The impact of certain factors on complications development in patients with multiple long bone fractures of lower extremities and severe associated trauma

The aim: to determine the influence of individual factors on the development of complications in patients with polytrauma and multiple long bone fractures of lower extremities.Materials and methods: a prospective study conducted inKyivCityClinicalHospital №17 from December 2016 to January 2020. The study included 57 patients with polytrauma and multiple long bone fractures of lower extremities, treated according to the proposed algorithm.Results: the most common complications were: pneumonia (21.1%), acute respiratory distress syndrome (ARDS) (15.8%), multiple organ failure (MOF) (15.8%), sepsis (8.8%), mortality (12.3%). A number of factors influenced the development of complications in patients with multiple long bone fractures of lower extremities and polytrauma were identified and the correlation analysis was conducted. These factors included: age; sex; the Injury Severity Score (ISS); the Glasgow Coma Scale (GCS); the severity of a general condition of a patient according to the Clinical Grading Scale (CGS); trauma to the head, and neck, chest, abdomen, pelvis; head and neck, chest, abdomen, pelvis trauma in accordance with the Abbreviated Injury Scale (AIS); the number of segments of damaged limbs; Gustilo-Anderson fracture type; blood loss volume; massive blood transfusions; respiratory index; duration of mechanical ventilation (MV); treatment tactics; osteosynthesis method; conversion phasing.Conclusion: the analysis allowed to identify the most significant factors that lead to complications in patients with multiple long bone fractures of lower extremities and polytrauma. Informative parameters were:−                   for pneumonia: GCS and CGS; chest injury; AIS head and neck, chest ≥ 4; duration of MV; treatment tactics; conversion phasing (IC = 1.0-2.1).−                   for ARDS: GCS and CGS; AIS chest ≥ 4; fractures > 2 long bones; blood loss volume; massive blood transfusions; respiratory index; duration of MV; treatment tactics (IC = 1.2-4.6).−                   for sepsis: GCS; trauma to the chest, abdomen; AIS head and neck, abdominal cavity ≥ 4; fractures > 2 long bones; conversion phasing (IC = 1.1-3.2).−                   for MOF: GCS and CGS; abdominal trauma; AIS abdominal cavity ≥ 4; fractures > 2 long bones; massive blood transfusions; conversion phasing (IC = 1.2-2.2).−                   for mortality: age, ISS, GCS and CGS; abdominal trauma; AIS head and neck; chest, abdomen, pelvis ≥ 4; blood loss volume; massive blood transfusions; duration of MV (IC = 1,1-5,9).Among the factors there were those for which the diagnostic and treatment process:−                   affected: the choice of treatment tactics (IC = 1,1-1,3); use of massive blood transfusions (IC = 1.8-4.8); duration of MV (IC = 1,2-2,1); conversion of the fixation method (IC = 1.2-1.8).−                   did not affect: GCS (IC = 1,2-3,1), CGS (IC = 1,1-1,3), AIS (IC = 1,0-6,2)

ECONOMIC METHODS OF PUBLIC ADMINISTRATION OF SOCIAL PROTECTION OF PERSONS WITH PERSISTENT HEALTH DISORDERS

The purpose of the article is to study the nature of various economic methods of public administration of social protection of persons with persistent health disorders. For this purpose, by means of the dialectical method, methods of analysis, documentary analysis, systematisation, explanation, comparison, induction and specification, legislative and theoretical-practical aspects of the relevant economic methods of public administration of the researched area were studied. As a result, the conceptual apparatus of the problem declared in the article was analysed, namely the existing definitions of the categories "disabled person", "social protection of persons with persistent health disorders", "public administration method" and "economic management methods". The authors' understanding of the concepts of "public administration of social protection of persons with persistent health disorders" and "economic methods of public administration of social protection of persons with persistent health disorders" is presented. Categories of persons who, in accordance with the legislation of Ukraine, are equated in social protection matters with persons with persistent health disorders, in particular: disabled persons; combatants; victims; the elderly; children with musculoskeletal disorders. Types of economic methods identified in the scientific literature (long-, medium- and short-term planning, licensing, quotas, commercial calculation, taxation, credit, budget system, economic regulators, incentives, setting minimum levels of social standards and benefits, pricing, responsibility). Given the specifics of the listed economic methods, it is proposed to classify them into five types according to the purpose of application. The study identified various economic methods of public administration in the researched area. These methods involve planning expenditures in state and local budgets focused on social protection for disabled individuals and financing for the same. The development, approval and implementation of social protection programs for disabled individuals and the elderly also fall under the purview of these methods. Additionally, financial aid is provided to support public movements in the field of social and legal protection for disabled individuals. Establishing minimum social standards, setting maximum prices for goods, works, and services, determining employment standards for disabled individuals, implementing measures to promote their employment, enforcing responsibility for non-compliance with legislation related to social protection of disabled persons, licensing specific types of economic activity, and implementing taxation regulations. Each of the economic methods is analysed in a distinct section of the article, with reference to the legislative norms that regulate their implementation, coupled with empirical evidence. The article's value lies in its intricate portrayal of the authors' perspective on the economic techniques employed, public administration methods for ensuring social protection of individuals with chronic health disorders, and their efficacy in safeguarding the rights of the socially vulnerable population

Tris(2,2′-bipyridine-κ2 N,N′)cobalt(III) tris­(oxalato-κ2 O 1,O 2)ferrate(III) mono­hydrate

The title compound, [Co(C10H8N2)3][Fe(C2O4)3]·H2O, con­sists of two discrete tris­(chelate) metal ions (CoIIIN6 and FeIIIO6 chromophores) and a water mol­ecule. The structure is highly symmetrical; the CoIII and FeIII ions occupy positions with site symmetry 3.2. The coordination polyhedra of the metal atoms have a nearly octa­hedral geometry with noticeable trigonal distortions. The Co—N and Fe—O bond lengths are equal by symmetry, viz. 1.981 (2) and 1.998 (4) Å, respectively. The cations and anions are arranged alternately along their threefold rotation axes parallel to [001], forming chains that are packed in a hexa­gonal manner. The water mol­ecules occupy voids between the chains. The crystal under investigation was an inversion twin

Hexa­kis­(dimethyl­formamide-κO)manganese(II) μ-oxido-bis­[trichlorido­ferrate(III)]

The title compound, [Mn(C3H7NO)6][Fe2Cl6O], was obtained unintentionally as a product of an attempted synthesis of heterometallic complexes with Schiff base ligands using manganese powder and FeCl3·6H2O as starting materials. In the [Fe2OCl6]2− anion, the O atom and the Fe atom occupy positions with site symmetry and 3, respectively, resulting in a linear Fe—O—Fe angle and a staggered conformation. The octa­hedrally surrounded cation (site symmetry ) and the [Fe2Cl6O]2− anion are alternately stacked along [001]

Business Risk in Changing Dynamics of Global Village 2

The monograph is prepared based on the presentations and discussions made at the II International Conference “BUSINESS RISK IN CHANGING DYNAMICS OF GLOBAL VILLAGE (BRCDGV 2019)”, November, 7th-08th, 2019, in Ternopil, Ukraine. The aim of this scientific international conference is to provide a platform for professional debate with the participation of experts from around the globe in order to identify & analyze risks and opportunities in today’s global business, and specifically in Ukraine. The conference will provide a framework for researchers, business elites and decision makers to uplift the business ties and minimise the risk for creating a better world and better Ukraine.The Conference is designed to call experts around the globe from different sectors of practices which are effected by globalization and watching changes in Europe as well as in Ukraine. It is an excellent platform for interactions and communication between academicians, corporate representatives, policy makers, representatives of organizations and community, as well as individuals being the part of this globalized world. The 1st edition of this conference was held at the University of Applied Sciences in Nysa, Poland (2017); the 2nd edition took place at Ternopil Ivan Puluj National Technical University, Ukraine (2019); the 3rd edition will be organized at Patna University, India (2020) in cooperation with Indo-European Education Foundation (IEEF, Poland) and its partner universities from Poland, India, Europe and other part of the world.Under modern conditions of globalization nowadays, economic activity is undergoing changes. Innovative technologies, new forms of business, dynamic changes taking place in the world today result in the emergence of the necessity to minimize risks in order to maximize benefits. The cooperation between experts from different fields with the aim to ensure sustainable growth – policymakers, scientists, universities representatives and business elites is essential nowadays. With the purpose to bring them together and discuss the main issues of todays’ global world this conference took place in Ternopil, Ukraine. As Ukraine is now passing through a dynamic period of changes, recommendations coming up from such discussions can be very beneficial for building stronger society and meet the risks globalization brings up. This monograph provides a useful review of economic, financial and policy issues in the context of globalization processes and has proven extremely popular with practitioners and industry advisors. This edition is given the continued high demand and interest for experts form different areas working on diminishing of business risks wishing to keep abreast of current thinking on this subject. According to many experts process of managing risks is currently one of the most relevant business technologies and at the same time it is a complex process which requires ground knowledge in the research field and practical experience. The popularity of business risks management is due to objective reasons such as dynamics of society, interconnections and interdependence between different players in the society, increasing role of human capital in the country’s sustainable developmen

Моделі та інформаційні технології проектування і управління в складних системах

Запропонований комплекс моделей для СППР оператора-керівника автоматизованих систем керування створює основу для автоматизації процесу надання операторові-керівникові інформаційної підтримки при ухваленні рішення про прийняття ергономічних розв'язків. У результаті проведених досліджень установлено факт приділення недостатньої уваги питанням управління при комп’ютеризації проектних робіт. Для реалізації можливості управління процесом проектування зроблено системний аналіз процесу проектування технічних об’єктів, запропоновано зв’язки системи автоматизації проектних робіт із зовнішнім середовищем, встановлена необхідність наявності трьох видів програмного забезпечення для функціонування системи, представлено обґрунтоване виконання проектних робіт за схемою «зверху-вниз», складено інформаційну модель для підтримки процесу проектування та отримано архітектурне рішення для системи автоматизації проектних робіт в організаціях, виявлено відсутність інформаційного опису процесів діяльності, який дозволяє їх супроводжувати протягом усього життєвого циклу. Єдина модель сприяє автоматизації роботи виконавців із різними рівнями повноважень, забезпечує однозначність розуміння ними виконуваних завдань

Advanced Bioactive Compounds Countering the Effects of Radiological, Chemical and Biological AgentsStrategies to Counter Biological Damage /

XVIII, 287 p. 67 illus.online resource