bluuebunny/crossref_metadata_2025 huggingface dataset:
Suitability of modified low carbon Roman cements for architectural restoration
Authors: Sanytsky Myroslav , Kropyvnytska Tetiana , Kotiv Roman , Bevz Mykola , Fic Stanislav
Published: June 2021

Article is devoted to the investigation of suitability of low carbon Roman cement for restoration and finishing works. The history of the development of Roman cement as a natural hydraulic binder, which was commonly used to decorate building facades in the 19th and early 20th centuries, is presented. The properties of mortars based on Roman cement make it an excellent product for architectural restoration and conservation, as they are characterized by fast setting, high porosity typical for lime mortars, high resistance to weather conditions, high initial strength. At the same time, due to the high surface activity and increased water demand for cement, with the age of hardening, shrinkage deformations can develop, which leads to the formation of main cracks on the surface of the products. It is shown that the addition of gypsum is an effective regulator of the setting time of Roman cement and contributes to an increase in the strength of the cement paste. Analogs of Roman cement based on multicomponent cement binders modified with plasticizing and air-entraining additives are presented.
Study of the influence of magnetized ferromagnetic additives on the processes of cement hydration
Authors: Sakhno Serhiy , Yanova Lyudmyla , Pischikova Olena , Liulchenko Yevhen , Sergiienko Tetiana
Published: June 2021

One of the essential tasks for a sustainable future is to reduce harmful emissions into the atmosphere significantly. Cement production is the world’s largest industrial carbon pollutant, accounting for 8 % of global emissions. More than 2.2 gigatons of carbon dioxide are emitted into the atmosphere every year. Therefore, reducing the energy intensity of products and reducing the number of harmful emissions in cement production is becoming critical. One strategy to reduce cement production emissions is to reduce the most energy-consuming component in cement – clinker. In this case, various activation methods are used for maintaining the same level of cement activity. One of these methods is the impact on the hardening binder with magnetic fields. The paper presented a study of hydration processes of blast-furnace cement activated by a magnetized ferromagnetic additive. The work established that the introduction of pre-magnetized ferromagnetic dust into blast-furnace cement composition has an activating effect on binder hydration. It shows that activation occurs both in the initial and long periods of hardening. The nature of the mutual influence of the components of the hydration system alite-lime-slag in a modified binder was revealed. The investigation determined that the ferromagnetic additive, intensifying the process of slag hardening, increases the proportion of hydrated slag by 1.5-2 times. It was revealed that the formation of the ettringite framework in the modified binder’s gel is completed within one day. It is shown that in the subsequent periods, hydration of aluminates occurs mainly due to the formation of tricalcium aluminate hexahydrate (C3AH6), which excludes destructive processes in the late periods of binder hardening. It has been established that under the action of a ferromagnetic additive, the degree of crystallization of hydro silicates in the modified binder increases.
Parameter analysis of non-metallic inclusion formation in thermite alloys
Authors: Skidin Ihor , Vodennikova Oksana , Vodennikov Sergii , Saithareiev Levan , Telkov Shamil
Published: June 2021

The methodology of calculating parameters of the primary and secondary non-metallic inclusion formation in thermite alloys is offered. The regularities of the growth time of non-metallic inclusion in the form of corundum depending on its size, mass and quantity are analysed. It is shown that in the thermite alloy obtained by self-propagating high-temperature synthesis, the average size of corundum inclusions, surrounding the heterogeneous inclusions of chromium carbide, is 15.4 μm. It is shown that during the process of aluminothermic reactions of the SHS process a significant number of small inclusions of corundum is formed. It is shown that the alumina particles are dissolved in the alloy and they are the centers of crystallization and play the role of inoculating modifier.
Relation between basic coal seam parameters and their gas saturation for Dobrudzha coal field, NE Bulgaria
Authors: Hristov Nikolay , Zaneva-Dobranova Efrosima , Meracheva Gergana , Dmytrenko Viktoriia , Vynnykov Yuriy
Published: June 2021

One of the main natural gas contained in the coal seams is methane. Most of it is adsorbed on the surface of the coal matrix, another is in free state in different in size and morphology pore spaces or dissolved gas in the waters that associate with the coal seams. The form of presence and the degree of gas saturation depends on the rank of the carbonization process, the petrophysical and physicochemical parameters of the environment. Methane in coal seams is accepted to be categorized as an unconventional energy resource. From this point of view, it is of interest in the Dobrudzha coal basin, located in the North-eastern part of Bulgaria. The specific geological conditions of the basin, the limited study, the presence of a thick covering aquifer make it difficult to extract coal by traditional methods. This requires the use of non-popular for the country methods for energy extraction and establishing relation between the basic parameters of coal seams and their gas saturation. The existing geological-geophysical, drilling and laboratory information is combined in a detailed petrophysical model, which extends over the best presented and studied coal seam (m5) from the field. The basic parameters that reflect the amount of adsorbed gas and are the subject of study are the content of moisture, carbon, ash and the degree of carbonization, expressed by the vitrinite and its reflectance.
Investigation of technogenic deposits of phosphogypsum dumps
Authors: Moshynskyi Viktor , Zhomyruk Ruslan , Vasylchuk Oleksandr , Semeniuk Vasil , Okseniuk Roman , Rysbekov Kanay , Yelemessov Kassym
Published: June 2021

The article contains research materials on the storage of man-made deposits, including phosphogypsum dumps. The consequences of long-term operation of phosphogypsum dumps and their negative impact on the environment have been established. The quantitative content of microelements to the soil within the storage of technogenic phosphogypsum deposit was determined. Graphical dependences of phosphorus, manganese, fluorine, mobile sulfur, zinc, nickel content depending on the depth of sampling and distance from phosphogypsum dumps to settlements and the Goryn River are presented. The directions of processing and utilization of the given waste are offered. The elemental composition of phosphogypsum dumps of PJSC "Rivneazot" has been established, in particular, the presence of a group of valuable rare earth elements.
Optimization of the drilling-and-blasting process to improve fragmentation by creating of a preliminary stress in a block
Authors: Yussupov Khalidilla , Myrzakhmetov Saifilmalik , Aben Khairulla , Nehrii Serhii , Nehrii Tetiana
Published: June 2021

At mining and processing complexes, many parameters today are evaluated from the point of view of the total process from geology to the final product. Changes in certain mining parameters inevitable lead to the changes in the following downstream processes. In this article, the focus is on the ore fragmentation, which is one of the most important parameters in many mines as it affects the downstream ore preparation and processing efficiencies, productivities and costs. In most of the cases, the cheapest way to improve the fragmentation of the ore is by changing the drilling-and-blasting design parameters. It of course increases the mining costs, but at the same time decreases the costs of the following processes, which are normally significantly higher. Therefore, authors of this article propose a new way of optimization of the drilling-and-blasting process by introducing new blast design modifications. Based on the analysis, research of the scientific information and the mining practise, the authors discuss the way of creation of the preliminary stress in the block of the open pit and hence improving fragmentation. Physical experimental blasts in “Belaya Gorka” open pit were performed and shown positive results reflecting a potential for continuation of the research in this direction in the future.
Determination of the parameters of local reinforced zones under the protection means
Authors: Nehrii Serhii , Nehrii Tetiana , Zolotarova Oksana , Aben Khairulla , Yussupov Khalidilla
Published: June 2021

In order to develop effective measures to ensure the operational condition of the development workings behind the face in the conditions of soft footwall rocks, the construction of local reinforced zones under the protection means has been proposed. The presence of such zones allows transferring the current load deep into the massif and creating a stable foundation under the protective structure. The results of researches concerning establishment of rational parameters of local reinforced zones with application of the method of finite elements, the method of experiment planning and the method of statistical processing of these results have been presented. The empirical dependence of the subsidence of the local reinforced footwall under the protection means on their load, deformation characteristics of the local reinforced zone and host rocks, width of protection means, strength of soft underlying rocks and geometric dimensions of the zone has been determined. The relative indicator of efficiency of local strengthening of a footwall which is used for determining of rational parameters of a locally reinforced zone has been offered.
Environmentally-efficient approaches to oil and gas producing sites
Authors: Liakh Mykhailo , Yatsyshyn Teodoziia , Gavryliv Svitlana , Gavryliv Yuriy , Shkitsa Lesia , Monkova Katarina , Monka Peter Pavol , Liakh Vasyl-Danylo
Published: June 2021

We have offered the investigations aimed at the design of eco-efficient technologies during oil and gas producing sites life cycle. The authors have conducted the analysis of conditions causing environmentally hazardous situations at oil and gas producing sites. We have established the necessity of quick maintenance of operation during emergencies that makes it possible to reduce material costs and environmental pollution. The increase of environmental safety in the process of winding up oil and gas wells emergencies that took place as a result of catching drilling string or some other pipe is crucial. We have analyzed different ways and various structural designs of the devices for pipe unscrewing from caught strings. We have established the ways of negative environmental impact reduction in the winding up emergencies at operating as well at stack oil and gas rigs. The recommendations regarding the structural design of the device are given. The device design is patented and the prototype model of the device is designed and manufactured. The device functions as the transformer of clockwise drilling string rotation into anticlockwise rotation of fishing tools. We have highlighted the positive effects after the implementation of the given device. We have noted the importance of innovative technologies design as well as the importance of forming adequate response skills during emergencies when wellsites are being constructed. The technical solutions and recommendations we have introduced make it possible to prevent negative environmental impact and reduce resource flows at different stages of wellsite life cycle.
Quantitative method for determining the solution error of the inverse problem in the electrometry of oil and gas wells
Authors: Myrontsov Mykyta , Karpenko Oleksiy , Horbulin Volodymyr
Published: June 2021

Determining the quantitative degree of connection between logging error and the corresponding error of oil and gas wells electrometry inverse problem solving is considered. A quantitative method to determine the magnitude of the error of solving the inverse problem depending on the magnitude of the logging error for a given model of a single layer or section as a whole is described. Examples of determining the error of the inverse problem for real well materials, taking into account the actual measurement error, are given. A method for determining the characteristics of the spatial resolution of electrometry methods is described. Examples of its use for low-frequency induction logging equipment are given. The proposed methods allow to determine the areas of equivalent solutions and the areas of existence of stable / unstable solutions of the inverse electrometry problem.
The essence and mechanisms of environmental competence formation in students of natural science departments
Authors: Romaniuk Ruslana , Antonova Olena , Sorochynska Oksana , Tsurul Olga , Sidorovich Marina
Published: June 2021

A comparative analysis of the ecological (environmental) educational component of the training in students of Natural Science Departments (Chemistry, Biology, Earth Sciences, Ecology) and future teachers of natural sciences has been carried out. The general and professional competences, program results of training, and applicants training educational programs on the example of several Ukrainian universities are analyzed. It is revealed that the formation of environmental competence is carried out by acquiring environmental education by means of interactive technologies, forms, and methods of organizing the educational process. The positive influence of students’ involvement in research, environmental, ecological, and naturalistic work in extracurricular time on the formation of their environmental competence has been confirmed. The role of educational and industrial practices in the process of students’ professional training and the formation of their environmental competence is emphasized.
Human factor in emergency occurrence at NPP during the pandemic COVID-19: new potential risks and recommendations to minimize them
Authors: Popov Oleksandr , Iatsyshyn Anna , Molitor Norbert , Iatsyshyn Andrii , Romanenko Yevhen , Deinega Iryna , Sharov Petr , Mnayarji Gabriel
Published: June 2021

COVID-19 pandemic is an emergency that spread across the planet. It threatens lives and health of the population, with many dead and injured. Also, during pandemic there was (and continues to be) a violation of normal living conditions, significant material damage to economies of different countries. Quarantine restrictions affected social, educational, cultural and spiritual spheres of society. There is an urgent threat to operation of critical infrastructure as the pandemic led to large numbers of hospitalized or self-isolated people and being treated at home. At present, the operation of critical infrastructure, and in particular nuclear power plants, is strategically important for the proper functioning of any country. Also, the research describes causes of emergencies at nuclear power plants and identifies another factor - the mass disease of NPP personnel or their relatives on COVID-19. It is determined that timely detection and appropriate work to restore mental health during the pandemic is no less important area of work along with providing medical care to population. Stress associated with uncertainty, threat to health, can have negative consequences for well-being and mental health of workers. Depression, emotional exhaustion, anxiety, irritability, suicidal thoughts, etc. can also be consequences. Socio-psychological support especially for critical infrastructure workers is important to promote mental health during COVID-19 pandemic. Recommendations for socio-psychological support of NPP personnel were developed. Specialized mobile applications are described as convenient and economical way for primary psychological care.
Mechanisms for ensuring the environmental safety of tourist destinations
Authors: Pobihun Olena , Korobeinykova Yaroslava , Nykodiuk Olha , Melnyk Andriy
Published: June 2021

Modern tourism is a sector of the economy that is developing very fast, for the last 10 years the growth was 25%. According to UNEP and the WTO, tourism is seen as a growing sector in contrast to the manufacturing sector. According to experts, the growth rate of the tourism industry will remain high, although global and regional structures of tourism change over the years (in recent years due to terrorism, the development of various diseases, natural disasters, pandemics, etc.). In 2019, about 1,500 million international trips were made. The same data indicate that the growth of tourism is due to developing countries. In countries with weak regulation of the market economy, tourism development can become a real threat to the quality of the environment. Therefore, the further development of tourism, in general, is possible only through its greening and finding a balance between economic and social development, taking into account environmental factors.
Modern means of assessing the impact of emergencies on the environmental condition of the ground layer of atmosphere
Authors: Turevych Anastasiia , Madzhd Svitlana , Cherniak Larysa , Pavlyuk Anatoliy , Ojeh Vincent
Published: June 2021

The problem of emergencies will not leave humanity as long as it exists, and therefore it is necessary to at least create conditions under which it is possible to reduce the risks of injuries, diseases and deaths of people who are in the emergency zone. This can be achieved by raising awareness of the nature of the emergency, the hazardous substances that are released in connection with it. Theoretical analysis of various remote means of assessing the impact of emergencies of man-made areas on the ecological state of the atmospheric air of the surrounding areas. It has been found that the use of remote sensing equipment greatly simplifies the procedure of operational monitoring of the environment during emergencies, as well as contributes to the health of professionals. A comparison of different remote means of environmental monitoring of air quality was performed: In particular, stationary automatic stations, mobile automatic stations, probes, and unmanned aerial vehicles (UAVs) were compared. It is proposed to use UAVs as remote means of operational monitoring of air quality. The functional scheme of UAV system implementation for the needs of operative ecological monitoring is offered. The legal features of the use of unmanned aerial vehicles as remote means of monitoring air quality during emergencies are analyzed.
Effect of liquid glass type on hygienic characteristics of coated electrodes for arc welding of tin bronzes
Authors: Levchenko Oleg , Bezushko Olga , Maidanchuk Taras , Lukianenko Anna , Goncharova Olga , Bajic Darko , Veljic Darko
Published: June 2021

The results of investigations of chemical composition and emission rates of the welding fume, generated during welding using electrodes for copper alloys, are presented with the aim of improvement of their sanitary and hygienic characteristics. It is shown that in order to create new grades of welding electrodes with improved hygienic characteristics, it is necessary to have the data of the initial sanitary and hygienic evaluation in accordance with international standards. It was established that the use of binder based on pure lithium liquid glass in the coating of electrodes for welding copper alloys, increases the rate of welding fume emission into the air, as well as the content of manganese and copper oxides in it. The minimum rates of harmful emissions were recorded during the use of sodium-potassium binder, which is recommended for mass production of this type of electrodes.
Quality of drinking water in rural areas: problems of legal environment
Authors: Yermolenko Volodymyr , Hafurova Olena , Deineha Maryna , Novak Tamara , Temnikova Alena , Naidansuren Erdene
Published: June 2021

The article is devoted to the scientific and theoretical analysis of the current state of legal provision of drinking water quality in rural areas. It was stated that in recent years there has been a steady trend of deteriorating quality of water used for drinking in rural areas, including due to increasing levels of nitrate pollution. Proposals have been made for: further implementation of Council Directive 98/83 / EU on the quality of water intended for human consumption and Council Directive 91/676/ EEC on the protection of waters against pollution caused by nitrates from agricultural sources in national legislation; elimination of substantive inconsistencies between State sanitary norms and rules 2.2.4-171-10 “Hygienic requirements for drinking water intended for human consumption” and National Standards of Ukraine 7525: 2014 “Drinking water. Requirements and methods of quality control “in terms of drinking water quality indicators; inclusion in the subjects of state water monitoring of the central executive body that implements the state policy in the field of health care (regarding the monitoring of drinking water); development of the Procedure for state monitoring of nitrate content in surface and groundwater as a component of state water monitoring; forecasting at the level of the National Target Program “Drinking Water of Ukraine” for 2021-2025 “development and operation of a single state information resource - Interactive map of drinking water quality in Ukraine.
Optimization of dose calculation of modified magnetite during sorption purification of water from copper ions to create environmentally friendly technology
Authors: Trus Inna , Gomelya Mukola , Chuprinov Evhen , Pylypenko Tetiana
Published: June 2021

Due to the growth of man-caused pollution, there is a need to use modern methods of water purification. It is advisable to use sorption methods for the extraction of heavy metals, which are considered to be particularly dangerous. It is established that sorbents based on magnetite are quite effective in the extraction of copper ions. It is shown that the sorption capacity of magnetite-based sorbents towards copper ions depends on the ratio of concentrations of Fe2+and Fe3+ions in the reaction mixture, and increases with increasing this indicator from 1/2 to 2. The sorption capacity of the sorbent towards copper ions increases by 4.4 times. It is shown that the efficiency of copper ions removal onto magnetite increases for sorbent modified with sodium sulfide. The proposed scheme provides the possibility of sorption treatment of large volumes of water from copper ions to the norms for the discharge of wastewater into fishery reservoirs. Post-productional magnetite is dehydrated and supplied to metallurgical enterprises for processing. The developed technology of water purification from copper ions is environmentally safe and energy efficient.
Principles of creating a system of sustainable water use in Ukraine
Authors: Kovshun Nataliia , Savina Nataliia , Diallo Mamadou Alouma , Kushnir Nina , Zhiwei Dong , Zoshchuk Vitalii
Published: June 2021

This research focuses on the problem of water supply, and its solution requires scientific and practical approaches in environmental, engineering, economic and other fields. Practical recommendations to create an integrated water use system in Ukraine are based on the delimitation of its target subsystems. Special attention is paid to an integrated approach to water resources management, identification of key issues, clear conceptual modeling, strategy development, and production of ‘useful’ scientific information. It is important to study the role of coordinating government bodies in the field of water space monitoring. In particular, this mechanism involves the development of national program for monitoring the aquatic environment, the formation of budgets of all bodies and institutions; search for additional sources of funding and organizational methods. An important tool for improving the state of water resources is the implementation of international environmental standards and conventions. These strategic decisions are entrusted to the Ministries of Environment and other governing bodies. The use of software products generate significant amounts of data accumulated in various information banks. The main direction of the study is the concentration of information data in one key database. It will provide clear assess to the data aquatic environment and make analytical studies.
Features of forming the salt balance in rice fields with various parameters and designs of the Danube rice irrigation systems
Authors: Turchenyuk Vasyl , Rokochinskiy Anatoliy , Prykhodko Nataliia , Volk Pavlo , Meshyk Oleh
Published: June 2021

Ecological-reclamation state of rice irrigation systems harvest of cultivated crops determined by a number of factors, including natural (soil, topographical, hydrogeological, climatic factors) and technological (irrigation norm, designs and parameters of irrigation and drainage networks, etc.) factors. One of the main factors influencing the formation of rice yield which is traditionally grown by flooding technology is the efficiency of the rice irrigation system’s design. Construction features of irrigation fields and their parameters (distances between the drains, depth of the drainage network) affect the intensity of the processes of salinization of soils and groundwater. Analysis of the components of salt balances of rice fields with different parameters and designs on example of the Danube rice irrigation systems showed that fields with the distances between the drains from 200 to 250 m have significant advantages over Krasnodar-type fields with the same parameters and over fields with 500 m distance between the drains creating optimal salt regime for rice and, accordingly, obtaining higher yields of rice. As on the card-checks with drainage with the distances between the drains 500 m uniform desalinization of soils on all area cannot be reached and yield of rice on them is close to 20 c/ha such card-checks with drainage must be converted into card-checks with drainage with the distances between the drains 250 m.
Environmental and economic assessment of the possibilities to increase the land preservation level in terms of open-pit mining
Authors: Babets Yevheniy , Terekhov Yevheniy , Mormul Taras , Melnikova Iryna , Komirna Vitalina
Published: June 2021

Conditions of the planning of open-pit mining objects have been identified, making it possible to reduce the need in the allotted land area during mineral extraction. The research results have allowed proposing a methodological approach to determine economic expediency of the increase in the technogenic land reclamation level under conditions of open-pit mining, being the reserves to expand the technogenic land areas returned to the economic use.
Challenges of sustainable and equal development of regions in Georgia
Authors: Gechbaia Badri , Kharaishvili Eteri , Mushkudiani Zurab , Goletiani Ketevan , Tsilosani Amiran
Published: June 2021

In the present paper is analysed opinions about the tools for sustainable development and the ways to reduce inequality. Has been estimated the importance of regional development programs and strategies as the settlement of the economic and social issues, provided proof of their role in the effective development of regional economic policy. Has been determined the concentration level of economic activity by regions using distribution index to estimate equal development of regions. Has been made the conclusion that none of the regions of Georgia is notably specialized. The concentration level of business sectors in regions is substantiated by the distribution curve. In distribution curve was considered retail and wholesale distribution, as an example of maximally near to ideal distribution. It is proved by the analysis of distribution of curves, that the concentration level of business sectors in Georgian regions is quite unequal and none of them could be highlighted in industry specialization. The paper identifies the problems related to sustainable and equal development of regions, provided conclusions and recommendations to settle the mentioned issue by their estimation. In the process of study has been determined the factors of endogenous development of regions and advisable to improve the quality and efficiency of regional development institutions through the development of trial-programs for regional development.
Status quo palliativmedizinischer Tageskliniken und Tageshospize in Deutschland: Ergebnisse einer gemischt-methodischen Studie
Authors: Apolinarski Beate , Herbst Franziska A. , Röwer Hanna A. A. , Schneider Nils , Stiel Stephanie
Published: June 2021

Ziel der Studie Der Bestand von Tageshospizen und palliativmedizinischen Tageskliniken in Deutschland soll erstmals systematisch erhoben und analysiert werden.

Methodik In dieser gemischt-methodischen Studie wurden Einrichtungsleitungen in leitfadengestützten Interviews (06.–07.2020) und standardisierter Fragebogenerhebung (08.–10.2020) zu einrichtungsbezogenen Kriterien befragt. Interviewdaten wurden qualitativ inhaltsanalytisch, quantitative Daten deskriptiv ausgewertet.

Ergebnisse Die Interviews (n = 7) liefern einen Überblick über Organisation und Versorgungsangebot hospizlich-palliativer Tageseinrichtungen. Von 28 standardisiert befragten Einrichtungen waren 13 bereits in Betrieb. Die zumeist an andere Versorger angebundenen Einrichtungen bieten in der Regel zwischen 2 und 8 Tagesplätze an.

Schlussfolgerung Aufgrund der gezeigten Entstehungsdynamik scheint eine systematische Integration der neuen Strukturen in die bestehende Hospiz- und Palliativversorgung sinnvoll.
Evaluating the Green Credentials of Flow Chemistry towards Industrial Applications
Authors: Baumann Marcus , Smyth Megan , Moody Thomas S. , Wharry Scott
Published: June 2021

Continuous flow chemistry is becoming an established technology platform that finds frequent application in industrial chemical manufacture with support and endorsements by the FDA for pharmaceuticals. Amongst the various advantages that are commonly cited for flow chemistry over batch processing, sustainability continues to require further advances and joint efforts by chemists and chemical engineers in both academia and industry. This short review highlights developments between 2015 and early 2021 that positively impact on the green credentials associated with flow chemistry, specifically when applied to the preparation of pharmaceuticals. An industrial perspective on current challenges is provided to whet discussion and stimulate further investment towards achieving greener modern synthetic technologies.

1 Introduction

2 Subject Areas and Relevant Case Studies

3 Industrial Outlook on Future Sustainability Driven through Continuous Manufacturing Approaches

4 Conclusions and Outlook
Efficacy and Safety of Antifibrinolytic Drugs in Pediatric Surgery: A Systematic Review
Authors: Hovgesen Nadia Thrane , Larsen Julie Brogaard , Fenger-Eriksen Christian , Hansen Anne Kirkeby , Hvas Anne-Mette
Published: June 2021

Antifibrinolytic drugs are used to reduce blood loss and subsequent transfusions during surgery and following trauma, but the optimal dosing regimen in the pediatric population is still unresolved. The aim of this systematic review was to evaluate efficacy and safety of antifibrinolytic drugs in pediatric surgery and trauma to determine the optimal dosing regimen. A literature search was performed in PubMed, Embase, Cochrane, and Web of Science on May 3, 2020. We included randomized controlled studies investigating the effect of tranexamic acid (TXA), aprotinin, and epsilon-aminocaproic acid, in terms of reducing blood loss, blood transfusions, reoperations, and rebleeds in pediatric patients aged 0 to 18 years undergoing cardiac surgery, noncardiac surgery, or trauma. Fifty randomized controlled trials (RCTs) were included; 28 RCTs investigated cardiac surgery and 22 investigated noncardiac surgery. No RCTs regarding trauma met the inclusion criteria. All antifibrinolytic drugs reduced postoperative blood loss and transfusions when used in pediatric surgery. The dosing regimen varied between studies, but similar effect sizes were found in terms of reduced blood loss regardless of the cumulative dose used. Few studies found adverse events, and no difference in incidence or type of adverse events was seen between the antifibrinolytic and the placebo group. In conclusion, use of antifibrinolytics is efficient and safe in children undergoing surgery. We propose TXA as the drug of choice based on its level of evidence and safety profile; we recommend a dosing regimen composed of a loading dose of 10 to 15 mg/kg prior to surgery followed by 1 to 5 mg/kg/h as continuous infusion throughout surgery.
New Classification of Gastric Varices: A Twenty-Year Experience
Authors: Singh Akash , Verma Nipun , Rathi Sahaj , Kumari Sunita , Chandel Shivani , Singh Virendra
Published: June 2021

Objectives Gastric varices (GV) have been classified by the Sarin classification for over two decades. However, a subset of these varices does not fit into this classification. We share our experience on GV in past 20 years and propose a modification.

Materials and Methods Consecutive patients with portal hypertension (PHT) posted for esophagogastroduodenoscopy were screened for GV between 1996 and 2016 at a tertiary-care hospital. GV were categorized as gastroesophageal varices (GOV1, GOV2) and isolated gastric varices (IGV1, IGV2) by Sarin’s classification. Patients with varices in esophagogastric region as well as distally in the stomach or duodenum, thus having efferent drainage into the superior as well as inferior vena cava simultaneously, remain unclassified and were coined as GOV3.

Statistical Analysis Descriptive data was represented as mean (standard deviation) or median (interquartile range) or number (percentage). Chi-squared test, t-test, and logistic regression were done to compare groups and identify outcomes of interest.

Results GV were recognized in 400 (11.5%) of 3,476 patients with PHT. Underlying disease was cirrhosis in 301 (75.2%), extrahepatic portal venous obstruction in 78 (19.5%), noncirrhotic portal fibrosis in 18 (4.5%) and Budd–Chiari syndrome in 3 (0.75%) patients with GV. GOV1, GOV2, IGV1, IGV2, and combined GOV1 with GOV2 were seen in 170 (42.5%), 154 (38.5%), 17 (4.3%), 5 (1.3%), and 12 (3.0%) patients; respectively. GOV3 were identified in 42 (10.5%) patients. Ninety-three patients with GV presented with gastrointestinal bleed and frequency of GOV2 was higher and GOV1 and GOV3 were lower among bleeders than non-bleeders.

Conclusions A significant proportion of patients with GV remain uncategorized by current classification among PHT patients. Addition of GOV3 in Sarin’s classification will make it more comprehensive, uniform, and reproducible for future studies.
Hypomyelination and Congenital Cataract: Clinical, Imaging, and Genetic Findings in Three Tunisian Families and Literature Review
Authors: Bouyacoub Yosra , Drissi Cyrine , Kraoua Ichraf , Chargui Mariem , Rebai Ibtihel , Chebil Ahmed , Klaa Hédia , Benrhouma Hanene , Hassen Aida , Gouider-Khouja Neziha , Abdelhak Sonia , Boespflug-Tanguy Odile , Youssef-Turki Ilhem Ben , Dorboz Imen
Published: June 2021

Hypomyelination and congenital cataract (HCC) is characterized by congenital cataract, progressive neurologic impairment, and diffuse myelin deficiency. This autosomal recessive disorder is caused by homozygous variant in the FAM126A gene. Five consanguineous Tunisian patients, belonging to three unrelated families, underwent routine blood tests, electroneuromyography, and magnetic resonance imaging of the brain. The direct sequencing of FAM126A exons was performed for the patients and their relatives. We summarized the 30 previously published HCC cases. All of our patients were carriers of a previously reported c.414 + 1G > T (IVS5 + 1G > T) variant, but the clinical spectrum was variable. Despite the absence of a phenotype–genotype correlation in HCC disease, screening of this splice site variant should be performed in family members at risk.
Iatrogenic Intracranial Hypotension after Surgery of Adolescent Idiopathic Scoliosis due to a Misplaced Screw within the Thoracic Thecal Sac
Authors: Heiler Ute , Pitzen Tobias , Ruf Michael
Published: June 2021

We present the case of a postoperative intracranial hypotension due to a misplaced intrathecal screw. Although typical symptoms such as orthostatic headache were present immediately after surgery, diagnosis was hidden until 20 years later, resulting in a disastrous clinical course.
Versatile Usage of the Modified Lateral Mass Screw as an Alternative to Cervical Pedicle Screw Fixation
Authors: Kim Moon-Kyu , Lee Jung-Jae , Cho Su-Hee , Kwak Dai-Soon
Published: June 2021

Objective Posterior subaxial cervical screw fixation is commonly performed using the cervical pedicle screws (CPS) and lateral mass screws (LMS); however, their compatibility is low. Modified lateral mass screws (mLMS, also called paravertebral foramen screw) fixation was introduced as a salvage technique for LMS fixation and has features of both LMS and CPS techniques. In the present study, the use of mLMS as an alternative to CPS was analyzed based on clinical results.

Methods Seventy-eight screws (38 CPSs and 40 mLMSs) were inserted into 12 patients. The misplacement of the screws was evaluated by computed tomography (CT). The failure of instrumentation and instability were evaluated using plain radiographs.

Results The total number of CPS misplacements was 3 (10.5%); however, neurologic complications were not observed. mLMSs were used in the middle segments of the fusion in 10 patients and 2 patients had mLMS fixation for single-level fusion. An additional bridging implant was not required for connecting both CPSs and mLMSs. Instability was not observed during the observation period (4–51 months). Complete fusion was seen in 10 patients.

Conclusions The alternative mLMS fixation can decrease the risk of screw misplacement compared with CPS fixation alone and achieves adequate stability leading to fusion.
Role of Covering Ileostomy in Causation of Anastomotic Strictures in Low Anterior Resections for Rectum Carcinoma
Authors: Khan Mudassir Ahmad , Wani Rauf A. , Mehraj Asif , Baba Arshad , Laway Mushtaq , Chowdri Nisar A. , Parray Fazl Q.
Published: June 2021

Background Colorectal resection anastomosis is the commonest cause of rectal strictures. Anastomotic site ischemia, incomplete doughnuts from stapled anastomosis and pelvic infection, are some of the risk factors that play a role in the development of postoperative rectal strictures. However, the role of diverting stoma in the development of rectal strictures has not been studied extensively.

Objectives To study the difference in the occurrence of anastomotic strictures (AS) in patients submitted to low anterior resection (LAR) with covering ileostomy (CI), and to LAR without CI for carcinoma rectum.

Methods This was a prospective, comparative case control study carried out at a tertiary care referral center. Low anterior resection with covering ileostomy was performed in patients with rectum carcinoma in the study group, while LAR without covering ileostomy was performed in the control group. The study group had 29 patients, while the control group had 33 patients with rectum carcinoma.

Results During the mean follow-up period of 9.1months, 8 (28%) patients in the study group and 2 (6%) patients in the control group developed AS (p =0.019). Out of these 8 patients with AS in the study group, 50% had Grade-I AS, 25% had Grade-II AS, while 25% of the patients had Grade-III (severe) AS. However, both patients who developed AS in the control group had a mild type (Grade I) of AS.

Conclusion Covering ileostomy increases the chances of AS formation after LAR for rectum carcinoma. Also, the SKIMS Clinical Grading of Rectal Strictures is a simple and handy tool available for every surgeon to grade, classify and monitor the postoperative rectal strictures.
Peristomal Dermatitis: Treatment with Green Banana Peel (Musa sapientum) Powder
Authors: da Silva Ana Cristina , Simões Isabella Stephanie , Salomé Geraldo Magela , Atzingen Dênia Amélia Novato Castelli von , Mendonça Adriana Rodrigues dos Anjos
Published: June 2021

Objective To develop green banana peel (Musa sapientum) powder for the treatment of peristomal dermatitis, and to evaluate its effectiveness and healing time.

Methods A clinical, analytical and longitudinal study. In total, 44 volunteers of both genders, aged > 18 years, with intestinal ostomy, who presented peristomal dermatitis, participated in the research. The sample was divided into two groups: the study group used a powder containing 10% of green banana peel, and the control group used ostomy powder. The research was approved by the Ethics in Research Committees (Comitês de Ética em Pesquisa, CEP, in Portuguese) under opinion n° 2.381.904.

Results The healing time of the study group was shorter than that of the control group (p = 0.022). To analyze the results, we used the two-sample t-test (mean days until healing for both study groups).

Conclusion The powder containing 10% of green banana peel was developed, and effective healing of the peristomal dermatitis was observed. Compared to the ostomy powder, it presented a shorter healing time.
Ovarian Metastasis from Colorectal Adenocarcinoma
Authors: Fillmann Lúcio Sarubbi , Fillmann Henrique Sarubbi , Fillmann Laura Pinho , Tubiana Ana Paula Reginatto , Ribeiro Raquel , Coelho Mariana
Published: June 2021

Introduction Ovarian metastases of gastrointestinal origin, also called Krukenberg tumors, have a guarded prognosis. Physicians need to look for alternatives in diagnosis and treatment for this clinical condition in order to improve the outcome of the patients.

Objectives To report the experience of the authors in the treatment of these patients, and to perform a review of the literature on the epidemiology, clinical presentation, diagnosis, treatment, and prognosis for ovarian metastases from colorectal cancer.

Methods We collected clinical information regarding the patients treated for ovarian metastasis from colorectal adenocarcinoma at our coloproctology service, and performed a search on the PubMed database using the terms colorectal cancer, ovarian metastasis, Krukenberg tumor and surgery.

Conclusion Large abdominal tumors are the most frequent presentation of ovarian metastasis from colorectal cancer. The diagnosis is based on a histopathological analysis, levels of carcinoembryonic antigen (CEA) and cancer antigen 125 (CA-125), and immunohistochemical studies for the cytokeratin 20 (CK20), caudal-type homeobox 2 (CDX2) and vilina markers. Citoreductive surgical procedures are the most promising approach to treatment, with the highest impact on overall survival. The prognosis is negatively influenced by the extent of the metastasis, by citoreductive surgical procedures with persistence of macro- or microscopic foci of the disease, and by low scores on the general well-being index of the patient.
Obstructive Jaundice Following Transarterial Chemoembolization for Hepatocellular Carcinoma with Bile Duct Invasion
Authors: Matsushita Kazuki , Kageyama Ken , Kameda Natsuhiko , Koizumi Yurina , Yamamoto Akira
Published: June 2021

Hepatocellular carcinoma (HCC) with bile duct invasion is considered rare. A case in which a fragment of intraductal tumor dropped into the common bile duct after transarterial chemoembolization (TACE) and caused abdominal pain, and obstructive jaundice secondary to biliary obstruction is presented. This case was successfully managed by emergent endoscopic sphincterotomy. Physicians should recognize one of the complications due to TACE for HCC with intraductal tumor invasion.
Management of Neurological Emergencies in Children: An Updated Overview
Authors: Mastrangelo Mario , Baglioni Valentina
Published: June 2021

Neurological emergencies account for about one-third of the highest severity codes attributed in emergency pediatric departments. About 75% of children with acute neurological symptoms presents with seizures, headache, or other paroxysmal events. Life-threatening conditions involve a minor proportion of patients (e.g., less than 15% of children with headache and less than 5% of children with febrile seizures). This review highlights updated insights about clinical features, diagnostic workup, and therapeutic management of pediatric neurological emergencies. Particularly, details will be provided about the most recent insights about headache, febrile seizures, status epilepticus, altered levels of consciousness, acute motor impairment, acute movement disorders, and functional disorders, as well as the role of diagnostic tools (e.g., neuroimaging, lumbar puncture, and electroencephalography), in the emergency setting. Moreover, the impact of the current novel coronavirus disease2019 (COVID-19) pandemic on the evaluation of pediatric neurologic emergencies will also be analyzed.
Neuroimaging Spectrum of Severe Hypernatremia in Infants with Neurological Manifestations
Authors: Saini Arushi Gahlot , Vyas Sameer , Kaur Amrit , Singh Prabhjyot , Jayashree Muralidharan , Sundaram Venkataseshan , Mukhopadhyay Kanya , Singh Paramjeet
Published: June 2021

Background Variable neurological manifestations and imaging findings have been described in children with severe hypernatremia. We aimed to describe the spectrum of neuroimaging changes in infants with severe hypernatremia.

Methods This retrospective study included infants with severe hypernatremia (serum sodium >160 mEq/L), abnormal neurological examination, and an abnormal magnetic resonance imaging (MRI) of the brain over a period of 2 years in a tertiary care hospital. Relevant clinical data, including the feeding practices, clinical features, complications, and biochemical and radiological parameters, were entered in a structured pro forma. MRI findings were classified as vascular (hemorrhages and cerebral sinus venous thrombosis), osmotic demyelination syndrome (pontine and extrapontine myelinolyses), and white matter changes.

Results The common clinical features in the neonates were poor feeding (n = 4) and decreased urine output (n = 4); the older infants presented with gastrointestinal losses (n = 5). All cases had dehydration with encephalopathy. The patterns of radiological injury were vascular (hemorrhages, n = 5 and venous thrombosis, n = 3), osmotic demyelination (n = 8), and white matter changes (n = 7). Coagulopathy was correlated with the vascular complications (r = 0.8, p < 0.0001); the degree of dehydration was correlated with the venous thrombosis (r = 0.7, p < 0.04) and acute kidney injury (r = 0.8, p < 0.001). Neurological sequelae were seen in four cases and correlated with hypernatremia (r = 0.6, p = 0.03) and hyperosmolarity (r = 0.6, p = 0.03).

Conclusion Characteristic neuroimaging findings are vascular changes in the form of venous thrombosis and hemorrhages, osmotic demyelination and white matter tract injury, and/or mostly combinations of these findings. Severe hypernatremia and resulting hyperosmolarity frequently cause neurological sequelae in neonates and infants.