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The reform of decentralization and the formation of capable territorial communities is a priority of the Ukrainian Government. The reform aims at creating an effective system of local self-government to provide a high quality of life for people, improving the quality of municipal services and to ensure the sustainable development of regions. The reform is based on the European principles of local self-government, which determines the voluntary nature of the association of territorial communities. Considerable work has been done in Ukraine to prepare the reform for implementation, in particular, the methodology of the capable communities’ formation. It determines which socio-economic factors should be taken into consideration when making decisions on the voluntary association of territorial communities and the development of perspective plans. However, the results of the reform are not satisfactory enough, as of August 2018, 753 united territorial communities were created, bringing together 3492 communities, although according to the Government's approved plans for 23 regions, 7913 existing communities should form 1206 integrated territorial communities.The study is devoted to examining the process of voluntary association of territorial communities in the context of implementing decentralization reform in Ukraine and identifying the socio-economic factors contributing to this.A factor analysis of the voluntary association of territorial communities in Ukraine during the period 2014—2017 was performed, using the software program STATA. The socio-economic factors that are significant in the decision-making for the voluntary association of communities were determined. Multiple regression and correlation analyses were performed to examine the impact of 24 demographic and socio-economic factors. The results of the study revealed that the following factors are significant: the average size of land area per household; share of united territorial communities created in the

Background. According to current literature, intestinal damage in gastroschisis (GS) leads to an increase in morbidity and mortality. However, the impact of intestinal affect severity on the clinical course and prognosis remains unresolved issue.Objective: to study the influence of eventrated organs status on the clinical course and prognosis of simple gastroschisis (SGS).Material and methods. The data of 83 patients with SGS were studied. The analysis of the frequency and nature of complications of clinical course, duration of hospitalization and levels of lethality depending on the degree of pathological changes of the evolved organs has been carried out. To investigate the influence of eviscerated organs status on the clinical course and prognosis of SGS, all patients were divided into three groups. Group 1 included patients with intact bowel (n=12; 14.5%). Newborns with moderate intestinal damage were included to the 2nd group (n=29; 34.9%). In the 3rd group, severe intestinal damage was diagnosed (n=42, 50.6%).Results. During evaluation of the statistical significance, the significant differences of the studied parameters between the 1 and 2 groups were not detected (P>0.05; p=0.07 — 0.4). When comparing the 2nd and 3rd groups, there is a significant increase in the length of hospital stay, the mortality and complications rate (P<0.05; p=0.00510.006) among patients in the third group. In children with severe pathological changes of the eventated organs, the development of respiratory distress syndrome, sepsis, cardiovascular and multiple organ failure was significantly more frequent (P<0.05; p=0.00310.007).Conclusions. Severe damage of eventrated organs in SGS was observed in 50.6% of patients. They have a significant impact on the incidence of clinical complications and increase the mortality of these newborns.

It has been shown using as an example the geological structure of the Precambrian basement of the Middle Bug area (the Ukrainian Shield) that the chronostratigraphic scheme of the Lower Archean needs to be modified, in particular, greenlevada suite of the Dniester-Bug series represented by supercrustal leucogranulite rock formation sho-uld be included. It has been found that leucogranulite formation of the Bug area are rocks (granitized biotite and garnet-biotite gneisses) which belong to formation-gene-tic type of quartz-feldspar metasomatites, particularly, to structural-formational association of metasomatites from regional fault zones. According to the data of geological, geochemical, tectonophysical, radioisotopic studies of the similar rocks in the exposures of the middle stream of the river South Bug, it has been proved that they were formed around 2.03 Ga ago as a result of diaftoresis of rocks of the Archean basement and their granulitic appearance as well as subvertical occurrence are related to dyna-mometamorphic including shear processes. Methodic problems of the studies of the age relations of the Catarchean rock complexes are under discussion. The well-known geological cross-section of Khoshchuvato-Zavalye site of the Middle Bug area has been considered and it has been shown that the stratigraphic method based on the principle of sequence of stratifying of supercrustal rocks is impossible to be effectively used in such complexes because of their strong tectonic and intrusive-metasomatic reprocessing, practical impossibility of their initial bedding to be found. The best way under these conditions is to be supported by more objective petrostructural, microstruc-tural, petrochemical, including radioisotopic and geophysical data.

Modern complex disinfectants should not only be highly effective against most pathogens, but also safe for the body of laboratory and farm animals. To determine the effect of microbicides on animal organism, there are several commonly accepted parameters that are regulated by relevant methodological documents. Taking into account the urgency of the development and implementation of modern disinfectants, the purpose of the researche was to study the effects of the drug "Orgsept" on the indicators of acute toxicity and its harmful effects on laboratory animals. The determination of acute toxicity, the study of the cumulative and skin-resorptive action of the drug "Orgasept" was performed on clinically healthy white mice, and the irritating effect and sensitizing properties were studied on Guinea pigs. The studies were conducted using generally accepted techniques (Yakubchak et al., 2005). According to the results of the research, acute toxicity, cumulative, sensitizing, irritating, skin-resorptive action of the disinfectant based on lactic acid and nanoparticles of silver "Orgasept" on laboratory animals were determined. It has been determined that the investigated preparation according to sanitary-and-hygienic norms GOST 12.1.007-76 belongs to the 3 groups of toxicity in concentrations which are significantly higher than bactericidal, it does not have a pronounced cumulative, sensitizing and skin-resorptive action.

Purpose. One of the main conditions of the effective and high-quality organization of rail hauling is availability of modern rolling stock. However, the analysis of technical condition confirms its considerable moral and physical deterioration. The main purpose of the article is search of possible ways of improvement of technical condition of the existing car fleet on the railroads of Ukraine. Methodology. The current state of a rail transport not fully meets the modern requirements. For the last decades updating of fixed assets has been provided generally at the expense of own means of the railroads and satisfied the need for capital investments only for 5-6 percent. At the same time, actually since declaration of independence of Ukraine the price growth rates for the products consumed by the railroads exceeded the fare growth rates that did not allow to update in necessary amount and to improve technical condition of the rolling stock. Findings. The article presents the analysis of freight rolling stock of Ukrainian Railways, which showed unsatisfactory condition of the cars. The railway industry today works on the old principles, which do not correspond to the modern world trends in organization of work of railway transport, contribute to the inefficiency of its functioning and impede further development, constraining the inflow of investment to this industry, hamper cooperation with private companies. Insufficient funding and imperfect system of repair and maintenance inhibit the development and reduce the competitiveness of railway transport of Ukraine. However, the implementation of strategic directions of development of the transport sector, a review of the above constraints and using the experience of advanced countries will steer the rail transport out of the crisis. Originality. The authors presented comprehensive consideration of issues to improve the car maintenance system while extending the life of their operation. Practical value. Possible ways to imp

Objective: To improve the results of treating patients with wounds, functional and aesthetic defects of mechanical origin by developing a comprehensive program of surgery to restore the form and function of trunk and limbs.Materials and methods. The criteria for the inclusion into the study: both genders patients aged over 17 years with diagnosed skin and adjacent soft tissues of trunk and limbs defect that needed restoration of body form and functions.We have operated 231 patients with integumentary tissue defects of a mechanical origin in the clinic. There were 129 men, 102 women of them. The patients’ age ranged from 17 to 76 years.Results. All the patients were divided into 4 groups depending on the size, depth and the extent of damage of soft tissues and other structures of the body and limbs. I group – 79 (34.2 %) patients with isolated soft tissues damage (to the fascia): 32 (13.85 %). II group – 67 (29 %) patients with injuries of integumentary tissues of a moderate severity whose vital activity was disturbed in a limited area with parawound zone (lower from fascia). III group – 48 (20.8 %) patients (tissues damage to a significant extent). IV Group – 37 (16 %) patients, whose trauma was accompanied by injury of a vascular-neural fascicle, partial or complete extremity abjunction.Conclusions. 1. The choice of corrective surgical intervention method and the closure of the integumentary tissue defect depended on the size, the depth of the wound and hemodynamic characteristics of the damaged area. 2. The new method of treating the consequences of traumatic injuries using the preparation of hyaluronic acid expanded the prospects of treating patients with integumentary tissues defects. 3. The differential approach to the choice of the method of closing the wound surfaces caused by mechanical damage made it possible to achieve satisfactory results in 97.84 % of cases.

Introduction. Incidence of gastroschisis (GS) complicated by intestinal atresia is 4.5–12.6% of cases. 80% of this obstructions are observed in jejunoileal segment. Association of GS with intestinal atresia (GIA) is usually diagnosed well, but at birth, diagnosis of atresia is often controversial. There is misdiagnosis of atresia during the initial surgery in about 12% of cases. The ideal treatment model of GIA had not already been set. Different surgical approaches were described in literature: abdominal closure modalities, terms of intestinal anastomoses creation and intestinal stomas formation remain outstanding issues. the severity of congenital defects may vary thus the tactics and strategy of surgical management as well as the ability to create primary intestinal anastomosis should be considered individually. Clinical case. GS with severe viscero-abdominal disproportion (VAD) in fetus was diagnosed prenatally by ultrasonography (US) at 21 week of gestation. Prenatal US follow-up monitoring and examinations were conducted. The presence of concomitant intestinal obstruction was suspected at 35 week of gestation. Regarding diagnosed malformations, according to developed in our clinic "First Minutes Surgery" tactics, operation was performed in 15 minutes after birth. During the initial surgery intestinal obstruction was not confirmed. Staged surgical management of GS was conducted. Intestinal obstruction was diagnosed and confirmed by radiography only after 21 days of age, after increasing of oral intakes volume to 15.0 ml. Jejunal web was found on surgery. Following web removal diamond-shaped anastomosis was created. During post-op period the recurrence of intestinal obstruction was not observed, full enteral nutrition was reached. The good outcome after exhibited surgical management was achieved. Conclusions. The proposed strategy and tactics of surgical management found to be effective and can be applied in the case of GS with severe VAD complicated by jejunal

Purpose — to determine the frequency and severity of viscero-abdominal disproportion and condition of eventrated organs in infants with gastroschisis depending on way of delivery. Patients and methods. The analysis of medical records of 100 children with gastroschisis for the period from 1987 to 2015 which were born naturally or via cesarean section was performed. Patients with gastroschisis were divided into 3 clinical groups depending on prenatal diagnosis, methods of transportation and delivery, surgical treatment (I — basic, II — comparison, III — comparison). Results. The frequency of viscero-abdominal disproportion in children which were born by cesarean section (I group) was 87.5% and did not differ significantly from those which were born naturally (II and III groups). It was determined that incidence of severe viscero-abdominal disproportion in patients from I group which were born by cesarean section was smaller and significantly lower than in infants with gastroschisis from II and III groups which were born naturally. In children with gastroschisis which were born by cesarean section (I group) physiological pink color of eventrated hollow viscus was observed more often, in contrast to patients who were born naturally (II and III groups). Peels frequency in children with gastroschisis which were born naturally (II and III groups) was much more higher than in babies with gastroschisis delivered by cesarean section. Conclusions. The frequency of viscero-abdominal disproportion in children with gastroschisis which were born by cesarean section is 87.5% and in newborns which were born naturally — 80.0% (II group) and 100% (III group). Patient transportation method (in-utero transport and postnatal transportation) affects viscero-abdominal disproportion frequency. Way of delivery affects severity of viscero-abdominal disproportion and eventrated organs condition and does not affects the frequency of viscero-abdominal disproportion in children with gastroschisis

Purpose. The research work focuses on forecasting of performance evaluation of the tractive and non-tractive vehicles that will satisfy and meet the needs and requirements of the railway industry, which is constantly evolving. Methodology. Analysis of the technical condition of the existing fleet of rolling stock (tractive and non-tractive) of Ukrainian Railways shows a substantial reduction that occurs in connection with its moral and physical wear and tear, as well as insufficient and limited purchase of new units of the tractive and non-tractive rolling stock in the desired quantity. In this situation there is a necessity of search of the methods for determination of rolling stock technical characteristics. One of such urgent and effective measures is to conduct forecasting of the defining characteristics of the vehicles based on the processes of their reproduction in conditions of limited resources using a continuous exponential function. The function of the growth rate of the projected figure degree for the vehicle determines the logistic characteristic that with unlimited resources has the form of an exponent, and with low ones – that of a line. Findings. The data obtained according to the proposed method allowed determining the expected (future) value, that is the ratio of load to volume of the body for non-tractive rolling stock (gondola cars) and weight-to-power for tractive rolling stock, the degree of forecast reliability and the standard forecast error, which show high prediction accuracy for the completed procedure. As a result, this will allow estimating the required characteristics of vehicles in the forecast year with high accuracy. Originality. The concept of forecasting the characteristics of the vehicles for decision-making on the evaluation of their prospects was proposed. Practical value. The forecasting methodology will reliably determine the technical parameters of tractive and non-tractive rolling stock, which will meet the modern requiremen

Objective — to develop and improve the nature and extent of prenatal and early postnatal diagnosis of gastroschisis in fetuses and newborns. Patients and methods. For the period 2006–2015 yy. in SI «Institute of Pediatrics, Obstetrics and Gynecology NAMS Ukraine» prenatally have been examined 43 fetuses with gastroschisis. During the prenatal fetal examinations with gastroschisis in addition to the ultrasound specialists obligatory was present pediatric surgeon. Results. At 100% operated newborns with gastroschisis diagnosis was established prenatally. The frequency of early prenatal diagnosis of gastroschisis (up to 22 weeks gestation) — 43.6%, which requires further improvements. Conclusions. The main criteria for prenatal diagnosis of gastroschisis in the fetus are: the localization and size of the through defect of anterior abdominal wall, character of eventrated organs, their condition and amount; the volume of the abdominal cavity and the degree visceroabdominal imbalances; definition of associated malformations and diseases; the amount of amniotic fluid; cytogenetic examination with the definition of fetal karyotype. The algorithm of postnatal diagnosis of gastroschisis and associated malformations of diseases in newborn includes: ultrasound investigation of the abdomen and extra-abdominal areas; echocardiography and cranial ultrasonography; plain radiography of the chest and abdomen, contrast passage through the gastrointestinal tract, ergography — for suspected intestinal obstruction; neurologist consultation, and if necessary — consultation of other professionals. Key words: newborns, gastroschisis, prenatal diagnosis, postnatal diagnosis.

A review of the literature and own clinical experience in the treatment of recurrent congenital diaphragmatic hernia in children was presented. Was studied the main risk factors including the use of various types of patches that affect the recurrence of congenital diaphragmatic hernia. The paper presents clinical cases of recurrence diaphragmatic hernia in children who were treated in the department of surgical correction of congenital malformations in children SI «Institute of Pediatrics, Obstetrics and Gynecology NAMS Ukraine». The main causes of recurrence of congenital diaphragmatic hernia were defined. Key words: children, diaphragmatic hernia, recurrence, patch, plastic diaphragm.

Objective — to develop and improve the nature and extent of prenatal and early postnatal diagnosis of gastroschisis in fetuses and newborns. Patients and methods. For the period 2006–2015 yy. in SI «Institute of Pediatrics, Obstetrics and Gynecology NAMS Ukraine» prenatally have been examined 43 fetuses with gastroschisis. During the prenatal fetal examinations with gastroschisis in addition to the ultrasound specialists obligatory was present pediatric surgeon. Results. At 100% operated newborns with gastroschisis diagnosis was established prenatally. The frequency of early prenatal diagnosis of gastroschisis (up to 22 weeks gestation) — 43.6%, which requires further improvements. Conclusions. The main criteria for prenatal diagnosis of gastroschisis in the fetus are: the localization and size of the through defect of anterior abdominal wall, character of eventrated organs, their condition and amount; the volume of the abdominal cavity and the degree visceroabdominal imbalances; definition of associated malformations and diseases; the amount of amniotic fluid; cytogenetic examination with the definition of fetal karyotype. The algorithm of postnatal diagnosis of gastroschisis and associated malformations of diseases in newborn includes: ultrasound investigation of the abdomen and extra-abdominal areas; echocardiography and cranial ultrasonography; plain radiography of the chest and abdomen, contrast passage through the gastrointestinal tract, ergography — for suspected intestinal obstruction; neurologist consultation, and if necessary — consultation of other professionals. Key words: newborns, gastroschisis, prenatal diagnosis, postnatal diagnosis.

The organization of the labor group for teenagers – this is one of the possible forms of summer recreation and health improvement, Организация трудового отряда для подростков – это одна из возможных форм летнего отдыха и оздоровления

Introduction. The mode of delivery for gravidas with fetuses with GS plays an important role among the factors influencing the results of gastroschisis (GS) treatment. More researchers come to univocal conclusion that elective and early cesarean section has positive impact on elimination (prevention) of GS complications compared to previous experience in natural deliveries in term. However, the impact of the mode of delivery to anatomical features of GS remains still not investigated.The objective of the research was to determine the impact of the delivery mode on anatomical characteristics of newborn children with GS.Materials and methods. Retrospective analysis of 100 patients’ case histories was conducted. Infants were born naturally or via C-section during the period from 1987 to 2015. All newborns were divided into 3 clinical groups according to prenatal diagnosis, mode of delivery, transportation, place and term of surgical treatment of GS.Results. Localization of penetration defect of anterior abdominal wall (AAW) remains constant and typical for GS in every clinical group; therefore the mode of delivery did not have any impact upon the localization of defects in case of this malformation. The size of the penetration defect was significantly smaller in children after C-section than those born via vaginal deliveries. Thus, in Group I (children born via C-section) the defects sizes were 3.15 ± 0.09 cm, while in Groups II and III (after vaginal deliveries) the sizes were 4.17 ± 0.3 cm, p<0.01, and 4.7 ± 0.29 cm, p<0.01, respectively. The eventration rate of retroperitoneal organs (pancreas and duodenum) was significantly higher in children with GS born via natural mode of delivery (II and III clinical group) than in neonates born via C-section (I clinical group), constituting 56.0% and 63.3% to 25.0%, respectively, with p<0.01.Conclusions. The mode of delivery (C-section or vaginal) has impact on anatomical features of GS in the newborns. The size of AA

Treatment of traumatic defects and chronic venous ulcers is one of the persistent problems of medical science.Objective. To improve outcomes of patients with wounds, traumatic, functional and aesthetic defects by developing a comprehensive program of surgery to restore form and functions of the body.Materials and methods. We have operated on 179 patients with wound defects of various etiology in the clinic. Depending on the cause of wound defect, the patients were divided into groups: trophic ulcers of vascular etiology – 75 patients, post-traumatic (mechanical) wound defects – 42 patients, postishemic wound defects (compartment syndrome) – 12 patients, neurotrophic ulcers – 15 patients, consequences of purulent – inflammatory diseases – 35 patients. We consider the ultrasound duplex scanning with color mapping as the primary diagnostic criterion in choosing patients’ treatment tactics.Results. In the patients’ group with trophic ulcers of vascular etiology the first stage of treatment was sanation of trophic defect with the mandatory appointment of specific antibacterial therapy, in 58 patients autodermoplasty with the split, perforated flap was performed, in 4 patients it was carried out with single-step alofibroblasts’ transplantation, 17 patients were performed transplantation of full layer skin grafts. In patients with wounds after injury cellulocutaneous and musculocutaneous flaps on the vascular pedicle, plasty with local tissues and split seed grafting autodermoplasty were used. In compartment syndrome secondary sutures were imposed and autodermoplasty with split seed grafting was performed. In neurotrophic ulcers of vertebral localization and in the geater tochanters’ area plasty with one or two V – like musculocutaneous rotation flaps, cellulocutaneous double lobe pedicle flap was used. In patients with consequences of purulent – inflammatory complications autodermoplasty with split seed grafting and rotation cellulocutaneous flaps on the axial blood suppl

Purpose. Presented a rare clinical case of the neonate with bilateral diaphragmatic hernia, that was prenatally diagnosed on the 22nd gestation week. Bilateral congenital diaphragmatic hernia is considered incompatible with life and is the main cause of intrauterine fetal demise. I did not find any case of reported intravitam diagnosis of bilateral diaphragmatic hernia in fetus and neonate, therefore our case represents an extremely rare and interesting in the academic as well as practical point of view for obstetricians, neonatologists, pediatric surgeons, genetics and prenatal medicine specialists. Key words: congenital malformation, bilateral diaphragmatic hernias, intravitam diagnosis, neonate.

We described clinical case of successful treatment of congenital bilateral chylothorax complicated by compression of hypoplastic lungs and asphyxia in neonate. Due prenatal diagnosis, before birth, we developed tactics and strategy of treatment of chylothorax, C-section on elective basis, with presence of pediatric surgeons and intesivists. Resuscitation began on the first minute of life, including pleural puncture and chest drain placement bilaterally. Followed by conservative treatment: octreotide, TPN, chest drainage, antibacterial treatment. Proposed tactics and strategy of treatment turned out effective, child discharged on the 54th day of life. During follow-up with pediatric surgeon and pediatrician on SE «IPOG NAMS Ukraine» at the age of 8 month — good treatment effect. Key words: bilateral chylothorax, prenatal diagnosis, tactics and strategy of treatment, neonate.

Розроблено алгоритм та програма у середовищі Mathcad для графічної побудови робочого простору та визначення п’ятикоординатного верстата з паралельною структурою об'єму. An algorithm is developed and the program is developed in Mathcad for the graphic construction of workspace and determination of his volume.

Розроблено алгоритм та програма у середовищі Mathcad для графічної побудови робочого простору та визначення п’ятикоординатного верстата з паралельною структурою об'єму. An algorithm is developed and the program is developed in Mathcad for the graphic construction of workspace and determination of his volume.

Розроблено алгоритм та програма у середовищі Mathcad для графічної побудови робочого простору та визначення п’ятикоординатного верстата з паралельною структурою об'єму. An algorithm is developed and the program is developed in Mathcad for the graphic construction of workspace and determination of his volume.

Coherent X-ray diffraction techniques play an increasingly significant role in the imaging of nanoscale structures, ranging from metallic and semiconductor to biological objects. In material science, X-rays are usually considered to be of a low-destructive nature, but under certain conditions they can cause significant radiation damage and heat loading on the samples. The qualitative literature data concerning the tolerance of nanostructured samples to synchrotron radiation in coherent diffraction imaging experiments are scarce. In this work the experimental evidence of a complete destruction of polymer and gold nanosamples by the synchrotron beam is reported in the case of imaging at 1-10 nm spatial resolution. Numerical simulations based on a heat-transfer model demonstrate the high sensitivity of temperature distribution in samples to macroscopic experimental parameters such as the conduction properties of materials, radiation heat transfer and convection. However, for realistic experimental conditions the calculated rates of temperature rise alone cannot explain the melting transitions observed in the nanosamples. Comparison of these results with the literature data allows a specific scenario of the sample destruction in each particular case to be presented, and a strategy for damage reduction to be proposed.