Institution of the Tyumen Region, Clinical Hospital for Infectious Diseases, City of Tyumen, during the period of 2018-2019 diagnosed with meningitis of herpesviral etiology. When analysing the data the following aspects were taken into account: age, sex, etiological agent, complaints at admission, results of clinical examination and laboratory findings. Results. Twenty-three (23) cases of herpesviral meningitis were registered during the period of two (2) years; mixed infection was detected in every fifth patient. Epstein Barr viral meningitis was diagnosed in most cases and was detected 3.5 times oftener in adults than in children. Herpes Simplex Virus meningitis was the second one in terms of detection rate and it affected only adults. Varicella Zoster Virus meningitis was detected two times rarer than Herpes Simplex Virus and only in adults. The herpesviral meningitis caused by human herpes virus type 6 was detected with the same rate as Varicella Zoster meningitis but was registered among children only. Cytomegaloviral meningitis was detected in one adult who was affected by severe immune deficiency. Conclusion. The detected specifics of the incidence of the herpesviral meningitis with respect to a patient’s age will enable a practitioner to suggest the possible meningitis etiology and to prescribe appropriate treatment thus improving the prognosis for the disease.
Pneumonia as a cause of chronic kidney disease. Clinical case
Authors:   Tyumen State Medical University, Tyumen, Elfimov D. A. , Elfimova I. V. ,   Tyumen State Medical University, Tyumen, Besedina M. A. ,   City polyclinic No. 5, Tyumen
Published: July 2021

In recent years, there has been a change in the clinical picture of chronic kidney disease. Often the patient does not notice any of its manifestations. Identifying a diagnosis becomes an “accidental find.” This fact indicates the “insidiousness” of kidney disease. This was probably influenced by changes in treatment methods. Another problem is diseases that previously “did not cause” kidney pathology. It would seem that ordinary pneumonia does not cause significant disorders of kidney function, but recently, more and more often we see extracellular pathology as the main cause of the development of chronic kidney disease.
Some features of the course of arterial hypertension in patients undergoing a new coronavirus infection (COVID-19)
Authors:   Tyumen State Medical University, Tyumen, Elfimov D. A. , Elfimova I. V. ,   Tyumen State Medical University, Tyumen, Khamitova I. R. ,   Hospital for war veterans, Tyumen, Kutergina T. I. ,   Tyumen State Medical University, Tyumen
Published: July 2021

The aim of the study was to analyze the incidence of arterial hypertension among comorbidities in patients with coronavirus infection, to consider the effect of coronavirus infection on the course of cardiovascular diseases according to instrumental diagnostic methods. Materials and methods: theoretical (analysis and synthesis of studies on the problem); empirical (observation, interviews); methods of quantitative data processing. Results of the study. Based on the analysis of the literature, our own observation and management of patients with arterial hypertension who had new coronavirus infection (COVID 19), we can suggest that therapy with angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers should be continued and their withdrawal during the pandemic is not justified, since at present there are no compelling data to discontinue therapy with renin-angiotensin-aldosterone system blockers to prevent infection or Conclusion. To date, there is no proven theory about the role of the renin-angiotensin-aldosterone system and its blockers in the development of complications and outcomes of coronavirus infection, and drugs from the groups of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. Are still vital drugs that determine the prognosis for patients with arterial hypertension, chronic heart failure, coronary heart disease, for those with diabetes, and discontinuation of treatment can have extremely adverse effects, including increased mortality. And the group of patients with concomitant cardiovascular diseases, long-term recipients of drugs from the group of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, should be considered, “as a risk group requiring more careful monitoring of the condition” with confirmed SARS-CoV-2 infection.
ПРОБЛЕМЫ УКЛОНЕНИЯ ОТ УПЛАТЫ НАЛОГОВ В СОВРЕМЕННОЙ РОССИИ
Authors: Гадаев Р.В.
Published: July 2021

В статье объясняются подробности уклонения от уплаты налогов и квалификационных требований, связанных с незаконным возвратом НДС. Общие и различные характеристики по существу этих преступлений анализируются на основе существующих пробелов в целях совершенствования уголовного законодательства.