Kyiv City Research Articles

Effects of urbanization and Kaniv Reservoir on the thermal characteristics in the region

This study contributes to understanding the effects of urbanization and a large body of water, Kaniv Reservoir, on thermal characteristics in the region. This was done by recording trends in air and surface temperatures in the growing seasons in the period 1985–2022. Specifically, the study’s objectives were to 1) detect and quantify changes in built-up areas using Landsat satellite data, and 2) analyse trends in land surface temperature (LST) in several shoreland zones of the reservoir with different land covers. To identify built-up areas, Landsat data was processed. LST was calculated using Google Earth Engine for the period studied for three shoreland zones and six types of land cover, including sites with substantial, partial and no change in land use. The built-up area increased unevenly over time and differently in each of the shoreland zones. The growth in built-up area was greatest, increasing by 3.7 times, in a zone close to the city of Kyiv. The highest mean LST values were recorded in the zone that was mainly agricultural. Positive LST trends were recorded throughout the entire period of the study, albeit with different trend slopes in individual months. Statistically significant trends were recorded only in August and September.

Споживання нутрієнтів та його зв’язок із психоемоційним станом і метаболічним профілем в українських жінок під час війни

Acute and chronic stress caused by war leads to psychoemotional disorders that can change eating habits and impair metabolic health. The aim of the study was to investigate the nutrient intake of Ukrainian women and its association with psychoemotional state and metabolic profile. The study included women aged 30-75 years, residents of the City of Kyiv and the Region of Kyiv, who underwent a comprehensive examination during the war (main group, n = 76) and before the war (control group, n = 80). Participants underwent anthropometry, analysis of glucose and lipid metabolism, nutrition was studied using a semi-quantitative food frequency questionnaire. In the main group, plasma cortisol level was measured and questionnaires were used to assess the psychoemotional state. Women examined during the war had worse glucose metabolism and changes in nutrient intake, such as an increase in total energy and the proportion of animal protein and plant fat accompanied by a high proportion of simple carbohydrates. Higher animal protein intake was an independent predictor of fasting glycaemia. Symptoms of post-traumatic stress disorder and insomnia were predictors of increased fasting glycaemia during the war and were accompanied by higher consumption of simple carbohydrates. Trait and state anxiety increased with lower animal protein intake and higher starch intake. State anxiety was also higher in women with a lower fat proportion in diet. Higher fat intake during the war may be a compensatory dietary change to mitigate negative emotions and chronic stress. To prevent the progression of metabolic disorders in women affected by war, it is necessary to develop healthy eating habits and provide psychological support to counteract stressful influences.

Forensic characteristics of injuries from thermo-baric explosive device

Since the beginning of the Russian Federation's invasion of Ukraine in 2022, explosive trauma has become an extremely urgent problem, as the main source of bodily injury among both the military in the combat zone and the civilian population in cities has been the impact of explosive devices. The aim of the study is the examination of the forensic characteristics of damage to biological objects that were formed from thermal exposure and shock wave as a result of the explosion of a cumulative munition and in the conditions of an experimental explosion model. The objects of the study were the materials of two examinations on the death of Ukrainian soldiers who died in the war zone (archival "Conclusions of the medical examination" of the Kyiv City Clinical Bureau of Forensic Medical Examination in 2023). Under the conditions of the experiment, studies of pathomorphological changes in the liver and small intestine of 30 white outbred rats from the action of an artificially created air shock wave with an overpressure of 31.62±4.84 kPa were carried out. The injuries were examined macroscopically and using standard laboratory histological techniques. Microscopy of histological sections was performed using an Axio Imager 2 microscope (Zeiss, Germany) at magnifications of ×200 and ×400. Statistical processing of the obtained quantitative results was carried out using the STATISTICA 6.1 software product. Under the condition of the explosion of the ammunition with the cumulative effect of the rocket-propelled infantry flamethrower "Bumblebee" on sectional incisions of the skin and muscles of the thigh in the projection of areas of redness, a picture of a gelatinous consistency of bright red color was macroscopically determined due to abundant blood impregnation of muscles and subcutaneous fat and partial loss of muscle structure with the release of myoglobin. The bright red color of the skin of the thigh and pelvis without burning the hair may indicate the superficial thermal effect of the explosive device and the protection of the skin by clothing. Diffusely located numerous both paired and single abrasions and shallow wounds, small rounded, oblong, circular in shape, which are the result of fragments of a rocket-propelled grenade equipped with a fire mixture, were also determined. The effect of an air shock wave with an overpressure of 31.62±4.84 kPa on the liver parenchyma of rats was determined by focal hemorrhages with rupture of the terminal central vein of the hepatic lobule, edema of the parasinusoidal spaces, and sludges in the sinusoids. In the wall of the small intestine, acute hemodynamic disorders occurred in the form of vasodilation of arterial vessels, venular and capillary stasis. There was layering and swelling of the small intestine wall, rupture of veins, focal hemorrhage. Thus, the revealed characteristic pathomorphological signs of the destructive effect of overpressure as a result of a blast wave (barotrauma) are typical and common both in the areas of the human thigh and pelvis, and in biological objects of experimental animals. The obtained results are consistent with the pathomorphological manifestations of barotrauma in areas of the human body as a result of the action of an explosive device with a cumulative effect.

Prognostication of zones with variable physical and mechanical characteristics of soil massifs

Purpose. The use of geographic information systems, in particular Google Earth Pro and Golden Software Surfer, to predict and visualize changes in the geological structure and create 3D models of built-up areas in the central part of Kyiv. Methodology. The research methodology included several stages and an integrated approach to the analysis of man-made soils in the city of Kyiv. Field studies were carried out with soil sampling in the building area for laboratory analyzes with the degree of concentration of man-made sediments. Modeling and data analysis with the creation of 3D models of man-made soils in the Surfer software package with interpolation of field and laboratory research data into GIS to analyze the distribution of man-made soils. The results of the study were obtained. The results of the study emphasize the importance of an integrated approach to the analysis and management of man-made soils in the urban environment, which contributes to improving the safety and efficiency of construction processes in Kyiv. Based on the collected data, 3D models of man-made soils were created, which made it possible to visualize their distribution and assess the risks associated with construction in dense urban areas. Originality. A methodology for studying the distribution of geotechnogenic soils depending on their concentration has been developed. The dependencies of the distribution of pollution in depth on the building area of the Podilskyi district of Kyiv have been obtained. The use of geographic information systems for forecasting the distribution and volumes of soils with variable physical and mechanical characteristics is proposed. Using Google Earth Pro cellular data and creating a 3D model allows you to analyze the concentration of pollution by man-made soils in an urbanized area. Practical value. The results of the study allow for a better understanding of the geological structure of man-made soils and their impact on the bearing capacity of building foundations. This helps to avoid possible problems with the stability of buildings and increases the safety of building structures. The use of geographic information systems and 3D modeling makes it possible to conveniently and accurately predict the distribution of man-made soils on construction sites, which contributes to the optimization of design solutions and efficient use of resources.

Catalogue of Nebria picicornis (Fabricius, 1792) (Coleoptera, Carabidae) specimens deposited in the State Museum of Natural History NASU, Lviv, Ukraine

The species Nebria picicornis (Fabricius, 1792) belongs to the genus, distributed in the Palaearctic, Middle East and North Africa, and represented by more than 500 described species (Catalogue of Life, 2023). In Ukraine, the genus is represented by 9 species. Nebria picicornis (Fabricius, 1792) has been recorded from thefollowing localities in Ukraine: outskirts of Sambir town, Spas village (Nowicki, 1858), the Eastern Beskydy up to Chornohora range (Nowicki, 1864), Ivano-Frankivsk city at the Bystrytsia river, in the river silt deposits (Łomnicki, 1886), beech forest zone of the Carpathians (Nowicki, 1873), Galicia, Bukovyna, Podilska gubernias , Zelemianka river, Bolekhiv town , NR «Gorgany» , foothill and lowland areas of the Carpathians: Ciscarpathian Upland, Beskydy massif, Gorgany massif, Pokutsko-Bukovynski Carpathians, Krasna range, as well as the Klavdievo village near Kyiv city, 10.V.1976 р., 2 spec., V.G. Dolin (IZU) , the Carpathians (including the Ciscarpathian Upland with foothills above 300 m a.s.l.), Right-Bank Polissia (mixed forest zone), Broadleaf Forest Zone (including the Ciscarpathian Upland, but with foothills of the Carpathians up to 300 m a.s.l. and Male Polissia) . Nebria picicornis (Fabricius, 1792) is distributed in the mountains and foothills of Central Europe and the northern part of southern Europe (Burakowski et al., 1973). In Ukraine it is found in the belts of oak and beech forests and lives along the banks of rivers and streams . There are 34 specimens of Nebria picicornis (Fabricius, 1792) in the collection of the State Museum of Natural History NASU, Lviv. The beetles were collected by Łomnicki M., Polianskyi S., Stöckl A., Susulovskyi A.S., Rizun V.B. Most of them were collected in the second half of the 19th century and the first half of the 20th century, a number of individuals – in recent decades. Three specimens (Inventory numbers: E2.19.01.08.02//17, Digital record number: SMNH010749, Data Centre “Biodiversity of Ukraine”: ID 58124; Inventory numbers: E2.19.01.08.02//18, Digital record number: SMNH010750, Data Centre “Biodiversity of Ukraine”: ID 58125; Inventory numbers: E2.19.01.08.02//19, Digital record number: SMNH010751, Data Centre “Biodiversity of Ukraine”: ID 58126) most probably were mentioned in the work by M. Łomniсki (Łomnicki M. Muzeum imienia Dzieduszyckich we Lwowe. Dział I. Zoologiczny oddział zwierząt bezkręgowych. IV. Chrząszcze, czyli Tęgoskrzydłe (Coleoptera). – Lwów, 1886. – 308 s.). In general, the collection contains specimens, collected from Ukraine: Lvivska, Ivano-Frankivska, Chernivetska, Zakarpatska provinces, and from Poland. Some part of the presented material was collected in nature conservation areas of Ukraine: the Nature Reserve «Gorgany», National Nature Parks «Boikivshchyna», «Carpathian» and «Hutsulshchyna». This article was written with the support of the National Research Foundation of Ukraine, call 2022.01 «Science for the Recovery of Ukraine in the War and Post-War Periods» the project 2022.01/0013 «Digitization of natural history collections damaged as a result of hostilities and related factors: development of protocols and implementation on the basis of the State Museum of Natural History of the National Academy of Sciences of Ukraine». The contents of this article do not necessarily reflect the views of the National Research Foundation of Ukraine and are the sole responsibility of the State Museum of Natural History, NAS of Ukraine.

Organization of Palliative Care Provision in the Palliative Care Department During War Time

The city of Kyiv is characterized by a high level (258.6 cases per 100,000 population) of cancer incidence and mortality. The objective: to determine the problem and prospects of providing inpatient oncology care based on the experience of the department of the Kyiv City Clinical Oncology Center (KCCOC). Materials and methods. A retrospective analysis of the work of the palliative care department of communal non-commercial enterprise “KCCOC” for 2001–2023 was carried out. The center includes a 25-bed hospital and mobile palliative care teams. A multidisciplinary approach was the basis of providing palliative care to an incurable cancer patient. Results. During this period 9,164 cancer patients in the terminal stage with high mortality rate (81.04%) received inpatient care. The average duration of stay in the hospital was 17.7 bed-days. Approximately 6% of patients readmit to the department, some of them – 3-4 times. Approximately 94% of hospitalized patients had a pain syndrome, 86% of patients received opioid analgesia. During this period, mobile palliative care teams registered and served 3,124 cancer patients, among whom 62% of patients were transferred after inpatient treatment, more than 5,700 primary visits were made. The clinical route of the palliative patient was developed and improved, which made it possible to optimize palliative care for a seriously ill oncological patient. The peculiarities of providing palliative care to incurable oncological patients in the conditions of martial law have been determined. Conclusions. Comprehensive palliative care should be a unified system of mobile and stationary care, which will make possible to control the somatic condition of the palliative patient, correct the symptoms of the disease, provide long-term support to the patient at home, which is economically feasible, allows to provide care to a larger number of patients and hospitalize in time if it is necessary. The creation of an extensive system of mobile palliative care is promising in improvement of palliative care for oncology patients (it will reduce the burden on general somatic hospitals and inpatient palliative departments), as well as qualitatively improve the provision of palliative care to patients in the primary care network.

Perinatal mortality after Chornobyl in contaminated regions of Ukraine.

Belarus and Ukraine were the countries most affected by the consequences of the Chornobyl nuclear power plant in 1986. A study of perinatal mortality in Belarus found a highly statistically significant increase in the 1990s in the most contaminated oblast Gomel but no increase during this period in the rest of Belarus. As a possible mechanism to interpret this increase as a late Chornobyl effect, it has been suggested that strontium-90 contained in Chornobyl fallout, incorporated during menarche, impairs the immune system of pregnant women which in turn increases perinatal mortality. In the present study, this hypothesis is tested using data from Ukraine. Annual data on perinatal mortality, in the period 1981-2006 were provided by the Ministry of Public Health of Ukraine. Trends in perinatal mortality rates in the most contaminated regions of Ukraine (Kyiv and Zhytomyr oblasts and the city of Kyiv; study region) were compared with rates in the rest of Ukraine (control region). To identify any differences in perinatal mortality trends between the study and control regions, the ratios of perinatal mortality rates in the study region to the rates in the control region were analyzed using the calculated strontium concentration as a predictor. A trend analysis of perinatal mortality rates in Ukraine revealed two bell-shaped deviations from a long-term exponential trend with maxima at the beginning and end of the 1990s. The same pattern was found in the data from the study and control regions, but the deviations were almost three times higher in the study region than in the control region. An analysis of the ratios of perinatal mortality rates in the study region to the rates in the control region (odds ratios) showed an increase and decrease during the 1990s which was approximated by a lognormal density distribution. The calculated strontium concentration, when used as a predictor, also fitted the data well. Thus, the data from Ukraine confirms the results from Belarus. The analysis of the odds ratios revealed about 1000 excess perinatal deaths in the study region in the period 1990-2004. The corresponding figure for Ukraine as a whole was estimated at 3500 perinatal deaths. It is hypothesized that the observed increase in perinatal mortality in the 1990s may be a late effect of incorporated strontium-90 on the immune system of pregnant women. The analysis is based on a theoretical model, as no data on strontium concentrations were available; the results should therefore be interpreted with caution. An updated study for Belarus would be desirable to corroborate the results.

Treatment of portal hypertension complicated by variceal bleeding

Background. Mortality in variceal bleeding (VB) on the background of portal hypertension (PH) is highest among patients with gastrointestinal bleeding. The treatment of PH complicated by VB is a complex problem that is far from being solved, especially in case of Child-Pugh class B and C decompensation. The aim of the study was to determine the causes of PH complicated by VB, features of conservative and interventional therapy, indications and nature of surgical procedures, treatment efficacy, as well as causes of complications and mortality. Materials and methods. We analyzed treatment outcomes of 923 inpatients with PH complicated by VB who were treated in the clinic of the Department of Surgery of the Faculty of Dentistry of Bogomolets National Medical University on the basis of the Kyiv City Clinical Emergency Hospital from 2012 to 2023. It was possible to talk about the cause of PH based on anamnestic data in 61 % of cases. In 711 (77 %) patients, the source of bleeding was detected endoscopically within 30–60 minutes from the moment of admission to the clinic. Conservative therapy included the administration of hemostatic and agents lowering pressure in the portal system, as well as vasoconstrictors that reduce portal blood flow. For the failure of conservative therapy, unstable hemostasis, and repeated previous bleedings, 59 (6.4 %) patients were operated. The methodology of the research analysis consisted in the fact that the arithmetic mean and standard error (M ± m) were determined as the characteristics of the groups for features with a distribution corresponding to the Gaussian law. This reference method of descriptive statistics was applied to evaluate surgical treatment in comparison with conservative therapy and interventional measures. Results. Endoscopic hemostasis by the ligature method was achieved in 97 (10.5 %) patients. Repeated endoscopy due to VB recurrence was done in 276 (29.9 %) participants. In cases of unsatisfactory endoscopic hemostasis, as well as recurrent VB, a Sengstaken-Blakemore probe was installed. In case of right-sided PH, the formation of varices in the esophagus is caused by the discharge of blood mainly through the coronary vein, which required its transection during еsophagogastric devascularization. In compliance with this rule, the patients underwent esophagogastric devascularization, circular transection of the esophagus, which provided portoazygous disconnection. The total mortality rate was 43.1 %, among operated people — 8.5 %, and among non-operated ones — 42.1 %. Conclusions. PH complicated by VB is evidence of decompensated processes in the liver parenchyma or obstruction in the portal system. Conservative therapy and interventional measures make it possible to stop bleeding and prepare the patient for elective surgery, if necessary. An operation that stops blood flow through dilated veins of the esophagus or stomach is an effective method of treating bleeding in portal hypertension.

Intramedullary stabilization of dislocated clavicle fractures with a compression rod

Despite the favorable prognosis of conservative treatment for clavicle fractures, unsatisfactory consequences reach 10–30 % cases. Surgical methods of treatment for dislocated clavicle fractures, such as osteosynthesis with a plate or an elastic titanium rod, are mostly used in practice. The disadvantage of the latter is the possible migration of the implant with perforation of the skin. The purpose was to study the effectiveness of an intramedullary rod, improved by us, for osteosynthesis of dislocated clavicle fractures type OTA 15A and OTA 15B according to the AO/ASIF classification. The essence of the improvement was the possibility of closed minimally invasive intramedullary osteosynthesis of the clavicle body, with a simplified technique of the surgical intervention itself, prevention of implant migration. The latter was achieved by the fact that one of the ends of the rod had a drill, which eliminated the need for predrilling the medullary cavity of the clavicle to insert the rod, and its opposite end had a thread onto which a nut is screwed to achieve compression between the clavicular fragments. Forty-two patients with closed dislocated clavicle fractures were under supervision in the clinic of traumatology and orthopedics of Kyiv City Clinical Hospital 6. They underwent intramedullary osteosynthesis for clavicle fractures with an improved compressing rod (closed in 28 cases, open in 14) under regional anesthesia. In dyna-mics of the postoperative period, a clinical and radiological examination was performed, the severity of the pain syndrome and the function of the upper limb were assessed according to the visual analog scale (VAS), Disability of Arm, Shoulder and Hand (DASH). As shown by the results of X-ray examinations, the average period of clavicle fracture union was 10.1 ± 1.4 weeks (range 8–12 weeks). During the observation of the patients, favorable dynamics on the VAS and DASH were noted; by the end of the study (12 months after the operation), the functional capabilities of the upper limb on the DASH corresponded to 1.54 ± 0.84 points, VAS score was 9.60 ± 2.11 points. The improved construction of the intramedullary rod for osteosynthesis of dislocated clavicle fractures of the OTA 15A and OTA 15B type can be recommended for use in practice, as it has demonstrated favorable clinical, radiological, and functional outcomes.

Assessing internal displacement patterns in Ukraine during the beginning of the Russian invasion in 2022

Given the worldwide increase of forcibly displaced populations, particularly internally displaced persons (IDPs), it’s crucial to have an up-to-date and precise tracking framework for population movements. Here, we study how the spatial and temporal pattern of a large-scale internal population movement can be monitored using human mobility datasets by exploring the case of IDPs in Ukraine at the beginning of the Russian invasion of 2022. Specifically, this study examines the sizes and travel distances of internal displacements based on GPS human mobility data, using the combinations of mobility pattern estimation methods such as truncated power law fitting and visualizing the results for humanitarian operations. Our analysis reveals that, although the city of Kyiv started to lose its population around 5 weeks before the invasion, a significant drop happened in the second week of the invasion (4.3 times larger than the size of the population lost in 5 weeks before the invasion), and the population coming to the city increased again from the third week of the invasion, indicating that displaced people started to back to their homes. Meanwhile, adjacent southern areas of Kyiv and the areas close to the western borders experienced many migrants from the first week of the invasion and from the second to third weeks of the invasion, respectively. In addition, people from relatively higher-wealth areas tended to relocate their home locations far away from their original locations compared to those from other areas. For example, 19 % of people who originally lived in higher wealth areas in the North region, including the city of Kyiv, moved their home location more than 500 km, while only 9 % of those who originally lived in lower wealth areas in the North region moved their home location more than 500 km..

МЕТОДИКА РОЗРАХУНКУ ЗОН ПОКРИТТЯ ЦИФРОВОГО ТЕЛЕВІЗІЙНОГО МОВЛЕННЯ

The introduction of DVB-T2 digital television broadcasting in the VHF waveband is currently underway, and test trials have already been conducted in some regions of Ukraine. To assess the effectiveness of the projects, it is of particular interest to compare the radio coverage areas of digital TV transmitters operating in the VHF and UHF wave bands. This requires extensive calculations for specific locations. For comparison, the city of Kyiv was chosen, where there is one multiplex MX-7 (8 TV channels) in the VHF band, and the following four multiplexes are represented in the UHF band: MX 1 (26 TV channels) and MX 3 (49 TV channels), which operate at the lowest and highest frequencies of the band. In this article, to predict the coverage areas of digital television broadcasting transmitters, the justification of the selected Longley-Rice radio wave propagation model is provided, which allows calculating the radio signal attenuation compared to free space propagation using terrain profiles (digital elevation maps) and the electrical characteristics of the Earth's surface, Taking into account the main mechanisms of radio wave propagation (interference on the line of sight, diffraction on irregular terrain, tropospheric scattering), it is more accurate and its results are closer to actual measurements. The calculations will be carried out using Radio Mobile software based on the Longley-Rice Irregular Terrain Model (ITM) and using Terrain Mission SRTM satellite maps with the possibility of further adding map data and roads from various sources. Based on the ITU R Recommendations on the design of DVB-T2 digital television broadcasting networks, the minimum required field strength to ensure reception with a given quality was calculated and the initial data for predicting the coverage areas of DVB-T2 digital television transmitters were prepared using the example of Kyiv. The proposed methodology and the data obtained will allow to calculate the boundaries of the coverage areas of DVB-T2 digital standard television transmitters in the VHF and UHF wave bands for selected television channels

Formation of Socially Successful Personality of Adolescent Pupils by Means of Gamification (Kyiv City, Ukraine)

The research highlights the essence of gamification and the approbation of the curriculum with elements of gamification "Social successfulness" in the educational process of educational institutions. Theoretical methods are applied – analysis, synthesis, comparison, systematization, generalization of materials from psychological and pedagogical sources regarding the problem of social successfulness and the possibilities of its formation in adolescents in the conditions of out-of-school and general secondary education institutions, specification for harmonizing the content of the curriculum "Social successfulness" and its process approvals; empirical methods – observation, questionnaires for collecting empirical information, blitz surveys concerning the awareness of the characteristics of a successful personality. The authors consider gamification as a set of various tools and mechanics that contribute to the significant enrichment of the educational process with entertaining, educational, educational, motivational, and social-communicative components. The researchers characterized the educational program "Social successfulness", in particular, determined its target orientations and key competencies of teenagers, highlighted the gamification tools necessary for the implementation of the program, found out that the mixed format is the optimal format for its implementation, as it combines the advantages of offline and online learning and can be effective in conditions of increased danger associated with martial law. The article carried out a pedagogical reflection and found out that, according to the results of the blitz survey, teenagers verbalize the two most common portraits of a socially successful personality (based on external indicators of success and personal qualities), according to the results of the questionnaire, the majority of respondents positively perceived game tools and recognized her own activity during training with the use of gamification as productive. The issue of using gamification tools for children of different ages, including those with special educational needs, and the creation of an algorithm for using gamification elements in various educational institutions require further research.

Amplification effects of ground motion due to the local geology of the building site in the cities of Kyiv, Kryvyi Rih, Odesa

The results of the research presented in the article elucidate the importance of taking into account the amplitude-frequency characteristics of soil stratum models in the context of seismic safety of construction objects on the territory of Ukraine, in different regions. The presented results of the analysis of the calculated amplitude-frequency characteristics of models of soil environments for different regions of Ukraine reveal that the amplification of vibrations by soils has a complex nature that depends on many factors and can differ significantly for different construction sites. We have shown that during the earthquake-resistant design of buildings and structures, it is necessary to properly take into account the properties of soil complexes under the research site, which can significantly increase oscillations at “resonant” frequencies. The article examines in detail the features of amplitude-frequency characteristic models of soil strata for different geological conditions in Kyiv, Kryvyi Rih and Odesa. The purpose of this study is to compare these characteristics and develop recommendations for reducing risks associated with seismic hazards.

New floristic records in Kyiv City and its environs

The results of floristic research in the territory of Kyiv City and its environs (in the adjacent territories of Kyiv Region) are presented. According to the results, five new taxa for the flora of Ukraine are reported: Cardamine occulta, Equisetum × moorei, Lolium × holmbergii, Limonium sinuatum, Lonicera maackii. Chrozophora tinctoria is a new species for the flora of the mainland part of Ukraine. Also, 16 new taxa were identified for the regional floras of the Ukrainian Polissya, Forest-Steppe, and Middle Dnipro regions. In addition, new locations of 69 rare aboriginal and expansive alien taxa are reported. In total, among the studied taxa 38 are native and 53 are alien. Among the studied alien plants, several are potentially invasive ones, and some of them have already demonstrated their invasive nature, in particular: Cornus sanguinea subsp. australis, Erigeron strigosus, Phragmites altissimus, and Vitis riparia. The results of our study confirm that the flora of Kyiv City and its environs is one of the richest floras in the plain part of Ukraine, and currently it is rapidly changing.

Characteristics of the course of multisystem inflammatory syndrome associated with COVID-19 in children according to the observations of the Kyiv City Children’s Clinical Hospital 2

Background. In the context of coronavirus diseases 2019 (COVID-19) pandemic associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a significant number of cases resembling Kawasaki disease in children have been reported worldwide and eventually termed “multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2”. Objective: to compare the clinical presentation, laboratory fin­dings, and instrumental examination data in children with Kawasaki-like MIS-C phenotype and MIS-C with a shock phenotype with cases, which met the US Centers for Disease Control and Prevention criteria. Materials and methods. The article presents the results of a retrospective analysis of the disease histories in 20 children aged 2.5 to 16 years with a Kawasaki-like MIS-C phenotype and with MIS-C with a shock phenotype associated with SARS-CoV-2 infection who were hospitalized in the MNPE “Kyiv City Children’s Clinical Hospital 2” in 2002–2021. Results. Patients were divided into 2 groups according to symptoms and pathological conditions. Group I included children with clinical signs similar to the Kawasaki disease (n = 8). They were classified as those with Kawasaki-like MIS-C phenotype. Complications such as coronary artery dilatations and aneurysms occurred only in this group. Group II consisted of patients (n = 12) who were classified as those with MIS-C with a shock phenotype. Children in this group had a higher number of involved organ systems, were more likely to have shock, pleuritis, peritonitis, and a higher prevalence of abdominal pain. Furthermore, they exhibited elevated levels of leukocytes and neutrophils (p = 0.043; p = 0.047), along with a higher neutrophil-to-lymphocyte ratio (p = 0.05), compared to the patients with Kawasaki-like phenotype. Conclusions. Our results suggest that multisystem inflammatory syndrome associated with SARS-CoV-2 in children is characterized by a wide range of clinical, laboratory and instrumental signs. Moreover, our findings highlight that children with features that correspond to MIS-C with a shock phenotype tend to have a more severe course of the disease and a higher rate of complications.

Prediction of the healing efficiency of episiotomy wounds using hydrogel dressings with lidocaine

The objective: to study the factors affecting the healing process of an episiotomy wound and the effectiveness of using hydrogel dressings with lidocaine for its healing.Materials and methods. The prospective randomized study includes the analysis of anamnestic data from the medical cards of 123 primiparous women with episiotomy wounds who gave birth in the Kyiv City Maternity Hospital No. 5 during 2021–2022. The women were divided into two groups: a comparison group – 63 patients who received standard treatment, and a research group – 60 patients who additionally used hydrogel dressings with lidocaine on the wound.The healing of episiotomy wounds was evaluated according to the REEDA scale. Factors that may influence episiotomy wound healing were studied in patients of both groups: anthropometric indicators (age, height, body mass index), interventions during childbirth, and indicators of obstetric and gynecological history (term of gestation, volume of blood loss during childbirth, body weight of the newborn, etc.). Statistical analysis was performed using the Fisher, Mann–Whitney, Student and chi-square tests of the statistical package EZR v. 1.54.Results. Age (p=0.689) and body mass index (p=0.974) of patients in both groups did not show statistically significant differences. The duration of the second period of labor on average was 72 min (57.6–86.4) in the comparison group versus 43.2 min (28.8–57.6) in the research group with a statistically significant difference (p<0.001). No statistically significant differences were found between the two groups regarding the term of delivery, the volume of blood loss, the weight of the newborn, the risk of pregnancy loss, the frequency of labor induction, the weakness of labor activity, manual revision of the uterine cavity, and vacuum extraction of the fetus. The frequency of use of different types of anesthesia during childbirth also did not differ (p=0.396).REEDA scale assessment revealed a reduced risk of high sum scores in the research group (odds ratio (OR) = 0.16, 95% confidence interval (CI): 0.07–0.38), that supports the efficacy of hydrogel dressings with lidocaine. Analysis of the duration of the second labor period and gestational term also revealed an association with the risk of a high sum of points on the REEDA scale (OR = 1.22, 95% CI: 1.02–1.45 per 0.01 days; OR = 1.65, 95% CI: 1.16–2.35 per week of pregnancy).A multivariate model which included research group, body mass index, duration of the second labor period, gestational term confirmed a reduced risk according to the REEDA scale in this group (OR = 0.19, 95% CI: 0.08–0.47). The four-factor model had a high accuracy (AUC = 0.81, 95% CI: 0.73–0.88), indicating a strong relationship between the selected factors and the risk of complications after episiotomy.Conclusions. The use of hydrogel dressings with lidocaine and taking into account some aspects of childbirth, namely, the duration of childbirth and gestational period, can contribute to the improvement of the course of healing of episiotomy wounds. Such a comprehensive approach supports the effectiveness and significance of using hydrogel dressings with lidocaine in the practice of modern obstetrics to improve the results of treatment of patients with an episiotomy wound.In the future, studies on the effectiveness of using hydrogel dressings for the treatment of episiotomy wounds are necessary.

Optimization of pharmaceutical care for children with diseases of the upper respiratory tract in outpatient polyclinic institutions

Introduction. The analysis of scientific and information materials has shown that the theoretical foundations and conceptual provisions of pharmaceutical management and pharmacoeconomic research have been developed in the works of domestic scientists. At the same time, research on optimization of pharmaceutical care for children in outpatient facilities is currently only fragmentary, and there is no systematic approach to solving this problem.
 The aim of the study. On the basis of a systemic approach, form a system of research on the optimization of pharmaceutical care for children with ENT diseases in outpatient polyclinic institutions.
 Materials and methods. The methodological basis is the approaches of modern management in the field of strategic management, pharmacoeconomics, approaches to the assessment of drug consumption, legislative and regulatory documents. The objects of the study were family outpatient clinics and children's outpatient polyclinic institutions in the city of Kyiv and the Kyiv region. The initial information was 390 outpatient charts of patients with ENT diseases aged 3 to 17 years for the period of 2022; 125 expert questionnaires of otolaryngologists; 50 questionnaires of a sociological survey of parents of patients with ENT diseases. The research used methods of logical, structural analysis, SWOT analysis, sociological methods (expert opinions, interactive survey, questionnaire).
 Results. A methodical approach to conducting pharmacoeconomic studies of pharmaceutical care for children in outpatient clinics has been developed. For the first time, an original method of multi-aspect matrix analysis was proposed, which makes it possible to evaluate and multi-factorially position the medicinal products of the researched assortment in order to justify its inclusion in the assortment list for the treatment of a certain nosology in ambulatory polyclinic conditions.
 Conclusions. The practical significance of the research results lies in the creation of a system of approaches to optimizing pharmaceutical care for children in outpatient settings at the territorial level.

Changes in the antibiotic-resistant properties of pathogenic microorganisms in patients with purulent-necrotic wounds against the background of type 2 diabetes when using a probiotic antiseptic

Antibiotic resistance remains a serious problem, leading to millions of deaths every year. The increasing prevalence of type 2 diabetes mellitus (T2DM) is contributing to the continued spread of this problem. Ukraine, like other countries, feels the consequences of this problem. Over the past ten years, the number of patients with T2DM has doubled, and diabetes is already the cause of disability and death for thousands of people. Complications of T2DM, such as diabetic foot syndrome, often require surgery and antibacterial therapy. New research shows the prospects of using probiotic antiseptics based on lactic acid bacteria of the genus Bacillus in the treatment of wounds, which may open new opportunities to combat this problem and improve treatment outcomes. Objective — to analyse changes in the antibiotic‑resistant properties of pathogenic microorganisms in patients with purulent‑necrotic wounds in type 2 diabetes mellitus. Materials and methods. The study, which was conducted at the Department of General Surgery No. 2 of Bogomolets National Medical University in Kyiv City Clinical Hospital No. 3, included 229 patients with purulent‑necrotic wounds and type II diabetes. A total of 229 patients were randomly divided into two groups, with one group receiving probiotic antiseptics and the other traditional chemical antiseptics, with subsequent analysis focusing on changes in antibiotic‑resistant properties against P. aeruginosa and K. pneumoniae. Antibiotic‑resistant properties were evaluated through microbiological examination, revealing significant changes in resistance patterns among patients treated with probiotic antiseptics compared to those using traditional chemical antiseptics, assessed using statistical methods including the Student’s t‑test and Wilcoxon W‑test. Results. When the first subgroups were compared on the first day, there was no statistically significant difference in the levels of P. aeruginosa wound contamination (p=0.671). On the seventh day, there was a statistically significant difference between contamination levels (p<0.05) and the emergence of sensitivity to reserve antibiotics (p<0.05). On the 14th day, there was a statistically significant difference between contamination levels (p<0.05) and the emergence of sensitivity to reserve antibiotics (p<0.05). Conclusions. Probiotic antiseptics have a statistically significant advantage over chemical antiseptics in terms of reducing contamination and emergence of antibiotic sensitivity in patients with purulent‑necrotic wounds in type 2 diabetes mellitus.

Calculation of the ecological and economic effect of collecting rainwater with «green» roofs

The problem of the availability of fresh water on the planet is substantiated and the main concepts of sustainable rainwater management, such as: "SuDS", "BMP", "LID", "GI", as well as the concept of "green" structures, are analyzed. The classification and characteristics of the main types of «green» roofs, as well as their main ecological advantages, are presented. The global market for green roofs is shown growing from USD 1.4 billion in 2020 to a CAGR of 17% from 2020 to 2027, to reach USD 4.2 billion by 2027, and is projected to the extensive type will account for more than half of the total market share. The problem of high costs for installation and maintenance of environmentally friendly solutions for the roof is highlighted, therefore the aim of the work is to calculate the ecological and economic effect of collecting rainwater obtained from "green" roofs, in contrast to traditional roofs, and to conduct an economic analysis of social and cost benefits. what green roofs generate over their life cycle using the Net Present Value (NPV) method. The ecological and economic effect of collecting rainwater with "green" roofs was calculated for four cities of Ukraine: Kyiv, Kharkiv, Dnipro and Lviv. According to the results of calculations, the ecological effect of EE ranges from 394,000 m3 in the city of Dnipro and 450,000 m3 in Kharkiv to 567,000 m3 in Kyiv and 647,000 m3 in Lviv. The difference in the obtained calculations depends primarily on the selected area of "green" roofs, which was the lowest in the city of Dnipro (1.47 million m2) and the highest in the city of Kyiv (2.50 million m2), the values of which were chosen conditionally, as well as from the indicator of the average annual amount of precipitation, which is the highest in the city of Lviv (740 mm). The average value of the ecological effect of EE in relation to water retention in the analyzed cities was calculated, which was 515,000 m3. By multiplying EE and water price, the average ECE for these 4 cities was determined to be $380,500. It was concluded that the price of water is a decisive dependent variable in the calculation of ECE. The calculation of the economic analysis of the profitability of investments in "green" roofs corresponding to 1 m2 of intensive and extensive "green" roofs, which was carried out on the basis of the net present value method (NPV). It is shown that investment costs for "green" roofs include the following stages: design of "green" roofs; installation of the "green" roof system; installation of waterproofing; production of substrate for roofs and its installation; selection and planting of plants on the roof; installation of the irrigation system. It is substantiated that both intensive and extensive "green" roofs have a positive indicator of the net present value of NPV. The average NPV per 1 m2 of an intensive "green" roof is more than 10 times higher than the average NPV per 1 m2 of an extensive "green" roof.

Increased heat stress for the population of urbanized areas against the background of global climate change

The combination of high temperature and relative humidity of the atmospheric air creates heat stress, which has a serious impact on the environment, society and the health of the population in urban areas. Using the example of the city of Kyiv, the paper investigated long-term changes in heat stress depending on global climate changes. Averaged monthly long-term climate data of the urban environment were studied, starting from 1981, based on monitoring data using the Copernicus Climate Change Service toolkit and data from the Borys Sreznevsky Central Geophysical Observatory. Predictive dynamics of temperature by conventional and wet bulb was investigated using OriginPro8 software. Data on the dependence of the frequency and unevenness of precipitation during the last decades are presented. The dependences of the value of the heat index (NI) on the temperature and air humidity for different observation periods were obtained. Over the past decade, Kyiv has seen a significant increase in average heat stress and the frequency of days and events with extreme heat stress. According to the obtained forecast estimates, in 2050 the heat index should increase by almost 30%, and the risk to the health of the population in the surrounding area and for workers in the open air will be interpreted as "high" levels at a relative humidity of 80%; "moderate" at a relative humidity of 50% and "low" at a relative humidity of 20%. The forecast temperature dynamics according to the conventional and according to the wet thermometer in the month of July at the end of different years is: 2021–2030 – 24.136°С and 26.24°С; 2030–2050 – 26.371°С and 28.918°С, respectively, with other equal conditions of the urban environment. An additional possibility of influence on the thermal dome appears already at the design stage, thanks to the variability of the placement of the projected buildings on the general plan, and the formation of individual buildings, in the correct area ratio green plantings to stone surfaces of facades and paving. The research data will be useful for the possible reduction of the size of the thermal dome over the city during the planning and reconstruction of the housing stock and the development of climate neutrality measures for the cities of Ukraine.