Remote Period Research Articles

Comparison of Early Outcomes in Patients Who Underwent Common Femoral Thromboendarterectomy with Vein versus Bovine Pericardial Patches

The treatment outcomesof vein and bovine pericardial patches in thromboendarterectomy (TEA) for common femoral artery (CFA) lesions in patients with peripheral arterial disease (PAD) remain unclear. The purpose of this study was to evaluate the efficacy and safety of the bovine pericardial patch by comparing it with vein patch angioplasty. This was a multicenter retrospective study. We reviewed the data of patients who underwent TEA with patch angioplasty (vein versus bovine pericardial patch angioplasty) for PAD between January 2018 and December 2022. Indication for revascularization is PAD patients with claudication symptoms to rest pain and foot ulcers that interfere with daily life, with lesions in the CFA region. The primary endpoint was 2-year patency. The secondary endpoints were postoperative wound complications, including patch rupture, and safety of remote-phase puncture of the patch area after patch angioplasty. Within the observation period, TEA was performed on 157 limbs in 136 patients using vein patches, and on 86 limbs in 79 patients using bovine pericardial patches. The number of claudication/rest pain/tissue loss was 110/13/34 cases in the vein patch group and 57/14/15 cases in the bovine pericardial patch group, respectively. No significant differences were observed in patient characteristics. No significant between group differences were observed in operative time, blood loss, or percentage of patients who underwent concomitant revascularization during the procedure. The 2-year primary patency rates of the vein and bovine pericardial patch were 95.6% and 92.8%, respectively (P= .49). The rate of surgical site infection (SSI) in this study was 2.5% in the vein patch group and 5.8% in the bovine pericardial patch group, respectively (P=.29). Rupture of the patch occurred in 4 (2.5%) and 4 (4.7%) patients in the vein and bovine pericardial patch groups, respectively (P= .46), and the percentage of cases requiring revision of the patch site was 7 (4.5%) and 5 (5.8%) in the vein and bovine pericardial patch groups, respectively (P= .76). Postoperatively, 23 patients in the vein and 13 patients in the bovine pericardial patch groups underwent patch puncture during the remote period. The median follow-up duration from the date of the surgery to the date of the puncture was 544 days and 374 days in the vein and bovine pericardial patch groups, respectively. No patch-related complications were observed during remote stage puncture. Compared with vein patches, TEA with bovine pericardial patches had acceptable outcomes in terms of patency and postoperative complications.

Effectiveness of Adjunctive Drug Therapy to Endoscopic Stenting in Liver Cirrhosis Complicated by Refractory Variceal Bleeding

AIM OF THE STUDY. Comparative clinical analysis of the efficacy of terlipressin and octreotide as additional drug therapy to mechanical hemostasis with nitinol stent in patients with liver cirrhosis complicated by bleeding from esophageal varices refractory to endoscopic treatment.MATERIAL AND METHODS. Thirty-one patients with liver cirrhosis complicated by esophageal variceal bleeding refractory to endoscopic treatment , in whose complex treatment program, as a first-line life­saving measure, hemostasis with a self-expanding hemostasis was performed nitinol stent were randomly assigned to two groups. In group A, 20 patients were treated with terlipressin as an adjuvant to mechanical hemostasis, and in group B, 11 patients were treated with octreotide. Unpaired Student’s t-test was used for statistical analysis of the results. Graphs for assessing the survival function of patients for 8 weeks after the end of treatment were constructed using the Kaplan-Meier method.RESULTS. In the acute observation period terlipressin and octreotide were equally effective in treating refractory variceal bleeding. In the subacute observation period, the administration of octreotide was generally accompanied by a greater number of side effects (54.5%) than terlipressin (30.0%) (p=0.453). In the remote observation period, 8-week survival in the group of patients receiving terlipressin was higher than in the group of patients receiving octreotide.CONCLUSION. Terlipressin is as effective as octreotide as an adjunct to endoscopic stenting in drug therapy for liver cirrhosis complicated by esophageal variceal bleeding refractory to endoscopic treatment. At the same time, terlipressin has a greater effect than octreotide on reducing 8-week mortality, which approaches statistical significance. In this regard, terlipressin may be the vasoactive drug of choice in acute refractory variceal bleeding.

Hypopressive abdominal gymnastics protocol in postpartum women after cesarean section in the remote period: Preliminary case series

Background: The postpartum period is pronounced by important changes to return to the pre-pregnancy situation. During pregnancy, the recumbent muscles of the abdomen suffer withdrawal, characterizing diastasis of the rectus abdominis muscles (DRAM), and this condition may remain pathological postpartum. Hypopressive abdominal gymnastics (HAG) has a beneficial role in activating the abdominal muscles, presenting positive results in reducing DRAM. Objective: To describe the effect of a HAG protocol in postpartum women undergoing cesarean section in the remote period, comparing the inter-rectum distance (IRD) and abdominal circumference before and after applying the protocol. Methods: Case series quasi-experimental character involving participants had their IRD assessed using a portable ultrasound machine with a linear transducer and abdominal circumference measured using a flexible measuring tape. They received a HAG protocol, with nine postures, for three weeks, twice a week, totaling six sessions lasting 45 to 60 minutes each. After intervention, all participants were reevaluated using the same methods. Results: Four postpartum women participated. The largest point before intervention was the umbilical at rest. Both supraumbilical points analyzed obtained greater results in reducing IRD. Participant 001 achieved the greatest reduction in IRD after the protocol, as she had higher IRD values ​​during evaluation, in addition to a high body mass index (BMI) and a largest measurement of abdominal circumference. The measurement of abdominal circumference showed a change after HAG, reaching a reduction of 10 cm in one of the participants. Conclusion: This case series demonstrated positive results from the practice of HAG in reducing RAD, mainly supra-umbilical, and also in reducing abdominal circumference. Participants with higher BMI and waist circumference showed greater reductions in IRD.

Reconstructive interventions on bile ducts in patients with benign obstructive jaundice

Aim. To evaluate immediate and long-term results of surgical reconstruction of the biliary system in various types of benign obstructive jaundice.Materials and methods. The study enrolled 110 patients with choledocholithiasis, iatrogenic biliary strictures, common bile duct strictures, as well as strictures of biliodigestive and biliobiliary anastomoses. Patients were divided into 3 groups. Group 1 included 43 patients with multiple choledocholithiasis and bile duct dilatation >15 mm. Group 2 enrolled 35 patients with multiple choledocholithiasis and hepaticolithiasis who were intraoperatively diagnosed with stricture, injury, or pressure ulcers of the common bile duct wall. Group 3 included 32 patients with cicatricial and iatrogenic biliary strictures. The immediate and long-term results of surgical treatment were compared.Results. In group 1, the survival rate comprised 89.4%, the average duration of surgery amounted to 137 minutes, complications involved wound infection, bile leakage, bile peritonitis. In group 2, the survival rate accounted for 91.4%, the average duration of surgery comprised 192 minutes; strictures of biliodigestive anastomosis were detected in the remote period, and reconstructive surgeries were performed. Group 3 revealed the survival rate of 100%, the average duration of surgery of 215 minutes, and no complications in the long term.Conclusion. The diameter of the common bile duct, its wall changes, size of gallstones, signs of cholangitis, patency of the bile papilla, and localization of biliary stricture determine the surgical tactics, when performing biliary reconstruction in patients with non-cancerous obstructive jaundice. In case minimally invasive surgery is found impossible under conditions of multiple choledocholithiasis, common bile duct diameter >15 mm, and preservation of its wall, choledocholithotomy with Kerr drainage is considered to be optimal. In case of damage to the CBD wall and patency of the bile papilla, preference shall be given to hepaticoenterostomy. Bile duct reconstruction with stent drainage is indicated for treatment of cicatricial and iatrogenic biliary strictures.

Left Atrial Plasty in Surgical Treatment of Combined Mitral-Aortic-Tricuspid Valve Diseases Complicated by Left Atrial Dilation

The aim. To study the possibilities of various techniques of the left atrial (LA) plasty in the correction of combined mitral-aortic-tricuspid valve diseases (cMATVD) in the presence of left atrial dilation (LAD). Materials and methods. The analysis included the results of surgical treatment of 360 patients with cMATVD combined with LAD, who were operated on at the National Amosov Institute of Cardiovascular Surgery from January 1, 2006 to January 1, 2023. The main group consisted of 73 patients who underwent cMATVD correction combined with original triangular plasty of LA. The comparison group included 287 patients who underwent only cMATVD correction in the presence of concomitant LAD. Results. Of the 73 operated patients in the main group, 3 died at the hospital stage (mortality rate 4.1%). The dynamics of echocardiographic parameters at the stages of treatment were as follows: left ventricular (LV) end- systolic index (ml/m2): 69.1 ± 12.1 (before surgery), 59.3 ± 8.5 (after surgery), and 48.4 ± 9.5 (long-term period); LV ejection fraction (%): 51.0 ± 5.0 (before surgery), 54.0 ± 5.0 (after surgery), and 56.0 ± 4.0 (long-term period); LA diameter (mm): 64.8 ± 4.1 (before surgery), 50.3 ± 2.1 (after surgery), and 51.2 ± 2.2 (long-term period). Of the 287 operated patients in the comparison group, 9 died (mortality rate 3.1%). The dynamics of echocardiographic parameters at the stages of treatment were as follows: LV end-systolic index (ml/m2): 68.3 ± 11.3 (before surgery), 60.4 ± 9.3 (after surgery), and 52.7 ± 7.2 (remote period); LV ejection fraction (%): 52.0 ± 5.0 (before surgery), 53.0 ± 5.0 (after surgery), and 50.0 ± 4.0 (remote period); LA diameter (mm): 65.5 ± 3.7 (before surgery), 64.1 ± 3.3 (after surgery), and 72.5 ± 2.8 (remote period). In the remote period, thromboembolic complications occurred in 5 (7.7%) patients of the main group (1 severe, 1 mild, and 3 fatal) and 25 (9.3%) patients of the comparison group (10 severe, 6 mild, and 9 fatal). The thromboembolic complications rates indicate the advisability of LA plasty simultaneously with resection of its appendage. Conclusions. In the correction of LAD, all plastic reconstructions of the dilated LA are low-traumatic and effective procedures that lead to a significant improvement in the morphometry of the LA both at the hospital stage and in the remote period. The methods are associated with low risk of hospital mortality, as well as a low level of thromboembolic complications in the remote period. In all methods of LA plasty, its appendage was resected, which also excluded conditions for thrombus formation.

Evaluation of the Results of Left Bundle Branch Pacing after Atrioventricular Junction Ablation in Patients with Chronic Atrial Fibrillation

Atrioventricular junction ablation (AVJA) together with the implantation of cardiac pacemaker has become a recognized and effective treatment strategy for patients with symptomatic tachysystolic atrial fibrillation that does not respond to heart rate control drug therapy. Left bundle branch pacing (LBBP) is a physiological alternative to right ventricular and biventricular pacing. The aim. To analyze the clinical results of the average duration with the use of LBBP and AVJA. Materials and methods. Over the period from January 2023 to July 2024, LBBP with subsequent AVJA was applied at the National Amosov Institute of Cardiovascular Surgery in 18 patients as a method of treatment of chronic tachysystolic atrial fibrillation to achieve heart rate control. Results. Mid-term results (at least 1 month) could be monitored in 15 out of 18 patients (84%); in the other three (16%) patients the time between pacemaker implantation and AVJA was too short. The mean period from pacemaker implantation to control examination was 5.07 ± 2.79 months (minimum period 1 month, maximum 12 months). During the period from implantation and ablation to the control observation in the study group, it was possible to observe an increase in left ventricular ejection fraction from 39.12 ± 10.56% to 46.38 ± 7.09%, p = 0.035; decrease in the values of end-diastolic volume from 184.22 ± 76.76 to 167.85 ± 36.93 ml, p = 0.074; decrease in the right ventricular pressure from 43.07 ± 8.29 to 34.38 ± 4.78 mm Hg, p = 0.013. It was also possible to observe a decrease in the left bundle branch capture thresholds from 1.27 ± 0.58 to 0.7 ± 0.39 V at 0.4 ms, p = 0.016; and a decrease in the average LBBP endocardial lead resistance from 638 ± 172.83 to 529.4 ± 120.15 Ohm, p = 0.012. Conclusions. Implantation of the LBBP pacemaker and AVJA was not associated with the occurrence of complications both in the intraoperative and postoperative periods, as well as in the remote period of the average duration in the studied group. The use of this approach in patients with chronic atrial fibrillation made it possible in a series of consecutive patients to improve the systolic function of the left ventricle, to reduce the values of the end-diastolic volume of the left ventricle and the right ventricular pressure at optimal pacing parameters.

Оценка результатов лечения больных с синдромом шейного ребра в послеоперационном периоде

The pectoral exit syndrome is of undoubted interest for surgeons, angiosurgeons and neurologists due to the possible compression of the vascular-nervous plexus, causing certain symptoms and reducing work abilities. Objective To conduct an analysis of the results of the treatment of patients with cervical rib syndrome in the short and remote observation periods in the postoperative period. Material and methods 138 patients with abnormal cervical ribs were the clinical material and the object for the study, abnormal cervical ribs caused the extravasal compression of the vascular bunch of the upper extremities at the exit from the chest. These patients were treated and were operated on in the vascular surgery department of the Republican Scientific Center of Cardiovascular Surgery from January 1990 to May 2020. Results Good postoperative results were observed in 89.1 % of patients in the short postoperative period. Intraoperative complications were noted in 5 (3.6 %), and in the short postoperative period – in 10 (7.2 %) patients. In the remote period, relapse of preoperative symptoms of the disease was noted in 8 (5.8 %) of all 138 patients observed. Relapse (or renewal of the symptoms of Reino) was mainly observed in the period of up to 3 years. At different times of observation, 5 patients were lost from sight. In the remote period, in terms of up to 1 year of observation, a good result was 97.2 %, from 2–3 years to more than 5 years – 90.6 %. Conclusions The early identification of intraoperative and postoperative complications allows to timely eliminate these complications. In the nearest postoperative period, only the hemodynamic effect of decompression operations and selective cervical-breed sympathctomy is obvious. Neurological symptoms regressed gradually in the remote period. In this case, it is necessary to emphasize the importance of timely rehabilitation therapy, the implementation of the recommendations of a specialist, since the restoration of dystrophic changes in the nerve trunks is a long process.

Experience with the use of hyaluronic acid solution (Diart) in the treatment of patients with degenerative-dystrophic diseases of the hip joint

Background. Degenerative-dystrophic diseases of the joints are chronic progressive pathological conditions, accompanied by such features as presence of pain syndrome, impaired functional capacity, muscle weakness, deformation and instability of the joints. The high prevalence of degenerative-dystrophic diseases of the hip joint necessitates the search for optimal non-invasive treatment methods. Objectives. This study aims to analyze the clinical results of intra-articular injections of hyaluronic acid solution (Diart) in the treatment of patients with II–III stages of degenerative-dystrophic diseases of the hip joint. Materials and methods. The clinical results of 30 patients with II–III stages of degenerative-dystrophic diseases of the hip joint were analyzed. The group included 11 (36.67%) males and 19 (63.33%) females. The mean age of group was 61.43±7.98 years. All patients underwent a course of drug therapy using hyaluronic acid solution (Diart), which included 3 intra-articular injections of the drug, which were performed with the 7-day interval. Clinical results were evaluated at the initial visit, at 7, 14, 30 and 90 days after the first injection of Diart by objective examination of patients and analysis of subjective data using the WOMAC questionnaire. Statistical analysis was performed using Statistica 13 software package. Results. The high effectiveness of intra-articular injections of hyaluronic acid (Diart) in the treatment of patients with II-III stages of degenerative-dystrophic diseases of the hip joint and the absence of complications associated with intra-articular injection of the drug have been established. Signs of post-injection sy- novitis, discomfort, swelling or other unpleasant sensations weren’t observed in any of the examined patients. Comparing the results established during remote period, on the 90th day of observation, and indicators determined at the initial visit, we proved a decrease in the intensity of the pain syndrome in the hip joint by 30.35%, in stiffness — by 29.57%, an improvement in the indicators characterizing the functional capacity by 21.34 % and the total values of the WOMAC index — by 27.37%, after a treatment course using Diart. Conclusion. The high efficiency of using intra-articular injections of hyaluronic acid solution (Diart) in the treatment of patients with II–III stages of degen- erative-dystrophic diseases of the hip joint has been proven.

Understanding the varieties in first-year university students’ experience of self-regulated learning during emergency remote teaching

ABSTRACT First-year students often lack basic self-regulated learning skills when transitioning to higher education. The emergency remote teaching period during the COVID-19 pandemic enhanced the importance of skills in self-regulated learning, due to the reduction of face-to-face contact with the teacher. This study focuses on first-year students’ experiences of their challenges related to self-regulated learning as well as how they engage in self-regulated learning during emergency remote teaching in autumn 2020. The data consisted of 67 reflective journals written by first-year students. The journals were analysed using a thematic analysis. The findings show that there were considerable differences between the students in terms of their ability to engage in self-regulated learning, particularly in how they approached the challenges mentally and in terms of study behaviour. However, most of the first-year students adjusted relatively well to emergency remote teaching in terms of their self-regulated learning and were able to utilise self-regulated learning strategies at least to some extent. This study stresses particularly the importance of some components of self-regulated learning: good time management skills and an ability to regulate attention, as well as positive academic emotions and a high level of self-efficacy. Conclusions of the study are also discussed.

Preferred techniques for forest mushrooms cooking by residents of contaminated areas of the Bryansk region in the remote period after the Chernobyl accident

The article presents results of the analysis of questionnaire survey data on preferences in the choice of cooking methods of different types of forest mushrooms by residents of the most contaminated south-western districts of the Bryansk region in the remote period after the Chernobyl accident. In the period from 2019 to 2022, the employees of Federal Budgetary Institution of Science «Saint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev» conducted a face-to-face questionnaire survey of the adult population. In addition to general questions about the respondent, the questionnaires included questions about the species composition of the mushroom basket, the volume and proportion of consumption of each type of mushroom by the respondent and his family members (both in the current and last year), as well as methods of culinary processing of the mushrooms consumed. Based on the analysis of individual survey data, a group of 1 311 respondents, whose diet included various types of mushrooms, was selected. Analysis of the survey results showes that respondents prefer to process a large proportion of freshly picked forest mushrooms (59%) for long-term storage (pickling, freezing, drying, salting, etc.); 41% of mushrooms are consumed immediately. The most popular pretreatments of freshly picked mushrooms are washing and boiling (34 and 26%, respectively). When freezing, pickling and pickling up to 97% of respondents carry out pre-treatment (rinsing, soaking and / or boiling) of freshly picked mushrooms. Less popular methods of the mushroom preparation (from 2 to 4%) are pickling, drying and frying of fresh mushrooms with their subsequent preservation. Thus, the majority of respondents actively use various types of culinary processing with the use of preliminary stages of technological processing in the form of rinsing, soaking and (or) boiling. The use of the above methods of pre-cooking of freshly harvested mushrooms leads to a decrease in the 137Cs content in the consumed product.

Implementing different teaching methods in geography during the remote learning period in 2020

Due to the COVID-19 pandemic the teachers were required to adjust their previous teaching methods, test both their pedagogical skills and their digital competence, as well as the digital competence of the students. The purpose of the research was to map out teaching methods by geography teachers in Estonia, the efficiency levels of those methods, while also receiving feedback about the teaching process as it applied to remote learning. Mixed methods research was conducted amongst 76 geography teachers, data collection method was a questionnaire. The results revealed: if the most efficient methods of learning were forms of discussion which called for active communication between the students themselves, as well as between students and teachers, then the least efficient method was teacher-centered lecture. Forms of discussion were used by teachers most often in synchronized video lessons, but they requested suitable short educational videos and a uniform repository of teaching materials. Half of teachers didn`t use map-related work, minority used work with maps in the e-testing environments or into worksheets. More than half of teachers adjusted the assessment system without making any compromises in terms of learning outcomes. Half of the teachers were so far satisfied with the teaching process and with their contact with the students, half of the teachers believed that their students failed to achieve the planned learning outcomes.

Exploring leaders' perceptions of school resilience during COVID-19: Constructing the framework for school development

The study aimed to develop a framework for evaluating school resilience, focusing on leaders' perceptions. This framework examined two critical aspects: firstly, how pre-pandemic school development activities influenced schools' response during the COVID-19 remote learning period, and secondly, how experiences gained during the pandemic could shape future practices.Two research questions guided the study: (1) What predictive factors contribute to leaders’ ability to manage daily leadership during distance learning? (2) What factors do leaders identify as enabling schools to enhance their learning capacity for the future?The survey was conducted among Estonian school leaders at the end of the first pandemic wave in June 2020. Two multiple linear regression models were employed to explore the variance in coping with leadership challenges during the remote learning period and the potential impact on future teaching practices.The results show that leaders effectively managed the challenges of the remote learning period, drawing on their pre-pandemic experience with joint discussions and distance teaching practices, established routines working with data and collaboration with parents. Moreover, the perception of the distance learning period as a learning opportunity for the future stemmed from their previous experiences in distance teaching, data-driven decision-making, and joint discussions with colleagues.The developed resilience framework serves as both a research and self-evaluation tool to assess schools' capacity to navigate uncertainty. Additionally, it can be integrated into leadership training or school development programs to bolster schools' resilience and cultivate context-sensitive leadership skills.

Analysis of The Influence of Company Fundamentals on Stcock Prices During the Transition Period and After the Implementation of the Remote Tranding System on the Stock Excange Indonesia (Study in Banking)

This study aims to determine the effect of ROE (Return on Equity, (PER) Price Earnings Ratio, DER (Debt to Equity Ratio), NPL (Non - Performing Loans), and BOPO (operating costs of operating income) on banking stock prices during the transition period and after the implementation of remote trading system technology on the Indonesian stock exchange and also examines whether there is a difference in the effect of these independent variables on stock prices in the two periods. This research was conducted with quantitative methods and used secondary data. The number of samples in this study was 6 banking companies listed on the Indonesia Stock Exchange from 2006 - 2020, where the transition period was from 2006-2009 and the remote trading period was from 2010-2020. The data were analyzed separately in both periods using multiple linear regression models, a classical assumption test, and also the Chow Test as an additional test using the SPSS 25 tool. The results showed that during the transition period only DER had no significant effect and 4 (four) other independent variables; BOPO, NPL, PER, and ROE have a significant effect on stock prices, while during remote trading the DER and PER variables have no significant effect and 3 (three) other independent variables; BOPO, PER, and NPL have a significant effect. During the transition period, the independent variables simultaneously have the effect of 70.3% on the price, but during the remote trading period, the ability of the five independent variables is only 35.5% in explaining the rise/fall of stock prices. The results of the Chow test show that there are differences in the influence or structural changes in the influence of independent variables on stock prices and the regression coefficients. There are also differences where the independent variables during the transition period are all inelastic (e < 1) and vice versa during remote trading all coefficient values the regression is elastic (e > 1).

School culture and teaching practices for the effective student- centred learning during emergency remote teaching

ABSTRACT This paper explores teaching practices during emergency remote teaching, drawing on data from a nationwide online survey of Estonian high schools. The study was motivated by an attempt to understand effective teaching under conditions of emergency-related logistic, online teaching and economic constraints faced by the schools during the COVID-19 pandemic. The study design adopted a quantitative approach, employing exploratory factor analyses and structural equation modelling of self-report data from a sample of 1,788 teachers. The model brought out three teaching strategies employed during the emergency remote teaching period and their relationship to school-level factors, perceived workload and perceived effectiveness of student learning. Student-centred learning strategies were especially perceived as effective and influenced by stronger collaboration at the school level. Our findings illuminate the necessity of implementing a varied and flexible teaching methodology under emergency remote teaching contexts, backed by a proactive and dynamic collaboration among school members and parents.

From crisis to recovery: scientific endeavors of the Institute of Agroecology and Environmental Management of the NAAS of Ukraine in minimizing the consequences of the Chornobyl accident

The participation of scientists from the Institute of Agroecology and Nature Management of the National Academy of Agrarian Sciences of Ukraine in mitigating and minimizing the consequences of the Chornobyl disaster during 1986–2024 is elucidated. It is demonstrated that the history of the development of radioecological research at the Institute originates from the early days following the Chornobyl Nuclear Power Plant accident. Actually, from this time onwards, the monitoring of radiation in agricultural lands affected by accidents has begun. One of the most crucial directions of work during this period was conducting of aerial and ground radiation reconnaissance. Active efforts were made in radioecological monitoring and dosimetric control of the population. The radioactive contamination of the territory was analyzed based on landscape, basin, and landscape-geochemical principles, upon which maps of radiation contamination of the territory for 137Cs, 90Sr, and 94Pu were compiled. During the remote period of Chornobyl disaster aftermath, the team of the unit was engaged in developing countermeasures for various types of economic activities in conditions of radioactive contamination, taking into account modern trends in the development of the natural-economic complex and new economic conditions based on landscape-ecological approach. Analysis of the results of scientific activities of the institution’s staff indicates that during the post-accident period, the team of radioecologists gathered and systematized significant volumes of information, which were transformed into various databases, cartographic materials, mathematical models, methodological recommendations, regulations, drafts of normative documents, and so forth. Information was provided on the contribution of the Institute’s employees to the development of radioecology, restoration of agricultural production on radioactively contaminated lands, and rehabilitation of territories affected by the Chornobyl Nuclear Power Plant accident. Furthermore, contemporary radioecological problems and threats posed by the full-scale military aggression of Russia against Ukraine were outlined, including its violation of all seven principles of radiation safety, as well as potential radiation-related hazards in the future.

QUALITY OF LIFE OF PATIENTS TREATED BY VALVE-SPARING AORTIC ROOT REPLACEMENT

The aim. To determine the effectiveness of David valve-preserving operation in comparison with Bentall operation based on the analysis of patients' quality of life after operations. Materials and methods. The study included 107 patients who underwent planned and urgent surgical treatment at the Heart Institute of the Ministry of Health of Ukraine from 2015 to 2023. The patients were divided into two groups depending on the type of surgical intervention: group A consisted of 53 patients (49,11±1,54 years; 47 (88,68%) males), who underwent the David procedure (valve-sparing replacement of aortic root and ascending aorta), group B – 55 patients (52,36±1,56 years; 53 (96,36%) males), who underwent Bentall surgery (replacement of the valve, root and ascending part of the aorta). The quality of life was assessed before the operation for each group, and in the long-term period after operation. The quality of life of the patients of both groups was compared. It was assessed using the Medical Outcomes Study Short Form 36 (MOS SF-36) questionnaire. Results. The obtained data indicated that the average preoperative values of quality of life indicators of patients of both groups with different types of aneurysm correction were significantly different from ideal health. The performed operations significantly improved the assessment of the quality of life. When comparing the quality of life in the remote period of the patients of both groups, the indicators were significantly better in group A. We noticed that the patients of group A had a significantly better psycho-social component, which probably influenced the assessment of other scales. Group A patients had statistically better all indicators of quality of life after surgery comparing with group B patients. Group B patients complained about the sound of the artificial aortic valve prosthesis, sometimes the occurrence of minor nosebleeds and the need for frequent visits of the doctor to monitor blood "thinning" indicators. Conclusions. The obtained results indicate a positive change in the quality of life in patients of both groups. When David operation is performed for aortic root and ascending aortic aneurysms, the quality of life is significantly better than in patients after Bentall operation. We recommend performing David operations at the highly specialized cardiac centers.

Molecular Characteristics of Blood Serum After Covid-19 Vaccination in a Remote Period

COVID-19 is a dangerous disease with long-lasting consequences. Vaccination contributes to the accumulation of neutralizing anti-S IgG antibodies, reducing the incidence of COVID-19 and its complications. However, in some individuals, the inflammatory process can persist for an indefinite period and lead to a wide range of dysfunctions. The current task is to investigate molecular markers for their detection. The aim of this study is to examine the levels of anti-S IgG antibodies, lactate, glucose, lactate dehydrogenase, and C-reactive protein in the peripheral blood of individuals who have and have not been affected by COVID-19 after vaccination. The research subject is venous blood. Among 547 employees of the Neurosurgery Institute (481 vaccinated against COVID-19 and 66 unvaccinated individuals), levels of anti-S IgG antibodies were investigated, as well as levels of lactate, lactate dehydrogenase, glucose, and C-reactive protein. At the time of the study, among 372 individuals, 16 months had passed from the first vaccination, and 12 months had passed from the second vaccination; in 21 individuals, 12 months had passed after a single vaccination, and in 88 individuals, 16 months had passed from the first vaccination, 12 months from the second, and 6 months from the third vaccination. Methods. Quantitative determination of IgG antibodies to the S protein of the SARS-CoV-2 virus. Confirmation of COVID-19 using the RT-PCR method (Allplex 2019-nCoV kit, SeeGene, Korea). Levels of lactate, lactate dehydrogenase, glucose, and C-reactive protein were determined using reagents from BioSystems (Spain). Statistical analysis of the obtained data was performed using Jamovi software (USA) and the following criteria: χ2 ‒ Kruskal-Wallis, W ‒ Dwass-Steel-Critchlow-Fligner (DSCF), χ2 ‒ Pearson, t ‒ Student, rs ‒ Spearman, τb ‒ Kendall. A statistically significant difference was considered at p < 0.05. Results. The level of anti-S IgG antibodies to the SARS-CoV-2 virus was higher in vaccinated individuals compared to unvaccinated individuals (Kruskal-Wallis χ2=14.09; p < 0.001). A higher level of antibodies to the S protein of the virus was observed when using the Comirnaty vaccine compared to vaccination with Moderna, AstraZeneca, Pfizer, and CoronaVac (Dwass-Steel-Critchlow-Fligner (DSCF): W 4.26, p=0.002; W 4.62, p=0.010; W 4.84, p=0.006, respectively). Vaccination reduces the likelihood of contracting the disease by 1.84 times (Odds Ratio (OR) 1.84; 95% Confidence Interval (CI) 1.02‒3.30; χ2=4.129; p=0.043). However, no statistically significant dependence on the prevention of COVID-19 incidence based on the type of vaccines used was found (Kruskal-Wallis χ2=2.072; p=0.72). A statistically significant difference in C-reactive protein levels is observed between groups with early mild complications and early moderate-severity complications (DSCF: W=4.193, p=0.009). A statistically significant difference in LDH levels is noted between individuals without chronic diseases and those with chronic diseases at the time of the study (Kruskal-Wallis χ2=6.08, p=0.014). In individuals vaccinated against the SARS-CoV-2 virus, a positive correlation is found between the levels of C-reactive protein and lactate dehydrogenase (Kendall's τb 0.134, p < 0.001). The mean levels of lactate among individuals with mild, moderate, and severe forms of COVID-19 are higher than the reference mean; similarly, the mean levels of glucose in these same groups are higher than the reference mean. A positive correlation exists between the levels of lactate and glucose among individuals vaccinated against the SARS-CoV-2 virus (Kendall's τb 0.082, p < 0.01). Conclusions. Vaccination contributes to an increase in antibody levels. The level of antibodies after the third vaccination exceeded the levels after the first (Dwass-Steel-Critchlow-Fligner (DSCF): W 4.42, p=0.005) and second vaccinations (W 4.24, p=0.008). Vaccination reduces the likelihood of COVID-19 infection by 1.84 times (Odds Ratio ‒ 1.84; 95% Confidence Interval 1.02‒3.30; Pearson χ2=4.129; p=0.043). The frequency of COVID-19 incidence is not dependent on the type of vaccine used: AstraZeneca, Comirnaty, CoronaVac, Moderna, Pfizer (Kruskal-Wallis χ2=2.072; p=0.723), and the level of antibodies in the vaccinated individuals' serum. In the post-COVID-19 remote period, regardless of vaccination status, various complications are observed. However, among the vaccinated, the number of individuals without complications or with minimal complications is greater than in the unvaccinated group, while the number of individuals with early and severe complications is lower (Kruskal-Wallis χ2=6.127; p=0.047). A high level of C-reactive protein (DSCF: W=4.19, p=0.009), a tendency toward increased levels of lactate dehydrogenase (DSCF: W=3.27, p=0.054), elevated levels of lactate (2.17+1.23, t=3.34; p=0.002), and glucose (6.06+0.048, t=10.54; p < 0.001) indicate that after recovering from COVID-19, regardless the type of vaccines used, in individuals with distant symptoms there are metabolic changes that are signs of a chronic inflammatory process. Individuals with chronic diseasees show an increase in the level of lactate dehydrogenase (χ2=6.08; p=0.014) and a tendency toward increased levels of C-reactive protein (χ2=3.74; p=0.053). Molecular markers of inflammation such as increased levels of lactate, glucose, C-reactive protein, and lactate dehydrogenase are informative for identifying individuals with an inflammatory process in the post-COVID-19 remote period.

La educación de jóvenes y adultos en la hostelería: un estudio sobre el curso técnico Proeja en alojamiento en el Instituto Federal de Maranhão

We aim with this work to identify the profile of the students of the Proeja Course (Youth and Adult Education) in Hotel Management at IFMA - Historic Center of São Luís - MA, to map the students' conceptions about the course, during the training process, aiming to present the main demands of this process. This was qualitative research supported by quantitative elements. A questionnaire was administered on Google Forms, as it was a remote class period. The research revealed that despite advances in Youth and Adult Education in Brazil and Maranhão, there is still a lot to do. Today, students still face and overcome many problems such as reconciling study time with work and caring for their families, (re)adaptation to school writing and reading activities. But there are positive points such as the awakening of a feeling of belonging to the history of São Luís, the motivation to continue studying and enter the job market. In other words, there is a stimulus for the personal and professional growth of students.

Developing a gamified digital platform to promote extracurricular activities in basic and secondary schools – preliminary findings

ABSTRACT Designing learning solutions in digitally mediated contexts requires attention to the level of immersion, interactivity, personalization, and engagement promoted, to which the incorporation of active learning methods and gamified strategies can be strategic. However, more research is needed on how teachers use technology-enhanced active learning strategies and on the impact of game-design elements inclusion in learning environments. This study provides findings from the informed exploration stage of a project, consisting of the development and assessment of a digital platform to be used in Portuguese basic and secondary schools to support participation in extracurricular projects and promote its users’ sense of belonging. A survey by questionnaire was publicly shared with Portuguese schoolteachers, in June 2022, to map the current technological reality in Portuguese schools and teachers’ relationship with technologies. 215 valid responses were analysed with descriptive statistics and content analysis. The use of digital technologies was found not to have decreased after the emergency remote learning period. Teachers assumed that the most used platforms coincided with those institutionally supported and that combining the promotion of active learning methods and the formal recognition of learners’ attitudes and skills in a digital solution was something innovative and required in Portuguese schools.

Minimally invasive techniques for surgical treatment of sacrococcygeal pilonidal disease

Sacrococcygeal pilonidal disease (SPD) is a common disease that affects mainly young men and leads to a decrease in their quality of life and a long‑term loss of working capacity. According to the available statistical data, the disease prevalence in Europe and North America ranges from 26 to 40 cases per 100,000 people.
 Objective — to determine the effectiveness of minimally invasive techniques for surgical treatment of chronic and recurrent forms of SPD.
 Materials and methods. The study included 23 patients with SPD. It was clinical prospective, with a follow‑up period of 18 months. The evaluation criteria were defined as recurrences, the frequency of postoperative complications, the severity of the pain syndrome, the patient’s self‑assessment of the cosmetic effect, the duration of hospitalisation, and the duration of surgery.
 The results. The recurrence rate during the 18 months of observation was 39.1%. The overall frequency of postoperative complications was 21.7%. The median duration of surgery was 20 (CI 95% 15—25) minutes, and the median duration of hospitalisation was 2 (CI 95% 1—3) days. The median score of the pain syndrome according to the modified visual analogue scale was 5 (CI 95% 4—5) points on the 0th postoperative day, 3 (CI 95% 3—4) points on the third postoperative day, and 2 (CI 95% 2—2) points on the fifth postoperative day. The cosmetic effect of surgical intervention was rated as rather dissatisfied (17.4%), rather satisfied (52.2%), and completely satisfied (30.4%).
 Conclusions. Minimally invasive techniques are effective for the surgical treatment of chronic and recurrent forms of sacrococcygeal pilonidal disease, reducing both the inpatient period and the surgery duration. Minimally invasive surgical treatment for chronic and recurrent forms of sacrococcygeal pilonidal disease has been observed to cause a moderate pain syndrome in the early postoperative period while contributing to satisfactory cosmetic results in the remote period. The surgical treatment of chronic and recurrent forms of sacrococcygeal pilonidal disease with minimally invasive techniques has been found to result in a relatively high recurrence rate (39.1% over 18 months of follow‑up).