bluuebunny/crossref_metadata_2025 huggingface dataset:
Overcoming Formation Evaluation Challenges in Highly Deviated Jurassic Wells with LWD and Advanced Mud Logging Services
Authors: Al-Azmi Mejbel Saad , Al-Otaibi Fahad , Kumar Joshi Girija , Tiwary Devendra , Al-Ashwak Samar , Dzhaykiev Bekdaulet , Shinde Neha , Hardman Douglas , Noueihed Rabih , Gadkari Shreerang
Published: September 2019

The complex nature of the reservoir dictated comprehensive formation evaluation logging that was typically done on wireline. The high angle designed for maximum reservoir exposure, high temperature, high pressure (HTHP), differential reservoir pressure and wellbore stability challenges necessitated a new approach to overall formation evaluation. The paper outlines Formation Evaluation strategy that reduced risk, increased efficiency and saved money, while ensuring high quality data collection, integration and interpretation.

After review of all risks, a decision to utilize Managed Pressure Drilling (MPD) for wellbore stability, Logging While Drilling (LWD) to replace wireline and Advanced Mudlogging Services was implemented. The Formation Evaluation team utilized LWD resistivity, neutron, density and nuclear magnetic resonance logs supplemented with x-ray diffraction (XRD), x-ray fluorescence (XRF) and advanced mud gas analysis to ensure comprehensive analysis. The paper outlines workflows and procedures necessary to ensure all data from LWD, XRF, XRD and mud gas are integrated properly for the analysis.

Effects of Managed Pressure Drilling on mud gas interpretation as well as cuttings and mud gas depth matching are addressed. Depth matching of all data, mud gasses, cuttings and logs are critical for detailed and accurate analysis and techniques are discussed that ensure consistent results. Complex mineralogy due to digenesis and effect of LWD logs are evident and only reconciled by detailed XRF and XRD data. The effects of some conductive mineralogy are so dramatic as to infer tool function compromise. The ability to determine acceptable tool response from tool failures eliminates unnecessary trips and leads to efficient operations. The final result of the above data collection, QC and processing resulted in a comprehensive formation evaluation interpretation of high confidence.

Finally, conclusions and recommendations are summarized to provide guidelines in Formation Evaluation in similar challenging highly deviated, HTHP, complex reservoir environments on land and offshore.
Green Field Development Workflow Involving Appraisal, Increased Scope, Optimizing Target Production And Reservoir Monitoring: A Case Study
Authors: Raghunathan Murali , Alkhatib Mohamad , Al Ali Abdulla Ali , Mukhtar Muhammad , Doucette Neil
Published: September 2019

A novel workflow was developed to select an optimal field development plan (FDP) which accounts for a number of associated uncertainties for an oil Greenfield concession that has a limited number of wells, production data and information. The FDP was revisited and updated to address the additional data acquired during the field delineation phase.

The study in Ref-1 demonstrates the comprehensive uncertainty analysis performed and the resulting optimized FDP. The FDP was developed to minimize the economic risk and uncertainty. Further field delineation activities have revealed a north and south extensions with an increase in hydrocarbon accumulation by 115%. A reservoir dynamic model was updated because of the increase in HC and input data from 17 wells.

A workflow has been created with a suitable development option to consider the recently appraised areas, which are:

– Updated saturation height functions (SHFs) which improve the match between newly drilled wells and water saturations logs – Updated reservoir models which were based on well tests and new analytical interpretations – History matching well test data with new acquisition data – Optimized field development options, that cover additional areas – Inputs to reservoir surveillance plan

Be implementing following an extensive analysis the most robust development concept was selected and will now in the field.
Dissecting Myocardial Mechanics in Patients With Severe Aortic Stenosis: 2-Dimensional vs 3-Dimensional–Speckle Tracking Echocardiography
Authors: Bi Xiaojun , Salah Husam M. , Calle Maria C. Arciniegas , Thaden Jeremy J. , Nhola Lara F. , Schaff Hartzell V. , Pislaru Sorin V. , Pellikka Patricia A. , Pochettino Alberto , Greason Kevin L. , Nkomo Vuyisile T. , Villarraga Hector R.
Published: September 2019

Background: Aortic valve stenosis (AS) commonly causes left ventricular (LV) pressure overload; thus, identifying patients with adverse remodeling/early LV dysfunction is critical. We compared 2-dimensional (2D) to 3-dimensional (3D) echocardiographic measures of LV myocardial deformation in patients with severe AS and studied the relation of LV preload and afterload (Zva) to myocardial deformation.

Methods: We prospectively included 168 symptomatic patients (72±12 years) with severe AS and ejection fractions ≥50%. Strain parameters from those patients were compared with normal values found in the literature. 3D full-volume and 2D images were analyzed for global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), systolic strain rate (SRs), basal rotation (Rotmax-B), apical rotation (Rotmax-A), and peak systolic twist (Twistmax).

Results: 2D–GLS and 2D–GCS decreased significantly compared with normal values (P˂.001 and P=.02, respectively); 2D Rotmax-B and Twistmax increased (P˂.001 vs normal values). Agreement between 2D–GLS and 3D–GLS by concordance correlation coefficient was 0.49 (95% CI, 0.39-0.57) in patients with AS. Both 2D– and 3D–GLS correlated with valvulo-arterial impedance (Zva) (r=0.34, P<.001; and r=0.23, P=.003, respectively).

Conclusion: In patients with severe AS, GLS and GCS decreased, and basal rotation and twist increased to maintain LV ejection fraction. 2D– and 3D–GLS had a relatively fair agreement. Both 2D– and 3D–GLS correlated modestly with Zva.
Changes in thyroid volume and thyroid function in acromegaly after surgery in Chinese population
Authors: Shao Qianqian , Li Jiayi , Gao Lu , Guo Xiaopeng , Wang Zihao , Deng Kan , Lian Wei , Xing Bing
Published: September 2019

Background : An increased prevalence of thyroid lesions was observed in acromegaly patients. However, the change of thyroid after remission of acromegaly was not clear in Chinese populations. The aims were to assess the thyroid structure and function changes before and after transsphenoidal pituitary adenoma resection in patients with acromegaly and to investigate the correlation between GH, IGF-1, disease duration and thyroid structure and function. Methods : We retrospectively studied 78 patients with acromegaly who underwent surgery between 2015 January and 2018 January at Peking Union Medical College Hospital. The pituitary hormone: random growth hormone (GH), nadir GH and insulin-like growth factor-1 (IGF-1); the thyroid hormone: thyroid stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroxine (FT4) and free triiodothyronine (FT3); four parameters of thyroid metabolism: thyroid’s secretory capacity (SPINA-GT), the sum activity of peripheral deiodinases (SPINA-GD), standard TSH index (sTSHI) and thyrotrophic thyroid hormone sensitivity index (TTSI); and thyroid ultrasound were assessed at baseline and 1 year after surgery. Results : Thyroid volume was significantly positively related random GH, nadir GH, and disease duration. TSH, sTSHI and TTSI was negatively related with pituitary hormone while IGF-1 showed a significant positive association with FT4 and SPINA-GT. After transsphenoidal resection of pituitary adenoma and over 1 year follow-up, the thyroid volume decreased significantly (p=0.000). T3 (p=0.049) and FT3 (p=0.022) also decreased significantly though within normal ranges. However, no significant changes were found in nodule maximum diameter and sTSHI. Thyroid volume change was positively correlated with GH change and nadir GH change. T3 change as well as SPINA-GD change was positively associated with IGF-1 change. Though no significant difference were observed between controlled patients and those who did not achieved “control” level, control patients had a larger decline in thyroid volume along with a smaller decrease in TSH. Conclusion: Enlarged thyroid volume, prevalent thyroid nodules, suppressive pituitary thyrotrophic function and elevated peripheral thyroid hormones are characteristic in acromegaly. A decrease in GH could have favorable effect on thyroid status on thyroid volume and thyroid hormones, while established thyroid nodules and impaired pituitary thyrotrophic function seemed to change little after surgery.
Transcriptomic dynamics changes in development of carmine radish (Raphanus sativus L.) fleshy roots using RNA-seq method
Authors: Gao Jian , Luo Mao , Liu Yi , Chen Fabo , Peng Hua , Li Wenbo
Published: September 2019

Radish ( Raphanus sativus L.), belonging to biennial root vegetable crop of Brassicaceae family, is an economically important vegetable crop with an edible taproot. Recently, most of differential expressed genes associating with anthocyanin biosynthesis have been identified in most of important fruit crops. However, transcriptome analysis of anthocyanin biosynthesis and expression of anthocyanin biosynthesis related genes in ‘Hongxin’ radish have not been fully investigated. Here, based on results from HPLC analysis, young fleshy roots obtained from the dynamics development stage of fleshy roots in carmine radish ‘Hongxin 1’ was used for RNA-Seq, including fleshy roots from seedling stage (SS), initial expansion (IE), full-expansion (FE), bolting stage (BS), initial flowering stage (IFS); full-bloom stage (FBS) and podding stage (PS). Subsequently, the putative candidate genes involved in the dynamics development stage of fleshy roots in carmine radish were identified. After that, DGE (differential gene expression) profile analysis was used to identify the pupative transcripts, compared with fleshy roots from seedling stage (SS). In addition, co-modulated DEGs (Common DEGs in the dynamic growing stages of fleshyroot in carmine radish) were also identified, from which most DGEs were more likely to participate in anthocyanin biosynthesis, including two transcription factors RsMYB and Rs RZFP . In addition, some related proteins e.g. RsCHS , RsDFR , RsANS , RsF’3H , RsF3GGT1 , Rs3AT1 , glutathione S-transferase F12, RsUFGT78D2-like and RsUDGT-75C1-like were significantly contributed to the regulatory mechanism during anthocyanin synthesis in the development stage of fleshy roots. Furthermore, GO terms comprised of “anthocyanin-containing compound biosynthetic process” and “anthocyanin-containing compound metabolic process” were commonly overrepresented in the other dynamics growing stages of fleshy roots after initial expansion of fleshy roots. Moreover, these results indicated that five significantly enrichment pathways of DEG were identified for the dynamics growing stages of fleshy roots in carmine radish, including Flavonoid biosynthesis, Flavone and flavonol biosynthesis, Diterpenoid biosynthesis, Anthocyanin biosynthesis, as well as Benzoxazinoid biosynthesis. These results will expand our understanding of complex molecular mechanism of the putative candidate genes involved in the dynamics development stage of fleshyroot in carmine radish.
Colchicine is associated with a decreased Risk for myocardial infarction in patients with Gout：A systematic review and meta-analysis
Authors: Duan Xinwang , Yu Le , Yuan Chen , Zhang Rongwei , Fan Jie , Zhang Xiuling , Xia Zhongbin
Published: September 2019

Objective: This meta-analysis aimed to identify the effects of Colchicine on myocardial infarction (MI) in patients with Gout. Methods: In July 2018, a systematic computer-based search was conducted in PubMed, EMBASE, and Cochrane Database of Systematic Reviews. Data on patients with Gout that compared Colchicine versus others (non-used Colchicine) were retrieved. The endpoints were the incidence rate for MI. After testing for heterogeneity between studies, data were aggregated for random-effects models when necessary. Results: Three clinical studies with 114371 patients (Colchicine group=1063, control group=113308) were finally included in the meta-analysis. Colchicine was associated with a decreased Risk for myocardial infarction (95% CI, 0.25, 0.33, P=.000). Conclusions: Colchicine was efficacious in the reduction of the incidence rate for MI in patients with Gout.
Reducing Nutrient and Irrigation Rates in Solar Greenhouse without Compromising Tomato Yield
Authors: Wang Shichao , Bai Xinlu , Zhou Jianbin , Chen Zhujun
Published: September 2019

Overapplication of nutrients and water is common in intensive greenhouse systems. A 2-year experiment (2011–13) was conducted to study the effect of different nutrient and water treatments on the growth and yield of tomato (Lycopersicum esculentum Mill.) and on soil nutrient accumulations in solar greenhouses in South Loess Plateau, China. The treatments included 1) current fertilizer and water practices (FW), 2) formula fertilizer and water 1 (FW1), 3) formula fertilizer and water 2 (FW2), and 4) farmer’s practice (FP). Compared with FW, FW1 and FW2 had yields not significantly different from grower control treatments; however, they saved 35% to 46% of the nitrogen (N) fertilizer, 40% to 54% of the phosphorus (P2O5) fertilizer, 19% to 35% of the potassium (K2O) fertilizer, and 15% to 21% of irrigation water. The economic profits of FW1 and FW2 were greater than those of the FW and FP treatments. The two formula treatments also reduced soil electrical conductivity (EC) and the accumulation of nitrate, available P, and available K in soil. However, the soil nutrients are still above optimal levels. Obvious N surplus in the greenhouse was observed in different treatments, mainly because of high N input from manures. This study revealed there is great potential to reduce nutrient and water use while maintaining the same yield in a greenhouse system.
Anthocyanin Production and Enzymatic Degradation during the Development of Dark Purple and Lilac Paprika Fruit
Authors: Yamada Yuji , Nakayama Masayoshi , Shibata Hiromitsu , Kishimoto Sanae , Ikeda Takashi
Published: September 2019

During development, the fruit of some paprika (Capsicum annuum L.) cultivars shows a change in color from green to dark purple (e.g., ‘Mavras’) or lilac (e.g., ‘Tequila’). However, this purple coloration is rare among paprika cultivars and disappears in ripened fruit, which are red. Therefore, we investigated the mechanism causing this color change in the cultivars Mavras and Tequila to better understand how purple ripened fruit could be generated. High-performance liquid chromatography (HPLC) analyses of the anthocyanin contents of the fruit indicated that anthocyanin was undetectable in green fruit, accumulated in dark purple or lilac ones, and then decreased again in red ones in both cultivars. Furthermore, expressions of most of the analyzed anthocyanin biosynthesis–related genes and genes for their transcription factors increased in dark purple or lilac fruit and decreased in red ones, i.e., it was synchronized with the changes in anthocyanin contents. Furthermore, anthocyanin degradation activity as a result of peroxidases was detected at all stages but increased when the lilac or dark purple color started to fade. Thus, the development of purple coloration is caused by increased anthocyanin biosynthesis, whereas the fading of this coloration is a result of both a decrease in anthocyanin biosynthesis and an increase in anthocyanin degradation. At the ripening stage, the green pigment (chlorophyll) contents decreased, whereas the red pigment (carotenoid, particularly capsanthin) contents increased. However, these timings did not completely coincide with the timing of anthocyanin degradation, suggesting that the content of each pigment is individually regulated, and so purple, green, and red coloration could be freely expressed in mature paprika fruit.
Gauged sigma models and magnetic Skyrmions
Authors: Schroers Bernd
Published: September 2019

We define a gauged non-linear sigma model for a 2-sphere valued field
and a SU(2)SU(2)
connection on an arbitrary Riemann surface whose energy functional
reduces to that for critically coupled magnetic skyrmions in the plane,
with arbitrary Dzyaloshinskii-Moriya interaction, for a suitably chosen
gauge field. We use the interplay of unitary and holomorphic structures
to derive a general solution of the first order Bogomol’nyi equation of
the model for any given connection. We illustrate this formula with
examples, and also point out applications to the study of
impurities.
High Risk of Type 2 Diabetes Mellitus among Working Adult
Authors: Syagata Anindhita Syahbi
Published: September 2019

This study aims to understand the relation between energy intake and waist circumference with the risk of T2DM. It was an observational study with a cross-sectional design using secondary data (ethical number, 476/KEP-UNISA/V/2018). Sample collected by simple random sampling. The minimum sample size was calculated using the Fisher formula. In this study, obtained 67 sample with inclusion criteria were not taking drugs to lower blood glucose levels. The independent variable in this study was T2DM risk, while the dependent variable was diet and waist circumference. The normality test of data used Kolmogorov-Smirnov. The Spearman correlation analysis used for knowing the relation between energy intake and waist circumference with blood glucose. The result showed that there was no relation between energy intake and blood glucose (r=0.19; p=0.12). There was no relation between waist circumference and blood glucose (r=0,18; p=0,16). There were 91 % of subjects having a high risk of T2DM and 52.2 % of subjects having a high total cholesterol. There is no relation either energy intake or waist circumference and blood glucose. Almost all subjects have high risk in T2DM.
Removal of ciprofloxacin from aqueous solution by electro-activated persulfate oxidation using aluminum electrodes
Authors: Malakootian Mohammad , Ahmadian Mohammad
Published: September 2019

The aim of this study was to determine the removal of ciprofloxacin (CIP) by the electro-persulfate (EC-PS) process using aluminum (Al) electrodes. The effects of variables including pH, contact time, PS concentration, initial CIP concentration and current density on the removal efficiency of CIP were studied. In order to determine the mechanisms of the EC-PS process, the radical scavenger tests, as well as energy dispersive spectroscopy (EDS) and Fourier transform infrared spectroscopy (FT-IR) were performed on the sludge. The results showed that the PS process alone had no effect on the CIP removal, and the EC process alone could remove 25% of CIP after 160 min. However, the EC-PS process under the optimum conditions: pH of 7, time of 40 min, current density of 2.75 mA/cm2, CIP concentration of 20 mg/L, and PS concentration of 0.84 mM removed 90% of CIP. The effect of the EC-PS process on the actual hospital wastewater was 81% in optimal conditions. The kinetic study also showed that the second-order kinetic model was the most consistent. The oxidation process during the initial contact was dominant in the EC-PS process and, over time, the EC process was dominant for CIP removal.
A função socioambiental da educação e da interpretação ambiental na conservação do patrimônio ambiental
Authors: Munhoz Elzira Maria Bagatin , Melo Júnior João Carlos Ferreira de , Dornelles Sidnei da Silva , Possamai Tarcísio
Published: September 2019

A Universidade da Região de Joinville (Univille), instituição comunitária do nordeste do estado de Santa Catarina, mantém um programa de extensão universitária que se dedica ao desenvolvimento de atividades de educação e interpretação ambiental em trilhas interpretativas: o Programa Trilhas. Suas atividades são desenvolvidas por uma equipe multidisciplinar de professores e acadêmicos de diversos cursos. Os percursos em trilhas implantadas em seus Centros de Estudos e Pesquisas Ambientais (Cepas) e no Jardim Botânico da instituição são monitorados por acadêmicos bolsistas de extensão, atendendo prioritariamente professores e estudantes da educação básica da região, além dos diversos cursos de graduação e pós-graduação oferecidos pela universidade. O discurso interpretativo desenvolvido ao longo das visitas monitoradas abarca os temas geradores que remetem às características do bioma mata atlântica, incluindo a geomorfologia regional, a importância dos fragmentos vegetais em áreas urbanas e seus arredores, o microclima e sua influência sobre as atividades locais, a biodiversidade da fauna e flora e informações a respeito da ocupação sociocultural da região. As visitas, realizadas mediante agendamento na universidade, são permeadas por dinâmicas de sensibilização socioambiental, visando ao envolvimento e à reflexão dos diferentes grupos a respeito da relação homem-natureza.
Samambaias e licófitas do Parque Estadual Acaraí, São Francisco do Sul, Santa Catarina, Brasil
Authors: Vieira Junior Nilton Paulo , Schroeder Gabriel da Rosa , Da Silva Mouga Denise Monique Dubet
Published: September 2019

Pesquisas e levantamentos florísticos específicos sobre samambaias e licófitas em restingas são escassos. O Parque Estadual Acaraí, unidade de conservação de proteção integral, maior remanescente de restinga em área contínua no estado de Santa Catarina, não tem estabelecidos a diversidade de samambaias e licófitas e seus respectivos aspectos ecológicos. Foram verificadas, pela compilação de dados da literatura e de herbários, 42 espécies, distribuídas em 30 gêneros e 18 famílias, das quais três espécies, distribuídas em três gêneros e uma família, são licófitas. Polypodiaceae foi a família mais representativa em número de espécies (13) e gêneros (6). A representatividade da família em restingas tem sido relatada na literatura. Os gêneros com maior riqueza de espécies foram Asplenium, Pecluma, Pleopeltis, Serpocaulon e Trichomanes (três cada um). Foram verificadas duas espécies exóticas subespontâneas e seis espécies endêmicas do Brasil. A forma de vida terrestre foi representada pela maioria das espécies (85,71%). São exclusivas da América do Sul 23 espécies. O conhecimento sobre a flora, a ecologia e o comportamento das espécies é importante, uma vez que se constitui em subsídio para a conservação.
Panorama da comunicação e da educação ambiental desenvolvidas nas Reservas Particulares do Patrimônio Natural de Santa Catarina
Authors: De Sena Jeniffer Cristine , Meneghelli Raquel Elisa Da Silva
Published: September 2019

As Reservas Particulares do Patrimônio Natural (RPPNs) constituem Unidades de Conservação com particularidades únicas. Identificar de que forma a educação ambiental e a comunicação são realizadas pelas RPPNs localizadas em Santa Catarina e avaliá-las sob o olhar das ações constantes nas diretrizes da Estratégia Nacional de Comunicação e Educação Ambiental em Unidades de Conservação (ENCEA) é o objetivo deste trabalho. A coleta de dados ocorreu em setembro e outubro de 2018, pela aplicação de questionário aos responsáveis. Dos 49 municípios que contam com RPPNs, 57% foram representados no questionário. Das 80 RPPNs de Santa Catarina, apenas 27% responderam aos questionários. Das RPPNs participantes, somente 40% dispõem de plano de manejo; 35% possuem visitação como uma das atividades permitidas em sua lei de criação ou plano de manejo; 50% não têm estrutura para receber visitantes; 65% não possuem educação ambiental como uma das atividades permitidas em sua lei de criação ou plano de manejo; 45% não se comunicam com seu público externo; 35% não se comunicam com a comunidade de seu entorno. A visitação, a educação ambiental e a comunicação desenvolvidas permitiram ter um panorama dessas ações.
Estudio etnobotánico y comercialización de plantas medicinales del bosque protector Murocomba y su área de influencia del cantón Valencia, Ecuador
Authors: Jiménez-Romero Edwin Miguel , Moreno-Vera Ana Nohemí , Villacis-Calderon Annabelle Cecilia , Rosado-Sabando Jenny Katherine , Morales-Moreira Diana Maribel , Bravo-Bravo Angie Daniela
Published: September 2019

En el presente artículo se determinó el uso etnobotánico de las plantas medicinales en el bosque protector Murocomba y su área de influencia, para lo cual se aplicaron 56 encuestas de tipo analítica en cinco localidades. Con el fin de obtener información sobre la propa-gación de plantas, se realizaron 20 encuestas en las localidades del bosque y, para la identificación de los procesos de comercialización, 40 encuestas a herbolarios en los cantones aledaños. Se registraron 51 especies, 44 géneros y 26 familias de plantas medicinales. Cymbopogon citratus presentó mayor frecuencia absoluta. La localidad con mayor número de especies e individuos fue Isla de la Libertad, así como con mayor diversidad con 3,42, según el índice de Shannon, y 0,9569, según el de Simpson. El índice de Jaccard presentó mayor interacción entre El Dorado e Isla de la Libertad. El Anova mostró diferencias significativas en frecuencia de especies entre las localidades. C. citratus y Ocimum americanum obtuvieron mayor Índice de Valor de Uso (IVU), Conocimiento Relativo de las Especies (RVU) y Uso Significativo Trámil (UST). La propagación de ocho especies con mayores UST se realiza mediante semilla, esquejes o división de planta. Las plantas medicinales en herbolarios con mayor demanda fueron Ruta graveolens, Matricaria chamomilla y Peumus boldus. Finalmente, en plantas medicinales con mayor UST se identificaron tres tipos de valor agregado: maceta, aceites esenciales yplantas deshidratadas, con costos de comercialización que oscilan entre $1,00 a $10,00 dólares.
Descriptive evaluation and accuracy of a mobile app to assess fall risk in seniors: Retrospective Case Control Study (Preprint)
Authors: Rabe Sophie , Azhand Arash , Pommer Wolfgang , Müller Swantje , Steinert Anika
Published: September 2019

BACKGROUND

Fall risk assessment is complex. Based on current scientific evidence, a multifactorial approach including the analysis of physical performance, gait parameters and both extrinsic and intrinsic risk factors is highly recommended. Using these determinants, a smartphone-based application was designed to assess the individual risk of falling with a score that combines multiple fall risk factors into one comprehensive metric.

OBJECTIVE

This study provides a descriptive evaluation of the designed fall risk score as well as an analysis of its discriminative ability based on real-world data.

METHODS

Anonymous data from 242 seniors was analyzed retrospectively. Data was collected between June 2018 and May 2019 using the fall risk assessment app. First, we provide a descriptive statistical analysis of the underlying dataset. Subsequently, multiple learning models (Logistic Regression, Gaussian Naive Bayes, Gradient Boosting, Support Vector Classification and Random Forest Regression) are trained on the dataset to obtain optimal decision boundaries. The receiver operating curve with its corresponding area under the curve (AUC) and sensitivity were the primary performance metrics utilized to assess the fall risk score’s ability to discriminate fallers from non-fallers. For the sake of completeness, specificity, precision and overall accuracy were provided for each model as well.

RESULTS

Out of 242 participants with a mean age of 84.6 ± 6.7 years, 139 (57.4%) reported no previous falls (non-faller), while 103 (42.5%) reported a previous fall (faller). The average fall risk was 29.5 ± 12.4 points. The performance metrics for the Logistic Regression Model were AUC = 0.9; Sensitivity = 100%; Specificity = 52%; Accuracy = 73%. The performance metrics for the Gaussian Naive Bayes Model were AUC = 0.9; Sensitivity = 100%; Specificity = 52%; Accuracy = 73%. The performance metrics for the Gradient Boosting Model were AUC = 0.85; Sensitivity = 88%; Specificity = 62%; Accuracy = 73%. The performance metrics for the Support Vector Classification Model are AUC = 0.84; Sensitivity = 88%; Specificity = 67%; Accuracy = 76%. The performance metrics for the Random Forest Model were AUC = 0.84; Sensitivity = 88%; Specificity = 57%; Accuracy = 70%.

CONCLUSIONS

Descriptive statistics for the dataset were provided as comparison and reference values. The fall risk score exhibited a high discriminative ability to distinguish fallers from non-fallers, irrespective of the learning model evaluated. The models had an average AUC of 0.86, an average sensitivity of 93% and an average specificity of 58%. Average overall accuracy was 73%. Hence, the fall risk app has the potential to support caretakers in easily conducting a valid fall risk assessment. The fall risk score’s prospective accuracy will be further validated in a prospective trial.
Біомеханічні аспекти експериментального дослідження функціонального лікування С-подібної сколіотичної деформації хребта
Authors: Golovaha M.L. , Tiazhelov O.A. , Letuchaya N.P. , Subbota I.A. , Karpinsky M.Yu.
Published: September 2019

Актуальність. У нашій клінічній практиці був розроблений комплекс фізичних вправ, в основу якого були покладені топічні особливості деформації хребта. Мета роботи: на підставі математичного моделювання обґрунтувати ефективність фізіофункціонального лікування пацієнтів із С-подібною деформацією хребта. Матеріали та методи. Як експериментальне дослідження ми використовували математичне моделювання, основою якого була математична модель хребта, що дозволила вивчати розподіл внутрішніх напружень у хребцевих рухових сегментах при різних варіантах навантаження. На даній математичній моделі було перевірено 15 вправ. Висновки. Дослідження за допомогою математичної моделі дозволило вивчити диференційний вплив методів кінезітерапії на С-подібну деформацію хребта при лікуванні сколіотичної хвороби. Дане дослідження дозволило біомеханічно обґрунтувати показання та протипоказання до використання різних фізичних вправ при лікуванні сколіотичної хвороби. Проведене дослідження дозволило удосконалити методологічний підхід до розробки комплексів лікувальної гімнастики з урахуванням топічних особливостей деформації хребта.
Спосіб лікування деформацій проксимального відділу великогомілкової кістки
Authors: Dunai O.H.
Published: September 2019

Актуальність. Дегенеративно-дистрофічні захворювання суглобів нижньої кінцівки досить поширені. Серед оперативних методів лікування, відповідно до стадії гонартрозу, корегуючі остеотомії проксимального відділу великогомілкової кістки (ПВВГК) займають важливе місце завдяки можливості перерозподілу навантаження в суглобі та подовженню терміну його функціонування. Мета: оцінка віддалених результатів лікування деформацій проксимального відділу великогомілкової кістки із застосуванням модифікованої нами методики Г.А. Ілізарова. Матеріали та методи. Спостерігали за 14 пацієнтами із деформацією ПВВГК, яким виконана корегуюча кортикотомія великогомілкової кістки з фіксацією в апараті Ілізарова за пропонованою нами методикою. Результати. Через 2 роки 10 із 14 прооперованих пацієнтів відзначали покращення стану суглоба: майже повністю зник біль, збільшилась амплітуда рухів, був відсутній синовіт. Через 10 років оглянуто 9 пацієнтів, які ще відносно активно користувалися прооперованою кінцівкою. Висновки. Запропонована нами методика кортикотомії великогомілкової кістки з подальшою фіксацією в апараті Ілізарова є досить ефективною при лікуванні деформацій ПВВГК завдяки малоінвазивності втручання, без необхідності застосування металевих фіксаторів та можливості корекції осі кінцівки в післяопераційному періоді. Крім того, немає потреби в кістковій пластиці та подальшому видаленні ­фіксатора.
Neurotransmitter serum levels in children with recurrent upper respiratory tract infections
Authors: Ovcharenko L.S. , Sheludko D.M. , Vertehel A.O. , Samokhin I.V. , Andrienko T.G. , Kryazhev A.V.
Published: September 2019

Background. Schoolchildren are prone to frequent respiratory tract diseases. In the structure of general morbidity, this pathology ranks first. Its prevalence is more than 60 %, which leads to frequent school absenteeism, lack of active games and outdoor walks. So, there is an increase in the amount of time that a child spent on means of mass electronic communication and electronic games, resulting in high affection and addiction, forming hypodynamia, which in aggregate has a negative impact on the regulatory systems functioning. Recurrent upper respiratory tract infections (URTI) contribute to the strain of neuro-endocrine-immune regulation, causing an imbalance of neuropeptides — mediators of neurogenic inflammation. The purpose of this work is to study the neurogenic inflammation parameters in schoolchildren with functional disorders of the cardiovascular system and recurrent respiratory tract diseases. Materials and methods. We surveyed 130 children with URTI aged 6 to 9 years in the somatic well-being period. The analysis of the contents of vasoactive intestinal peptide (VIP), substance P and final stable metabolites of nitric oxide (FSM NO) in serum was carried out. An increase in substance P level in children with recurrent URTI was found, which had statistically significant differences with the healthy children indices (p < 0.05). Results. It has been found that high concentration of substance P increases the risk of recurrent URTI. It has been proved that in children with recurrent URTI due to increased FSM NO serum content that has a pro-inflammatory orientation, there is an increased neurogenic inflammation activity. It was found that the reliable reduction in the content of VIP as an anti-inflammatory transmitter in children with recurrent URTI can not suppress the activity of neurogenic inflammation, resulting in its excessive stimulation. Conclusions. Children with recurrent URTI in the somatic well-being period have increased serum levels of substance Р and FSM NO. In the somatic well-being period in schoolchildren with recurrent URTI, a decrease in the concentration of anti-inflammatory neuropeptide VIP is observed.
Metabolic nephropathy in children: gender features of oxalate excretion, relationship with oxidative stress severity and antioxidant defense system
Authors: Aib N.R.
Published: September 2019

Background. The purpose was to investigate gender features of oxalate excretion in metabolic nephropathy, the state of oxidative stress and antioxidant system, depending on oxalate excretion. Material and methods. One hundred seventy-six children with oxalate nephropathy and 84 healthy children were included in the study. Clinical, instrumental and laboratory methods were used. The level of lipid peroxidation (diene conjugates, malondialdehyde) and antioxidant protection enzyme (redox glutathione, glutathione peroxidase and serum catalase), and peroxidation of proteins (neutral and basic aldehyde and ketone derivatives of dinitrophenylhydrazone) were evaluated. Results. The level of oxalate excretion and oxalate/creatinine ratio in the first void urine of patients with metabolic nephropathy was significantly higher vs. control group (p < 0.05). The absolute risk of high and mode­rate oxalate excretion in girls was 62.0 % higher than that of boys (p < 0.05). The moderate and high oxalate/creatinine ratio was found in 57.0 % of girls and in 27.0 % of boys. Low levels of creatinine excretion and oxalate/creatinine ratio were detected in male patients (p < 0.05). All patients with metabolic nephropathy had significantly increased level of neutral aldehyde and ketone derivatives (p < 0.05) compared to control group. The level of basic aldehyde and ketone derivatives was significantly increased compared to controls in moderate and high oxalate excretion (p < 0.05). Moderate and severe oxalaturia in children with metabolic nephropathy was associated with a decreased plasma and erythrocytic malondialdehyde level compared to control group with mild oxalaturia (p1 < 0.05). In patients with metabolic nephropathy, the activation of the lipid peroxidation was accompanied by a significant decrease in superoxide dismutase, increased activity of catalase and glutathione peroxidase vs. control group (p < 0.05). Conclusions. There is gender dependence between the level of oxalate excretion in metabolic nephropathy; the state of oxidative stress and the system of peroxide oxidation depends on the intensity of first void urinary excretion of oxalates.
Uncontrolled measles in the age of controlled infections
Authors: Volyanska L.A. , Burbela E.I. , Romanyuk L.B.
Published: September 2019

Background. In the last decade, the incidence of meas­les has a number of features. The infection migrates from country to country, from continent to continent within a year — a year and a half, despite the state of collective immunity in the territory of its spread. The age priority has disappeared, this infection has lost the status of pediatric, all age categories are affected, with a shift to 14–25 year olds. The purpose was to analyze the causes of insufficient control of the epidemiological process of measles in the Ternopil region in the context of situation in Ukraine. Materials and methods. The materials of the reporting documentation of the Main Epidemiological Service and the children’s infectious diseases hospitals of the Ternopil region were used. Results. In the region, some differences in the incidence of measles were observed. In general, they are a reflection of the nationwide problem of managing this infection. The amount of measles, which was recorded in the Ternopil region in 2001, exceeded the general Ukrainian indexes by almost 6 times, which was overcome by active vaccination already in the next peak 2005–2019, and bring the incidence to the republican levels. The regional peak incidence rates were at least 1 year ahead of the national ones, which indicates that this infection was imported into our region across the western border, since there is a coincidence with European data. Epidemic situation of measles in 2000–2019 has a clear dependence on the timeliness and completeness of vaccination coverage by age, state of population immunity. During 2011–2019, 10–18 year olds (65.27 %) with a positive vaccine history dominated in the statistics of measles cases in Ternopil. Among measles patients, the number of people vaccinated is increasing, especially among the age group of 10–18 years. The number of measles among infants is increasing due to the lack of immunity (post-vaccination or post-infectious) in Ukrainian mothers. The incidence rate is determined by the completeness of the coverage of the children’s population with calendar vaccinations. Incidence peak shifted to the period of 14–25 years makes it necessary to conduct regular revaccination against measles in this age.
Чреспищеводная эхокардиография и ее место в периоперационном мониторинге (обзор литературы)
Authors: Vasylyv M. , Pidhirnyy Ya.
Published: September 2019

Эхокардиография (использование ультразвука для исследования сердца) — это безопасная, мощная, неинвазивная и безболезненная техника. С момента своего клинического введения в 80-е годы интраоперационная чреспищеводная эхокардиография (ЧПЭхоКГ) стала одним из крупнейших достижений современной анестезиологии. Цель статьи — всесторонний обзор интраоперационного использования ЧПЭхоКГ в кардиохирургии. Эта полуинвазивная техника позволяет осуществлять прямую и быструю визуализацию структурной анатомии сердца и крупных сосудов, а также оценивать гемодинамику и функциональное состояние сердечно-сосудистой системы. Чреспищеводная эхокардиография сначала применялась интраоперационно для оценки систолической функции левого желудочка, но за последние два десятилетия клиническое применение ЧПЭхоКГ значительно расширилось и сейчас включает: оценку диастолической функции, оценку патологии и функции митрального и аортального клапанов, выявление остаточных внутрисердечных дефектов и шунтов, выявление внутрисердечных тромбов и оценку восходящей аорты. Таким образом, чреспищеводная эхокардиография — это безопасное обследование с низким уровнем риска, которое использовалось в течение нескольких десятилетий в интра- и послеоперационном периодах в кардиохирургии. Метод превосходит другие способы сердечно-сосудистого мониторинга благодаря предоставлению детальной анатомической и физиологической информации в реальном времени. Чреспищеводная эхокардиография способна обеспечить данные, которые влияют на хирургическую тактику и анестезию, а также позволяют выполнить немедленную оценку хирургических результатов. Основные ограничения по его повседневному использованию связаны со стоимостью оборудования и необходимостью профессиональной подготовки. Анестезиолог расширяет свою роль в периоперационной медицине, предоставляя жизненно необходимую клиническую информацию для анестезиологической процедуры. Исходя из всех преимуществ, представленных в статье, и с учетом низкого риска авторы подтверждают нынешние рекомендации по использованию интраоперационной ЧПЭхоКГ у кардиохирургических пациентов.
Стрессовая гипергликемия: обсуждение пути ее устранения с помощью применения многоатомных спиртов
Authors: Kursov S.V. , Nikonov V.V.
Published: September 2019

В литературном обзоре рассматривается перспектива возобновления активного использования многоатомных спиртов в практике интенсивной терапии. Информация ориентирована на особенности метаболизма и ожидаемые эффекты многоатомного пятиуглеродного спирта ксилита. Целесообразность применения растворов ксилита аргументируется снижением риска развития гипергликемии, уменьшением потребности во введении инсулина и вместе с тем закономерным снижением риска формирования гипогликемических состояний, а также возможностью предупреждения развития эффекта Варбурга. Эффект Варбурга заключается в активном переключении основной клеточной энергетической продукции с митохондриального окислительного фосфорилирования на гликолиз, даже в условиях достаточного обеспечения организма кислородом. Современные исследования показывают, что эффект Варбурга играет важную роль в прогрессировании онкологической патологии, но также присутствует при неонкологических заболеваниях, таких как сепсис, атеросклероз, легочная гипертензия, сердечная недостаточность, болезнь Альцгеймера, туберкулезная инфекция. Большое количество методик, используемых в практике интенсивной терапии, способствует активации процессов гликолиза и формированию лактат­ацидоза. Опасность этого механизма повреждения организма и эффекта его блокирования клиницистами до сих пор не оценена. В Украине одобрены препараты для инфузионной терапии, приготовленные на основе ксилитола.
Экспериментальное обоснование объема локального анестетика при выполнении блокады квадратной мышцы поясницы (quadratus lumborum block)
Authors: Zaletskyi B.V. , Dmytriiev D.V. , Pivtorak V.I. , Dusik A.V. , Kalinchuk O.O. , Konoplitskyi V.S.
Published: September 2019

Актуальность. Блокада квадратной мышцы поясницы (qudratus lumborum block) находит широкое применение как компонент периоперационного обезболивания в абдоминальной хирургии у взрослых и мало используется в детской практике. Целью нашего исследования были изучение анатомических особенностей пространства квадратной мышцы поясницы и распределение местного анальгетика в пространстве в зависимости от введенной дозы, что позволит найти наиболее эффективную и безопасную дозу препаратов для обезболивания. Материалы и методы. Исследование проведено на 12 трупах лиц разных полов и возраста (20–73 года). Методом препарирования изучали топографоанатомические особенности мышц, фасциально-клетчаточных пространств, сосудов и нервов поясничной области. Выполнено послойное препарирование тканей поясничной области. Затем после визуализации целевых анатомических структур с помощью ультразвука в технике in-plane иглой 22 G выполнялось введение в передне-медиальном направлении в боковом положении по заднему краю квадратной мышцы поясницы (qudratus lumborum block) красителя метиленового синего для изу­чения распространения анестетика. Статистическую обработку полученных данных проводили с применением методов вариационной статистики с помощью программы Stаtistica 5.5 (принадлежит ЦНИТ ВНМУ им. Н.И. Пирогова, лицензионный № AXXR910A374605FA). Результаты. Исследовали площадь поверхности поперечной мышцы спины, которая колебалась в пределах 10,4–14,3 см2 и в среднем составляла 12,01 ± 2,30 см2. Исследование распределения раствора в пространстве квадратной мышцы поясницы в зависимости от дозы показало, что при применении дозы 0,2 мл/кг массы тела распределение раствора составляет в среднем всего 6,2 ± 2,1 см2, что не позволяет заполнить все пространство раствором, а при использовании дозы 0,3 мл/кг массы тела — 12,1 ± 1,4 см2, что вполне соответствует средней площади исследуемого пространства. Выводы. Изучение площади распределения раствора в пространстве квадратной мышцы поясницы позволяет предположить, что для обезболивания будет достаточно местного анестетика в дозе 0,3 мл/кг массы тела. Эта доза безопасна для использования как у взрослых, так и у детей. Клиническая эффективность требует дальнейшего изучения.
Отлучение от искусственной вентиляции легких у пациента с постгипоксической энцефалопатией и центральной гипертермией
Authors: Filyk O.V.
Published: September 2019

Актуальность. Постгипоксическое повреждение центральной нервной системы часто сопровождается полиорганной дисфункцией, персистирующим неврологическим дефицитом и может осложниться центральной гипертермией. Целью данного исследования было проанализировать литературные данные о методах лечения гипертермии центрального генеза и предложить стратегию отлучения от респираторной терапии у такого пациента. Материалы и методы. Поиск литературных источников проводился в базах данных PubMed и MedLine за последние 13 лет. Поисковыми словами были «гипертермия центрального генеза» и «отлучение от искусственной вентиляции легких у детей с постгипоксической энцефалопатией». Наблюдение и лечение пациента осуществлялись на клинической базе кафедры анестезиологии и интенсивной терапии Львовского национального медицинского университета имени Данила Галицкого в отделении анестезиологии с койками интенсивной терапии КНП «Львовская областная клиническая больница «ОХМАТДЕТ» в сентябре — октябре 2018 года. Результаты. У ребенка в возрасте 7 мес. после перенесенной клинической смерти и успешного восстановления спонтанного кровообращения развились постгипоксическая энцефалопатия, синдром полиорганной дисфункции и гипертермия центрального генеза. Это привело к росту минутной вентиляции легких, тахикардии и, соответственно, проблеме с отлучением от респираторной поддержки. Кроме того, у пациента был клинически значимый гипертонус мышц нижних конечностей с постоянным спонтанным разведением в тазобедренных суставах более 180°. В лечение был добавлен баклофен в дозе 0,3 мг/кг/сут per os, которая через 7 дней была увеличена до 0,6 мг/кг/сут. На 3-и сутки с момента назначения баклофена температура тела стала стабильно ниже 38 °C, на 5-е сутки не превышала 37,5 °C. Отлучение от искусственной вентиляции легких проводилось поэтапно — от принудительно-вспомогательного режима искусственной вентиляции легких с постепенным снижением параметров поддержки до вспомогательного режима с ежедневным увеличением интервала спонтанного дыхания пациента без респираторной поддержки, начиная от 2–4 ч в дневной период времени в течение 2–3 дней и перехода к плановой вспомогательной вентиляции только в ночное время и полному отлучению от вспомогательной вентиляции. Полное отлучение от искусственной вентиляции легких произошло на 7-е сутки с момента назначения баклофена. Выводы. Контроль над лихорадкой у пациентов, перенесших повреждения центральной нервной системы, может улучшить результаты лечения, особенно если будут разработаны более эффективные стратегии мониторинга и лечения гипертермии.