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The interaction of water streams in channels with a complex cross section, involving the exchange of water mass and momentum between slowly flowing water in the floodplains and fast water in the main channel, significantly depends on the diversification of the surface roughness between the main channel and floodplains. Additionally, trees increase flow resistance strongly in floodplains and significantly in the main channel by intensifying the interaction process. As a result, the water velocity and the discharge capacity of both parts of the channel decrease and, at the same time, affect the flow conditions in the main channel. The results of laboratory experiments were used to determine the effect of floodplain trees on the discharge capacity of the channel with diversified roughness. The reduction in the velocity of the main channel caused by the stream interactions is described with the apparent friction coefficients introduced at the boundary between the main channel and the floodplain. The values of resistance coefficients and their changes as a result of the significant influence of trees on the interaction process were determined for different surface roughnesses of the main-channel bottom.

The COVID-19 pandemic put academic institutions around the world in the difficult position of suddenly having to organize many lectures and examinations over online channels only, due to students' physical access to their campus buildings being restricted. While the search for possible solutions to this problem was often challenging, this situation also offered the unique opportunity to establish remote examination options, that might hold the potential to be continued even after the pandemic has hopefully ended. This report looks at how the Munich University of Applied Sciences (MUAS), one of the biggest universities of applied sciences in Germany, established its own solution for remote examination over the Internet. This report provides an overview of how MUAS developed its on-site competence- and application-oriented digital examination tool to work remotely during the pandemic, its general framework and experiences that were made during its inception. Included are descriptions of the technical setting of the solution, as well as some challenges that were had when implementing it and how those were resolved. As part of this research it was concluded, that support and administrative work for this kind of remote examination was much more intensive than for on-site digital examinations, but also lessened each subsequent semester. A well-organized support system makes it possible to offer remote digital examinations with good conditions regarding, for example, student equal opportunities and secure examination environments, although even now perfect conditions cannot be guaranteed. While not without its own deficiencies, MUAS new established system was lauded by many Bavarian educational facilities and is in the process of being deployed to other Bavarian universities. This paper serves to highlight a qualitative example of how e-learning approaches can be of use in the context of higher education examinations and hopefully provide ideas for others trying to establish their own similar solutions.

The issue of the volume of lymphatic dissection in patients with complicated forms of colon cancer and the possibility of using methods of intraoperative visualisation of the affected lymph nodes remains controversial. The aim of the study – to analyse the results of using the intraoperative luminescent method of detecting affected lymph nodes in patients with complicated forms of malignant diseases of the large intestine. Materials and methods. The study group included 109 patients with complicated forms of colon cancer. In the gender structure, female patients predominated – 57 (52.29 %), there were 52 (47.71 %) men. The average age of the patients was 69.78 ± 16.37 years. Contrasting of regional lymph nodes was carried out using a 10 % sodium fluorescein solution. Results. According to the results of the fluorescence examination, in 67 (61.47 %) patients, lymph nodes were visualized in the regional lymphatic outflow: in 39 (58.21 %) cases, the visualized lymph nodes were located in the area of epi- and paracolic nodes (lymphodissection D1), in 23 (34.33 %) of patients – in the zone of mesocolic lymph nodes (lymphodissection D2) and in 5 (7.46 %) – in the zone of apical lymph nodes (3rd level of lymph drainage). A total of 268 lymph nodes were detected in 109 patients, which was an average of 2.46 lymph nodes per 1 patient. These nodes were marked and sent for histological examination separately from the main preparation. In total, a pathohistological examination of 1436 lymph nodes from the regional zone of lymph drainage from colon cancer was carried out, which was an average of 13.17 lymph nodes per 1 patient. Conclusions. The use of a 10 % solution of sodium fluorescein as a preparation for photoluminescence examination made it possible to visualize lymph nodes in the regional lymphatic outflow zone for the tumor in 67 (61.47 %) patients. The use of photoluminescence made it possible to determine the optimal volumes of lymphatic dissection without unjustified expansion in the case of surgical interventions for complicated forms of colon cancer. The levels of sensitivity and specificity of the photoluminescent method of detecting affected lymph nodes using a 10 % solution of sodium fluorescein had quite high results and amounted to 72.41 % and 93.28 %, respectively.

The aim of the study. To evaluate long-term outcomes in patients who underwent surgery due to complications of colon cancer in a general surgical hospital. Materials and methods. The study group included 71 (100 %) patients with complicated forms of colon cancer. Radical surgical interventions were performed in 48 (67.6 %) patients, palliative cytoreductive operations – in 18 (25.4 %) hospitalized patients, symptomatic – in 5 (7.0 %) patients. Results. In the postoperative period, only 37 (58.7 %) patients sought help from an oncologist at the third level of medical care. The remaining 26 (41.3 %) patients refused to consult an oncologist and specific treatments for whatever reason. Conclusions. Of the 37 (58.7 %) operated patients who sought oncological care, a chemotherapy course was initiated for 19 (51.4 %), dynamic follow-up without specific treatments was recommended for 7 (18.9 %) patients and symptomatic treatments according to the standards of palliative medical care – for 9 (24.3 %). During the follow-up period, among 43 (68.3 %) patients with non-metastatic cancer, 6 (14.0 %) of the operated patients had local recurrences, 8 (18.6 %) – regional, and 12 (27.9 %) – distant ones. In 17 (39.5 %) patients, no findings on recurrent colon cancer were revealed. Cumulative 1-year and 3-year survival rates in this category of patients were 56.3 ± 5.9 % and 38.0 ± 5.8 %, respectively.

Background. Achalasia cardia is a disease characterized by an esophageal motility disorder in which the lower esophageal sphincter fails to fully relax in response to swallo-wing and esophageal motility progressively decreases. The aim of the work is to improve the outcomes of endoscopic treatment for esophageal achalasia by modifying peroral endoscopic myotomy (POEM) in stage II–III achalasia cardia. Materials and methods. In 2019–2023, 35 (100.0 %) patients with stage II–III achalasia cardia were examined and underwent POEM at the multidisciplinary surgical department in the Educational and Scientific Medical Center “University Clinic” of the Zaporizhzhia State Medical and Pharmaceutical University. The diagnosis was made based on the following data: complaints, clinical course, esophagram, endoscopic diagnosis, and computed tomography. The average age of the patients was 50.0 ± 15.7 years. Analyzing the frequency of this disease according to the WHO age classification, there were 16 (45.7 %) young, 8 (22.9 %) middle-aged, 10 (28.6 %) elderly, and 1 (2.8 %) senile patient. The group was equal in terms of gender: 16 men (45.7 %) and 19 women (54.3 %), p = 0.9654. Inclusion criteria: age over 18 years, stage II–III achalasia cardia, informed consent of a patient. Exclusion criteria: achalasia cardia stage I, as we believe that at this stage only conservative treatment and balloon dilatation are indicated; achalasia cardia stage IV for which only Heller myotomy with Dor fundoplication are indicated. Results. All patients of the study group were operated by the method of POEM under total intravenous ane-sthesia with artificial lung ventilation. Esophageal myotomy was performed along the posterior wall, considering the risk of recurrence and preservation of the anterior wall for repeated peroral myotomy or laparoscopic Heller myotomy. The length of the myotomy was determined depending on the stage of achalasia. So, for stage II, the beginning of the endoscopic tunnel formation and myotomy was determined from the first persistent esophageal spasm, which most often corresponded to a distance of 25.0 ± 2.0 cm from the incisors and, accordingly, myotomy of the esophagus, lower esophageal sphincter, and gastric myotomy averaged 15.0 ± 3.0 cm. We noted that in all operated patients six months after the operation, a propulsive activity appeared during contrast X-ray of the esophagus, and its volume decreased from 5.6 ± 0.4 cm at stage II to 2.3–4.1 cm (p = 0.0324) and from 7.4 ± 0.2 cm at stage III to 3.6 ± 0.8 cm (p = 0.0267), which indicates a decreased pressure in the lower esophageal sphincter after surgery. Based on the evaluation of the results of multichannel esophageal gastric pH monitoring, reflux was confirmed in 1 (6.7 %) patient with achalasia stage II and in 1 (5.0 %) case with achalasia stage III. Conclusions. Peroral endoscopic myotomy is an effective minimally invasive method of treating patients with achalasia cardia stage II–III. According to the Eckardt symptom score, reliable results were achieved already one month after surgery: 7.6 ± 1.1 points before surgery and 2.1 ± 0.4 points when evaluated one month after surgical treatment (p < 0.0001, U = 475.0). Given the effectiveness and minimal trauma, the low risk of postoperative complications, a significant reduction in hospital stay and rapid postoperative rehabilitation, POEM can be an alternative to laparoscopic Heller myotomy.

This paper presents the results of a laboratory study on the discharge capacity of sharp-crested weirs fitted with a horizontal edge in pipes during open-channel flow conditions and clean water used to measure the outflow. Such sharp-crested weirs are mounted in pipes and are used to control the inflow to separators. The stream profile does not correspond to the profile given by Bazin for sharp crested weirs in channels. A desired location of the water level measurement point for flow rate calculations was provided. Discharge curves were identified for three sharp-crested weirs of 0.0465, 0.0634 and 0.0771 m in height, installed in the pipe of 0.1534 m in diameter and inclinations of 0.5 and 1.0%. The discharge curves for weir flow with free nappe does not show a significant effect of the pipe slope on the weir discharge capacity. The non-dimensional formulas for the discharge capacity of the sharp-crested weir were found as general polynomial regressions. The results indicate that the calibrated sharp-crested weir with a horizontal edge placed in a pipe can be used to control the flow. Due to the scale effect, relationships obtained from the calibration cannot be generalised to other pipe diameters and weirs heights than those analysed.

The connection between military trauma and cancer is not sufficiently studied. We present a clinical observation of metastasis of cancer of unknown primary localization into a keloid scar of the neck, which occurred after surgical treatment of a wound due to a previously suffered mine-explosive injury. There are no similar descriptions in the literature. The aim of this article is analysis of a clinical case of adenocarcinoma metastases in keloid scar tissue, which occurred after gunshot wounds to the body. Clinical observation. A young man, a military serviceman, developed a keloid scar after a landmine-explosive wound and primary surgical treatment of a neck wound, in which 2 years after excision, a metastasis of intestinal-type adenocarcinoma was detected (Cytokeratin-20+, Cytokeratin-7-, CDX-2+ and SATB 2+). With the help of clinical, endoscopic and radiological methods (computed tomography and positron emission tomography / computed tomography), the primary tumor and additional metastases in the neck, chest, abdominal cavity and pelvis could not be detected. The article analyzes the possible mechanisms of the rare case of metastasis of adenocarcinoma in the tissue of an uninfected keloid scar and discusses the concept of the formation of a premetastatic niche in the early stages of carcinogenesis of a preclinical tumor. Conclusions. This observation raises new questions for fundamental and translational studies of the process of hematogenous metastasis during the parallel progression of the primary tumor and its metastases.

Achalasia is an esophageal motility disorder characterized by symptoms of dysphagia, regurgitation of undigested food, respiratory symptoms (nocturnal cough, recurrent aspiration, and pneumonia), chest pain, and weight loss. The aim: to evaluate the results of surgical treatment for achalasia cardia by the method of laparoscopic Heller’s cardiomyotomy in combination with Dor fundoplication. Materials and methods. To evaluate the treatment results of achalasia cardia by the method of laparoscopic Heller’s cardiomyotomy with Dor fundoplication, we analyzed 30 case histories of patients who were treated in the period from 2011 to 2022. Inclusion criteria were age 18 years or older, diagnosis of stage II, III cardia achalasia confirmed using instrumental examinations. Exclusion criterion was stage I achalasia. The mean age of the patients was 53.0 ± 15.3 years. In terms of sex, this group was almost equal, there were 14 (46.7 %) women and 16 (53.3 %) men. The average duration of the disease was 5.0 ± 1.2 years. To determine the degree of achalasia, we used the radiological classification of the distal esophageal morphology in achalasia and distinguished 4 stages. Based on this classification, stage II achalasia was detected in 24 (80.0 %) patients, and stage III – in 6 (20.0 %), p = 0.0007, U = 180.0. Results. All the patients were operated on as planned. The total duration of preoperative preparation in the hospital was 0.8 ± 0.2 days. The main method of treatment in this group was laparoscopic Heller’s cardiomyotomy with Dor fundoplication. Conclusions. Laparoscopic Heller’s cardiomyotomy with fundoplication is currently one of the most effective methods of treatment for achalasia cardia. Minimally invasive surgical treatment methods for achalasia are effective in most patients, however, recurrence of symptoms in the long term occurs in 10.0–20.0 %, leaving open the question of finding new effective methods for the treatment of this pathology.

European railway borders are facing a particular exposure to security threats and need a delicate balance between securitization and free movement, especially amid globalisation, the current geopolitical landscape and increased migrant flows. For example, the war in Ukraine illustrated the challenges experienced at the Eastern EU borders by the refugee migration surge in early 2022. This exploratory focuses on the European border security control process from the rail border perspective. It encompasses a descriptive synthesis of the lessons learned from the UIC Refugee Task Force as well as insights from the ongoing EU-funded Horizon Europe project ODYSSEUS (Unobtrusive Technologies for Secure and Seamless Border Crossing for Travel Facilitation). Project ODYSSEUS aims to support the security and integrity of the European space, reduce illegal movements of people and goods across EU borders, facilitate travelling for citizens all while protecting fundamental rights of travellers. The project will test a combination of multi-behavioural and General Data Protection Regulation (GDPR) compliant biometric user identity verification tools, allowing, when possible, citizens to cross EU border without any interruption or queue. Further, novel luggage and baggage checks will allow citizens’ vehicles and cargos to be remotely checked at land borders to speed up the border check processes in a secure and reliable manner. The project will run three pilot tests at road, rail and water borders. In this paper, we analyse the implementation of project’s technologies in the rail border crossing pilot test and discuss the implications for the actors involved in the process of railway border crossing (e.g., border authorities, railway operators and railway travellers).

The development of agriculture is a key factor in the sustainable development of society in the future. The country's integration into the European community creates new opportunities for agriculture and, at the same time, requires innovative approaches to the development and competitiveness of the sector in the globalised world. The study was aimed at analysing and improving the existing strategic approaches to the development of agriculture in Ukraine based on increasing gross value added in the context of accelerated integration into the EU. A variety of methods was used, such as analytical, statistical, functional, systems analysis, deduction, synthesis, and comparison. The analysis of the development and distribution of gross domestic product and gross value added in agriculture of Ukraine and the EU, including the specifics of the development of gross value added in Ukrainian agriculture, was carried out. The influence of European integration processes on the development of agriculture, in particular, their needs and opportunities to increase gross value added, was investigated. A model of a cybernetic system with management in agriculture for the growth of gross value added in the context of accelerated integration into the EU has been developed, which allows substantiating the forecast of changes in the format of development of Ukrainian agriculture to avoid the economy as a raw material appendage of the EU. The results of the study showed that the development of agriculture in Ukraine based on increasing gross value added in the context of accelerated integration into the EU involves the use of a comprehensive strategy that considers the specifics of the industry, European innovative approaches, and best practices of in-depth processing of products of the European Union countries. The practical significance of the study was to develop specific practical recommendations and strategies for public administration bodies, agricultural enterprises to optimise the use of the available natural resource potential for the growth of agricultural production, introducing advanced technologies for its deep processing in order to accumulate gross value added, which is the basis for the development of agriculture

The aim of the study: to evaluate the 1- and 3-year survival of patients operated for complicated forms of colon cancer (СC) in general surgical hospital. Materials and methods. The study group included 71 (100 %) patients with complicated forms of СС. Acute intestinal obstruction was detected in 49 (69.1 %) patients, tumor perforation – in 13 (18.3 %), acute colonic bleeding – in 3 (4.2 %) patients, a combination of acute intestinal obstruction with tumor perforation – in 4 (5.6 %) and intestinal obstruction with bleeding – in 2 (2.8 %) operated patients. Radical operations were performed in 48 (67.6 %) patients, palliative operations – in 18 (25.4 %), symptomatic operations – in 5 (7.0 %) patients. II stage of the disease was diagnosed in 15 (21.1 %), III stage – in 32 (45.1 %), IV stage – in 24 (33.8 %) operated patients. 19 (30.2 %) patients underwent specific chemotherapy after surgery. Results. Among patients with the II stage of the oncological process 1-year survival was 76.9 ± 11.7 %, 3-year – 53.8 ± 13.8 %; with stage III, 1-year survival was 65.6 ± 8.4 %, 3-year – 50.0 ± 8.8 %; in persons with IV stage of СC – 29.2 ± 9.3 % and 8.3 ± 2.6 % respectively (χ2 = 21.8, p = 0.0001). Among male patients, 1-year survival was 51.4 ± 8.5 %, 3-year – 31.4 ± 7.9 %; women – 61.1 ± 8.1 % and 44.4 ± 8.3 %, respectively (χ2 = 2.3, p = 0.1302). Better indicators were found in the case of cancer of the left sections of the large intestine than the right sections – the 1-year survival rate was 60.4 ± 7.1 % and 43.5 ± 10.3 % respectively; 3-year – 39.6 ± 7.1 % and 30.4 ± 9.6 % (χ2 = 0.74, p = 0.3906). Conclusions. The conducted analysis indicates a clear dependence of the survival results on the stage of the disease, gender and localization of the tumor process.

The aim of this research was to experimentally analyse the possibility of using a rubber hose placed inside a pipeline to mitigate the water hammer phenomenon. The experiments were conducted using a steel pipeline with an inner diameter of 53 mm and an EPDM rubber hose with a diameter of 6 mm. Hydraulic transients were induced by a rapid closure of the valve located at the downstream end of the pipeline system. In order to analyse the influence of steady-state flow conditions on the maximum pressure increase, measurements were carried out for different values of initial pressure and discharge. The experimental results indicate that placing a rubber hose inside a pipeline can substantially attenuate valve-induced pressure oscillations. It was observed that the initial pressure has a significant influence on the capacity of the rubber hose to dampen the water hammer phenomenon. Comparative numerical calculations were performed using the Brunone–Vitkovský instant acceleration-based model of unsteady friction. It was demonstrated that this approach does not allow satisfactory reproduction of the observed pressure oscillations due to the viscoelastic properties of the EPDM hose used in the tests.

Abstract BackgroundIn recent years, the implementation of artificial intelligence (AI) in health care is progressively transforming medical fields, with the use of clinical decision support systems (CDSSs) as a notable application. Laboratory tests are vital for accurate diagnoses, but their increasing reliance presents challenges. The need for effective strategies for managing laboratory test interpretation is evident from the millions of monthly searches on test results’ significance. As the potential role of CDSSs in laboratory diagnostics gains significance, however, more research is needed to explore this area. ObjectiveThe primary objective of our study was to assess the accuracy and safety of LabTest Checker (LTC), a CDSS designed to support medical diagnoses by analyzing both laboratory test results and patients’ medical histories. MethodsThis cohort study embraced a prospective data collection approach. A total of 101 patients aged ≥18 years, in stable condition, and requiring comprehensive diagnosis were enrolled. A panel of blood laboratory tests was conducted for each participant. Participants used LTC for test result interpretation. The accuracy and safety of the tool were assessed by comparing AI-generated suggestions to experienced doctor (consultant) recommendations, which are considered the gold standard. ResultsThe system achieved a 74.3% accuracy and 100% sensitivity for emergency safety and 92.3% sensitivity for urgent cases. It potentially reduced unnecessary medical visits by 41.6% (42/101) and achieved an 82.9% accuracy in identifying underlying pathologies. ConclusionsThis study underscores the transformative potential of AI-based CDSSs in laboratory diagnostics, contributing to enhanced patient care, efficient health care systems, and improved medical outcomes. LTC’s performance evaluation highlights the advancements in AI’s role in laboratory medicine.

Complicated forms of colon cancer occupy a significant share of emergency operations in general surgical departments with high rates of mortality and complications. Assessment of possible complications and mortality before surgery is an important aspect in choosing treatment tactics for this group of patients. The aim of the study. To analyze the risks of complications and mortality in the perioperative period in patients with complicated forms of colorectal cancer using the prognostic CR-POSSUM scoring system and to determine the critical levels of the CR-POSSUM score using ROC analysis. Materials and methods. The data of 71 (100 %) patients who were treated for complicated forms of colorectal cancer were analyzed. The studied group included 36 (50.71 %) men and 35 (49.29 %) women aged 67.97 ± 12.71 years. In the postoperative period, complications were found in 32 (45.07 %) patients, there were 8 (11.27 %) deaths. Results. The mortality risk at the time of hospitalization was 6.40 (3.50; 19.10) %. The actual mortality rate in the studied group was 8 (11.27 %) patients, which corresponded to the CR-POSSUM theoretically calculated mortality risk, U = 234.0, p = 0.739. Conclusions. Increased level of complications was noted at the critical score ˃20 points, AUC = 0.744, p ˂ 0.001 (sensitivity – 71.0 %, specificity – 67.5 %) and the critical score of increasing the mortality rate was ˃22 points, AUC = 0.781, p = 0.005 (sensitivity – 75.0 %, specificity – 74.6 %) as defined by CR-POSSUM. According to the ROC analysis, the increase in mortality in the studied group did not depend on the character and complexity of surgical interventions (p = 0.159), but on the general patient condition at the time of hospital admission (р ˂ 0.001). At the same time, the increased level of complications in the group depended on both the character and complexity of the surgical intervention (p = 0.028) and on the general patient health at the time of hospitalization to the general surgical department (р ˂ 0.001).

Objective(s): We investigated the effect of short-term low-intensity direct current (LIDC) on Staphylococcus aureus.Materials and Methods: The reference strain of S. aureus was used. Experiments were performed in agar culture and on a model of rat’s femur osteomyelitis. K-wires were used as electrodes. The exposure to LIDC of 150 μA continued for one minute. In vitro exposure was performed once. In vivo group 1 was a control group. Osteomyelitis was modeled in three groups but only groups 3 and 4 were exposed to LIDC four times: either from day 1 or from day 7 post-surgery. The effect was evaluated on day 21. Microbiological, histological, scanning electron, and light microscopy methods were used for evaluation of the LIDC effect. Results: Bacteria diameter, oblongness, and division increased 15 min after LIDC exposure in the culture around the cathode. After 24 hr, the amount of exomatrix was lower than in the control test, and the cell diameter and roundness increased. Similar changes around the anode were less pronounced. In vivo, biofilm formation on the intramedullary wire cathode was suppressed in group 3. In group 4, detachment and destruction of the biofilm were observed. The formation of S. aureus microcolonies was suppressed, and the adhesion of fibroblasts and immune cells was activated. LIDC did not stop the development of the osteomyelitis process.Conclusion: Short-term exposure to LIDC suppresses S. aureus biofilm formation on the implant cathode surface in the acute and early postoperative period but does not have an impact on the development of osteomyelitis.

The article delves into the theoretical and legal dimensions of safeguarding children's rights within the framework of enforcement proceedings guarantees. It presents the guarantee system as comprising various elements, such as procedural oversight, appeals mechanisms against executor actions, measures for holding violators accountable, involvement of relevant professionals, and the normative regulation of rights and obligations for all participants. Through legislative analysis and practical examination, the article asserts that safeguarding children's rights in enforcement proceedings unfolds in two primary facets: protection of property rights and protection of personal non-property rights. In the realm of property rights, emphasis is placed on securing child support payments from debtor parents to foster the child's well-rounded development. Additionally, it addresses preventing the eviction of a minor from mortgaged housing in cases involving parents-mortgagors. For the protection of non-property rights, measures include child removal, establishment of visitation rights, and removal of obstacles to visitation. The article underscores the importance of sound reasoning and evidence when considering temporary child placement and ensures debtors receive copies of enforcement proceedings decisions during searches. It advocates for petitioning the court to amend or clarify visitation-related decisions. Special attention is given to the involvement of professionals such as doctors, teachers, and psychologists in enforcement proceedings to safeguard minors' rights, ensuring their mental and physical well-being and preventing potential abuse by involved parties

Aim. To assess the condition severity and predict postoperative complications and mortality in elderly and senile patients with perforated gastric and duodenal ulcer using the P-POSSUM score. Materials and methods. To conduct a scientific study, 80 (100.0 %) cases of treatment for patients aged 60 to 89 years with a diagnosis of gastric or duodenal ulcer perforation were analyzed. At the stage of hospitalization, the general condition was assessed using the variables of the P-POSSUM score. All patients underwent emergency surgery. Results. The obtained sum of points was compared with postoperative complications and mortality. We defined the discrimination point as >43 points for postoperative complications and >48 points for mortality. Based on the result, the patients were divided into group A with a sum of points up to 43 inclusive – 39 patients (48.8 %), and with a greater number of points – 41 patients (51.2 %) – group B. Evaluation of the detected complications in the postoperative period and comparison with the sum of points significantly confirmed an increase in their frequency in group B (sum of points >43) as compared to group A (sum of points ≤43) – p = 0.0018, U = 474.0. To compare the mortality rate, all the patients were divided into group C – 48 (60.0 %) patients with a sum of points ≤48, and group D – 32 patients (40.0 %) with a sum of points ≥49. In the group of patients with a total score >48 (group D), the mortality rate was significantly increased compared to group C with a score ≤48, p = 0.0002, U = 384.0. Conclusions. Our study has led to the following conclusions: the P-POSSUM score use in elderly and senile patients with perforated gastric and duodenal ulcers significantly confirms the increase in the frequency of postoperative complications, in group A – 6 (15.4 %) patients, while in group B – 23 (56.1 %), p = 0.0018, U = 474.0 and increased mortality, in group C – 6.3 %, in group D – 56.3 %, p = 0.0002, U = 384.0; the P-POSSUM score provides reliable prediction an increase in the risk of postoperative complications and mortality. This, in turn, makes it possible to predict and change treatment approaches and improve the quality of emergency surgical care for elderly and senile patients.

The article continues a series of studies of the intentional space of social media and discursive markers of users’ intentions. The aim of the study was to test the possibility of determining speech intentions by their markers in the discourse. Participants — 291 individuals (77 males, 214 females; M=19.4 years). Respondents filled out a methodology prepared taking into account expert assessment, which contained 18 statements of social network users, and noted the intentions expressed in them. The first version of the methodology form, with statements without markers, was completed by 97 respondents, the second one, with one marker, by 96 respondents, and the third, with three markers, by 98 respondents. It has been founded that the intentions “to express doubt”, “to object” and “to insult” are best defined, while the intention “to criticize” is the worst identified. The addition of discourse markers generally improves the determination of intentions, which is consistent with their understanding as specific discourse regulators that clarify the contextual reference of what is said. This tendency is not found in all the categories studied, which is due to the possibility of subjective interpretation of sayings and ambiguity of the context. The variants of mixing of intentions in case of their incorrect identification are described. Some intentions are more often mixed with one category, which is due to their cognitive closeness, while others are mixed with a set of intentions, which indicates their blurring in consciousness. An analysis of the use of markers showes that only some intentions can be considered discursively identified. This encourages further search for markers of speech intentions and opens up new research perspectives.

The article presents an approach to studying the psychological impact of cinema in the context of narrative influence. The theory of transportation developed by M. Green and T. Brock (Transportation Theory) and the concept of transportation introduced by them as a special state of involvement and immersion in a narrative. It helps to enhance the psychological impact and can lead to a change in a person’s beliefs related to the content of the narrative. There are two main groups of factors, which determine the level of narrative transportation: the quality of the narrative and the individual psychological characteristics of the recipient. The empirical study conducted on 1171 university students aged 17 to 29 years (49.3% men and 50.7% women; M=19.8, SD=1.9) showed that the level of narrative transportation differs depending on gender, which may be due to the greater proximity of a particular film to a certain audience. The sudy revealed a connection between transportation, empathy, as well as , openness to experience and extraversion. Empathy was the most significant predictor of transportation. The feedback of the respondents with high and low levels of transportation helped us to identify the characteristics of transportable narratives. Among them were that the film had an idea, the importance and relevance of the problems posed, a potential impact, as well as the plot of the film, its logic and dynamism, the realism of what was shown, and the attractiveness of the story itself

The situation in which Ukraine has found itself since February 2022 has also contributed to the development of digitalisation of all processes in higher education. Thus, higher education institutions have forms of control such as course design, diploma design, various practices, etc. In this context, the issue of digitalising the process of diploma design is the most relevant since explanatory notes to qualification works must be kept at the university upon graduation and go through several stages to be admitted to defence. The article presents the experience of the Zhytomyr Polytechnic State University in digitalising the process of diploma design. The procedure of preparing and defending a qualification work with a detailed description of each step is presented. The article discusses the peculiarities of implementing an electronic digital signature in the Zhytomyr Polytechnic Portal

Aim: to assess the treatment effectiveness in patients with soft tissue gunshot shrapnel injuries by applying primary delayed sutures in combination with platelet-rich autoplasma injections into wounds. Materials and methods. The study included 60 (100.0 %) patients with soft tissue gunshot shrapnel wounds. All wounded were divided into two groups. The comparison group consisted of 30 (50.0 %) patients admitted to a hospital with primary delayed sutures (6–7 days). The main group included 30 (50.0 %) patients whose local treatment modification consisted in a combination of primary delayed suturing with platelet-rich autoplasma injection into a wound. A wound channel was observed on the 8th, 11th –14th days from the moment of injury using visual inspection, linear measurements and diagnostic ultrasound system (Mindray M6, 220A). Results. 60 (100.0 %) patients were urgently hospitalized to the third stage of medical evacuation and treated according to standard treatment protocols for this pathology at the third stage of evacuation. According to a wound defect localization, the wounded of the comparison groups, 30 (50.00 %), were distributed as follows: a lower limb wound – 22 (73.33 %) patients, an upper limb wound – 6 (20.00 %), and a trunk wound – 2 (6.67 %). The main group also included 30 (50.00 %) wounded, whose treatment at the third stage of medical evacuation was modified by using a combination of primary delayed sutures and platelet-rich autoplasma injection. On the 8th day after an injury, a visual inspection of the wounds detected no hyperemia or suppuration in both groups. The visual inspection of wounds in the comparison group at 11.0 ± 3.9 days post-injury revealed 24 (80.00 %) patients with complications such as seromas in 17 (56.67 %) cases, hematomas with wound suppuration – in 7 (23.33 %). In the main group, 2 (6.67 %) cases of wound suppuration were detected (U = 120.00, p = 0.000001). The basic parameters of wound linear measurements according to the diagnostic ultrasound system data at the 11th–14th day post-injury after primary and delayed suturing in the studied groups: in the comparison group, upper limb wounds – S (mm2) 43.3 ± 12.6, V (mm3) 53.3 ± 13.9; lower limb wounds – S (mm2) 194.7 ± 50.7, V (mm3) 706.3 ± 190.4; trunk wounds – S (mm2) 20.5 ± 7.2, V (mm3) 22.5 ± 5.4. In the main group, upper limb wounds – S (mm2) 28.2 ± 8.5, V (mm3) 23.2 ± 7.1; lower limb wounds – S (mm2) 56.4 ± 19.6, V (mm3) 102.4 ± 21.1; trunk wounds – S (mm2) 12.3 ± 3.2, V (mm3) 10.4 ± 2.9. The total duration of inpatient treatment at the 3rd stage of medical evacuation in the comparison group wounded was 30.0 ± 2.3 days, and in the main group it was 12.0 ± 3.1 days (U = 290.00, p = 0.0354). Conclusions. In the structure of gunshot shrapnel wounds in both groups, there were 43 (71.67 %) lower limb traumatic injuries, 11 (18.33 %) upper limb, and 6 (10.00 %) trunk injuries. The use of platelet-rich autoplasma in combination with primary delayed suturing stimulated wound healing and accelerated wound-healing process as evidenced by a significant decrease in the wound defect area and volume on the 11th–14th day post-injury in the main group compared to the comparison group. The method for treatment of gunshot shrapnel wounds developed by us reduced the frequency of postoperative complications since 24 (80.00 %) patients were diagnosed with complications in the comparison group, while only 2 (6.67 %) patients in the main group (U = 120.00, p = 0.00001). The use of platelet-rich autoplasma made it possible to reduce the length of hospital stay for patients at the third stage of medical evacuation: in the comparison group, this period was 30.0 ± 2.3 days, and in the main group, 12.0 ± 3.1 days (U = 290.00, p = 0.0354).

Intestinal obstruction is observed in about 9.0 % of patients with acute surgical pathology of the abdominal cavity. The disease occurs at any age, but more often between 25–50 years. Mixed intestinal obstruction is only 3–7 %. The most common form of mixed intestinal obstruction is intestinal invasion. The most common cause of intussusception in adults is an intestinal tumor. Early diagnosis and the optimal amount of surgical treatment are the main components of successful treatment of the patient. Aim: to familiarize practitioners with a rare case of intestinal obstruction in adults and its management strategies in a surgical hospital. Materials and methods. The patient was treated in the surgical department of the Communal Non-Profit Enterprise “City Hospital No. 7” Zaporizhzhia City Consul. The patient underwent preoperative preparation and surgical intervention. Results. The patient underwent an emergency median laparotomy under total intravenous anesthesia with artificial lung ventilation. During the examination of the abdominal cavity, multiple distended loops of the small intestine were visualized. During the revision, at a distance of 1.5 meters from the ligament of Treitz, a volumetric formation of the small intestine of dense-elastic consistency, represented by small-intestinal invasion, up to 10 cm long, was detected. The proximal sections of the small intestine are distended, light purple in color. The sections of the small intestine that were distal to the site of invasion were inflamed. Manual disinvagination of the small intestine was performed. The visual examination showed that the intestine was viable. There was a tumor was found on the antrumeral margin, measuring 1.8 × 2.5 cm, dense in consistency, finely tuberculated, dark purple heterogeneous in color, infiltrating and deforming the wall of the small intestine. Resection of the invaded area of the small intestine with the tumor was performed with the imposition of a small-small intestinal anastomosis “side to side” with two-row nylon sutures. Conclusions. In this clinical case, it was possible to establish the final diagnosis and determine further surgical strategy only intraoperatively. Only early diagnosis of melanoma will allow avoiding the complications identified in this patient.

Tiliroside is a natural polyphenolic compound with a wide range of biological activity, and defatted strawberry seeds are its rich source. The goal of this study was to optimize accelerated solvent extraction (ASE) conditions, including temperature, solvent composition, and the number of extraction cycles, using Box–Behnken design to maximize the yield of tiliroside. UPLC-DAD-MS was applied to investigate the polyphenolic composition of the extracts, and preparative liquid chromatography (pLC) was used for isolation. All obtained mathematical models generally showed an increase in the efficiency of isolating polyphenolic compounds with an increase in temperature, ethanol content, and the number of extraction cycles. The optimal established ASE conditions for tiliroside were as follows: a temperature of 65 °C, 63% ethanol in water, and four extraction cycles. This allowed for the obtainment of a tiliroside-rich fraction, and the recovery of isolated tiliroside from plant material reached 243.2 mg from 100 g. Our study showed that ASE ensures the isolation of a tiliroside-rich fraction with high effectiveness. Furthermore, defatted strawberry seeds proved to be a convenient source of tiliroside because the matrix of accompanying components is relatively poor, which facilitates separation.

The aim of the study: to analyze the results of surgical treatment and pathomorphological examination of preparations of patients who were urgently operated on for complicated forms of colon cancer, and to assess their influence on the correct staging of the tumor process in the postoperative period. Materials and methods. An analysis of data from pathomorphological studies of 71 (100 %) patients who underwent treatment at the surgical department for complicated forms of colon cancer was carried out. Results. Colon adenocarcinoma was detected in all 71 (100 %) patients (mucinous adenocarcinoma in 3 (4.23 %) patients, and the rest 68 (95.77 %) – unspecified adenocarcinoma). 44 (61.97 %) patients were diagnosed with moderately differentiated adenocarcinoma of the colon, 25 (35.21 %) – with poorly differentiated, and 2 (2.82 %) – with highly differentiated tumors. Conclusions. In the case of surgical interventions for complicated forms of colon cancer, lymphatic dissection in the minimum extent (D1) was performed in 54 (76.06 %) patients, and 17 (23.94 %) patients were operated on without removal of lymph nodes. The insufficient level of performing lymphatic dissections in patients with complicated forms of malignant pathology of the large intestine does not make it possible to assess the real picture of metastatic lesions of regional lymph nodes and to assign the correct stage of pN according to TNM 8 (in 17 (23.94 %) patients, no pathomorphological assessment was performed at all, and in 40 (56.34 %) patients, the number of examined lymph nodes were not indicated in the preparation). In the structure of staging of oncopathology, in 12 (16.90 %) patients, the stage of cancer was assign only according to the criterion of the degree of invasion (T) and in 5 (7.04 %) patients – only according to the data of instrumental examination and intraoperative revision (clinically), and was overestimated. Lack of a clear consistent assessment of the macroscopic, microscopic, immunohistochemical and molecular characteristics of the tumor process in 17 (23.94 %) patients leads to inaccuracies in the assessment of the stage of the tumor process, which in turn affects the prognosis for relapse and survival of the patient, and the tactic of postoperative treatment.

Onion stemphiliosis is a relatively new disease in Ukraine, so a deeper study of Stemphylium, the species composition of the pathocenosis, and isolation and determination of the species belonging of pathogens of the disease are relevant. The purpose of the study was to examine the species composition of pathocenosis, the biofenology of the causative agent of stemphiliosis, and determine the effectiveness of fungicides for further control of stemphiliosis in onion crops. The main research methods were: field – to determine the spread, development, and harmfulness of stemphiliosis; laboratory – to examine pathogens of onion diseases; visual and mathematical – statistical. The method of mycological crops on potato-dextrose agar (PDA) was used in the work. Field surveys in 2019-2021 established the spread and development of stemphiliosis in onion plantings in the Odesa District of the Odesa region. It was identified that the growing season of 2021 was the most favourable for stemphiliosis, when against the background of high humidity and air temperatures, the spread of the disease was 100%, and the development of the disease reached 79%. In onion crops, the disease developed unevenly, its spread was low in June, with rapid growth in July. At the beginning of August, the percentage of the disease reached 80%. Eight types of fungi were identified, of which Stemphylium vesicarium (Wallr.) Simm, Stemphylium botryosum Wallr, Stemphylium herbarum Simm. – are pathogens of onion stemphiliosis. Laboratory studies established the frequency of their distribution in samples. It is proved that five-time spraying with fungicides helps to reduce the further development of stemphiliosis in onion plantings. The high effectiveness of spraying plants with appropriate fungicides with the active substance fluopyram (200 g/l) + tebuconazole (200 g/l) and fluoxastrobin (100 g/l) + prothioconazole (100 g/l) to suppress the development of spores of pathogens is proven. The provisions and conclusions on the phytosanitary condition of onion plantations in the Odesa region are further developed. The results of the research can serve to develop recommendations for production on the implementation of measures to protect onions from stemphiliosis