In this thesis, techniques for testing aircraft models in ground effect in a low speed wind tunnel are investigated. Although these types of tests have been done before, the current study is unique in that forces are measured with an overhead balance instead of an internal balance. This has the advantage that the types of models that are difficult to mount on a sting with an internal balance, can often be mounted with a strut protruding from the top of the model. Positioning a sting-mounted model close to the ground at a high angle-of-attack is also usually difficult if not impossible. Finally, drag measurements are often more accurate when measured with an overhead balance rather than with an internal sting-type balance. The disadvantages associated with this method of testing are identified and solutions suggested. These include accurate moment transfers and correcting for support tares and interference. The thesis also investigates general procedures associated with ground effect testing such as proper boundary corrections and the necessity of a rolling floor. A simplified preliminary test series was performed in order to identify shortcomings in the existing equipment and procedures. This series is explained in Chapter 2. Chapter 4 and 5 describe changes made to the existing equipment following this test series. These include a novel telescopic fairing to shroud the mounting strut and an internal pitching mechanism. The correction techniques and general theory are summarised in Chapter 3. The author concludes in Chapter 6 that with the application of the techniques described in this thesis, the test engineer should be able to obtain accurate and reliable data from most aircraft configurations. Additional suggestions for testing models in ground effect are also given in this chapter. Finally, a few shortcomings that still need to be investigated are mentioned at the end of Chapter 6. AFRIKAANS : Hierdie verhandeling ondersoek tegnieke om vliegtuigmodelle in grondeffek in 'n laespoed-windtonnel te toets. Alhoewel hierdie tipe van toetse al voorheen gedoen is, is die huidige studie uniek deurdat 'n oorhoofse balans eerder as 'n interne balans gebruik word. Die voordeel hiervan is dat modelle wat moeilik op 'n naald- of "sting"-balans monteer kan word, baie keer makliker monteer kan word met 'n stang wat deur die bokant van die model steek. Posisioneering van 'n naald-gemonteerde model naby aan die vloer van die tonnel by hoe invalshoeke is gewoonlik ook baie moeilik indien nie onmoontlik nie. Laastens is sleurkrag-metings wat met 'n oorhoofse balans gemeet is gewoonlik meer akkuraat as sleurkrag-metings wat met 'n interne naald-tipe balans gedoen is. Die nadele wat met hierdie toetsmetode geassosieer kan word, word geïdentifiseer en moontlike oplossing word voorgestel. Hierdie sluit die berekening in van akkurate moment-transformasies en monteersleureffekte en -steurings. Die verhandeling ondersoek ook algemene prosedures wat met grondeffektoetse geassosieer kan word, byvoorbeeld akkurate wandkorreksies en die nodigheid van die rolvloer. 'n Vereenvoudigde vooraf-toetsreeks was uitgevoer om moontlike tekortkominge in die bestaande toerusting en prosedures te identifiseer. Hierdie toetsreeks word in Hoofstuk 2 bespreek. Hoofstuk 4 en 5 verduidelik die veranderinge wat aan die bestaande toerusting gemaak is na aanleidng van hierdie toetsreeks. Hierdie veranderinge sluit 'n teleskopiese windskerm in om die monteerstang te isoleer van die wind, sowel as 'n interne heimeganisme om die invalshoek van die model te verstel. Die korreksieprosedures en algemene teorie word in Hoofstuk 3 opgesom. Die outeur se gevolgtekking in Hoofstuk 6 stel dat die toetsingenieur, met behulp van die gebruik van die tegnieke in hierdie verhandeling beskryf, in staat behoort te wees om betroubare metings te kan neem van meeste vliegtuigkonfigurasies. Verdere voorstelle vir die toets van modelle in grondeffek word ook in hierdie hoofstuk gemaak. Uiteindelik word 'n paar tekortkominge genoem wat moontlik in 'n toekomstige studie ondersoek kan word. / Dissertation (MEng)--University of Pretoria, 1999. / Mechanical and Aeronautical Engineering / unrestricted

An der TU Chemnitz haben sich seit über zwei Jahrzehnten die Gebiete der rechnergestützten Wissenschaften (Computational Science) sowie des parallelen und verteilten Hochleistungsrechnens mit zunehmender Verzahnung entwickelt. Die Koordinierung und Bündelung entsprechender Forschungsarbeiten in der Profillinie 6 “Modellierung, Simulation, Hochleistungsrechnen” wird es ermöglichen, im internationalen Wettbewerb des Wissens mitzuhalten.

<p>Hirur&scaron;ka inetrvencija aktivira odgovor organizma na stres, pokreću se neuroendokrine promene u organizmu, &scaron;to rezultira neželjenom hemodinamskom nestabilno&scaron;ću, promenama metabolizma, endokrinog i imunog sistema. Cilj ovog istraživanja je bio da se utvrdi uticaj kaudalnog bloka na nivo perioperativnog stresa i njegova efikasnot u zbrinjavanju intra- i postoperativnog bola. Ovo prospektivno, randomizirano kliničko ispitivanje obuhvatalo je 80 dečaka, uzrasta 2-5godina, kojima su bile indikovane urolo&scaron;ke operacije. Jedna grupa (n = 38) je primila op&scaron;tu anesteziju, a druga (n = 38) op&scaron;tu anesteziju sa kaudalnim blokom. Mereni su intraoperativno hemodinamski parametri u 8 merenja, ukupna potro&scaron;nja svih datih lekova i intenzitet bola u 3 navrata postoperativno. Uzorci krvi uzeti su pre uvoda u anesteziju i nakon buđenja pacijenta, i ispitivan je nivo glukoze, kortizola, leukocita, leukocitarne formule, pH i laktata. Deca koja su primila kaudalni blok imala su, postoperativno, značajno niži nivo glukoze u serumu (p &lt;0,01), koncentracije kortizola (p &lt;0,01), leukocita i neutrofila (p &lt;0,01), laktata i acidoze, a takođe su imali i niže ocene bola u sve tri momenta merenja (p&lt;0,01). Intraoperativno utvrđena je veća hemodinamska stabilnost i manja potro&scaron;nja analgetika perioperativno. Takođe, u toj grupi nije bilo komplikacija. Kombinacija kaudalnog bloka sa op&scaron;tom anestezijom je bezbedna metoda, koja dovodi do manjeg stresa, veće hemodinamske stabilnosti, nižih ocena bola i manje potro&scaron;nje<br />lekova.</p> / <p>Surgery generates a neuroendocrine stress response, resulting in undesirable haemodynamic instability, alterations in metabolic response and malfunctioning of the immune system. The aim of this research was to determine the effectiveness of caudal blocks in intra- and postoperative pain management and in reducing the stress response in children during the same periods. This prospective, randomized clinical trial included 80 patients scheduled for elective urological operations. One group (n = 38) received general anaesthesia and the other (n = 38) received general anaesthesia with a caudal block. Haemodynamic paramethers, drug consumption and pain intensity were measured. Blood samples for serum glucose, cortisol level, leukocytes, pH and lactate level were taken before anaesthesia induction and after awakening the patient. Children who received a caudal block had, postoperativly, significantly lower serum glucose (p &lt; 0.01), cortisol concentrations (p &lt; 0.01), leukocytes (p&lt;0,01), lower lactate level and acidosis,also pain scores were lower at all 3 measurments (p&lt;0,01). Intraoperativly greater haemodynamic stability and lower drug consumption were noticed. Also, there were no side effects or complications identified in that group. The combination of caudal block with general anaesthesia is a safe method that leads to less stress, greater haemodynamic stability, lower pain scores and lower consumption of medication.</p>

<p>UVOD: Uspe&scaron;nost revaskularizacije aortoilijačne bolesti procenjuje se prohodno&scaron;ću (patentno&scaron;ću) nakon revaskularizacije i brojem komplikacija. Osnovni cilj ove studije je bio utvrditi da li postoji razlika u učestalosti komplikacija, prohodnosti (patentnosti) i uticaj prohodnosti arterija donjeg vaskularnog korita na rekonstrukcije aortoilijačne bolesti nakon lečenja endovaskularnim i klasičnim hirur&scaron;kim pristupom. MATERIJAL I METODOLOGIJA: uzorak je činilo 229 bolesnika lečenih od aortoilijačne bolesti koji su pripadali TASC-u B i C a nakon procene prohodnosti femoropoplitealnog segmenta kao i broja prohodnih potkolenih arterija, bolesnici su stratifikovani u dve glavne grupe a svaka grupa od po tri podgrupe prema kvalitetu utočnog korita. Prvu grupu čine bolesnici sa jednoetažnom ili multiplim kraćim lezijama aortoilijačne signifikantne stenoze, sa ne signifikantnom aortoilijačnom stenozom i sa aortoilijačnom okluzijom. Drugu grupu čine bolesnici sa vi&scaron;eetažnom aortoilijačnom signifikantnom stenozom uz signifikantnu femoropoplitealnu stenozu i/ili popliteokruralnu stenozu. Studija je kreirana kao retrospektivna i prospektivna gde smo pratili rezultate revaskularizacije endovaskularnim procedurama i klasičnim hirur&scaron;kim pristupom. REZULTATI: Računanjem Mahalanobisove distance između homogenost jednoetažne, multiplih kraćih lezija i vi&scaron;eetažne aortoilijačne bolesti kod ispitivanih bolesnika dobija se najmanje rastojanje između homogenost jednoetažne, multiplih kraćih lezija i vi&scaron;eetažne aortoilijačne bolesti zato smo se i rukovodili da jednoetažne lezije, multiple kraće lezije tretiramo endovaskularnim procedurama a vi&scaron;eetažne lezije klasičnim hirur&scaron;kim pristupom. Nije bilo statističke značajne razlike među komplikacijama endovaskularnih procedura i klasičnog hirur&scaron;kog pristupa p&gt;0,1. U lečenju aortoilijačne bolesti endovakularne procedure imaju manji broj bolničkih dana, podjednaku primarnu asistiranu patentnost ali ne&scaron;to slabiju primarnu patentnost u odnosu na klasični hirur&scaron;ki pristup dok je sekundarna patentnost neznatno lo&scaron;ija od klasičnog hirur&scaron;kog pristupa. Da bi smo odreditli uticaj prohodnosti arterija donjeg vaskularnog korita na rekonstrukcije aortoilijačne bolesti kreirali smo matematički model kome smo dali obeležja prema kome bi mogli prognozirati smanjenje primarne patenosti nakon aortoilijačne revaskularizacije endovaskularnim procedurama i klasičnim hirur&scaron;kim pristupom. Postojanjem značajnih razlika između stepena patentnosti u odnosu na obeležja faktora rizika, definisali smo funkciju razgraničenja svih mogućih kombinacija od dva stepena patentnosti. Na osnovu te funkicije (x) moguće je izvr&scaron;iti prognozu kom stepenu patentnosti pripada (dobra,solidna, lo&scaron;a) za bolesnike koji nisu obuhvaćeni ovom studijom, kao i pouzdanost tom stepenu. ZAKLJUČAK: Aortoilijačna bolest je u većini slučajeva udružena sa bole&scaron;ću donjeg vaskularnog korita. Bez obzira na ekstenzivnost aortoilijačne bolesti endovaskularne procedure su efektivna i bezbedna, adekvatna alternativa klasičnom hirur&scaron;kom pristupu. Ova studija pokazuje da su endovaskularne procedure i klasični hirur&scaron;ki pristup u lečenju aortoilijačne bolesti komplementarne a ne komparativne metode.</p> / <p>BACKGROUND. The effectiveness of revascularization aortoiliac occlusive disease is the estimated patency after revascularization and is connected to the number of complications. The main objective of this study was to determine whether there is a difference in the incidence of complications and patency of lower artery vascular tree on the reconstruction aortoiliac occlusive disease after treatment of endovascular and conventional surgical approach. MATERIAL AND METHODOLOGY: The sample consisted of 229 patients treated for the aortoiliac occlusive disease who belonged in TASC B and C after a mobility assessment of the femoropopliteal segment and the number of walk-on below knee arteries, patients were stratified into two groups and each group of three subgroups according to the quality of the inflow. The first group consists of patients with one storey or multiple shorter lesions, and aortoiliac significant stenosis with aortoiliac not as significant stenosis and occlusion aortoiliac. The second group consists of patients with multi-floor aortoiliac significant stenosis with a significant femoropopliteal stenosis and/or popliteocrural stenosis. The study was designed as a retrospective and prospective study, where we track the results of endovascular revascularization procedures and compare to the conventional surgical approach. RESULTS: By calculating the Mahalanobis distance between the homogeneity of one story, multiple lesions and multi-storey short aortoiliac occlusive disease the studied patients received a minimum distance between the homogeneity of one story, multiple lesions and multi-storey short aortoiliac disease, multiple lesions treated fewer endovascular procedures and multi-storey lesions than a classical surgical approach. There were no statistically significant differences among the complications of endovascular procedures and classic surgical approach p&gt; 0.1. The patients treated with aortoiliac (endovascular) procedure have fewer hospital days, equal-assisted primary patent protection or slightly less primary patent protection compared to a traditional surgical approach while secondary patent protection is slightly worse than the classic surgical approach. In order to determine the impact of vascular patency of the arteries of the lower stories to the reconstruction treatment of aortoiliac occlusive diseases, we have created a mathematical model to which we gave the characteristics by with which it could predict the reduction of primary patency of aortoiliac revascularization after endovascular procedures and the conventional surgical approach. The existence of significant differences between the degree of patent protection in relation to the characteristics of the risk factors, we have defined the function of the demarcation of all possible combinations of two degrees of patent protection. Based on this function of (x) it is possible to forecast to what extent patent protection belongs (good, solid&sbquo; bad) for patients who are not included in this study, as well as the reliability of this level. CONCLUSION: the aortoiliac occlusive disease is in most cases associated with vascular disease of the lower artery vascular tree. Regardless of the extensiveness of the disease, aortoiliac occlusive disease endovascular procedures are safe and effective, an adequate alternative to the conventional surgical approach. This study shows that endovascular procedures and the conventional surgical approach in the treatment of aortoiliac occlusive diseases with a complementary rather than competitive method.</p>

The purpose of this study is to focus on constructing a modelling-based learning environment to improve learner performance in grade 6 mathematics classrooms. The purpose emanates from the continued poor performance of learners in mathematics at different school levels, especially grade 6. The teaching and learning of mathematics is explained from an ontological point of departure, focussing on constructivist paradigms. Different types of constructivism are discussed with special attention to the school mathematics domain. The learning, problem based learning, problem solving and learning environment are key components in the discussion. A theoretical perspective on the design of modelling as a powerful learning environment in primary schools mathematics classrooms is provided. Focus is placed on the applicability of the modelling-based learning environment on the South African mathematics curriculum and on study orientation as a key component to help develop an understanding of why learners perform or do not perform in mathematics. A mixed method research design, in which quantitative and qualitative are combined to achieve the outcomes of the research problem, is chosen for this research study project to provide a purposeful research framework. The findings of the research include not only learners’ improvement in dealing with non-routine, mathematical word problems but also in general-routine, mathematical word problems. A second finding shows that the overall SOM pre/post/retention showed good reliability, acceptable construct validity, good practical significance, and large effect but had low to medium effect in individual fields. The univariate analysis for the Crossover design used indicated that the problem solving field had statistical significance and practical significance, and the study milieu and mathematical confidence field might have statistical significance and practical significance. The third finding provided evidence concerning teacher administration, teacher and learner interaction, assessment and homework. The findings from the quantitative and qualitative data-analysis and interpretations, and literature review, guided the researcher in proposing a construct for a modelling-based learning environment as a means to improve learners’ mathematics performance in grade 6 mathematics classes in the John Toalo Gaetswe (JTG) District. The contribution that this study makes is to propose a construct for a modelling-based learning environment to improve learner performance in grade 6 mathematics. / PhD (Mathematics Education), North-West University, Potchefstroom Campus, 2014

The purpose of this study is to focus on constructing a modelling-based learning environment to improve learner performance in grade 6 mathematics classrooms. The purpose emanates from the continued poor performance of learners in mathematics at different school levels, especially grade 6. The teaching and learning of mathematics is explained from an ontological point of departure, focussing on constructivist paradigms. Different types of constructivism are discussed with special attention to the school mathematics domain. The learning, problem based learning, problem solving and learning environment are key components in the discussion. A theoretical perspective on the design of modelling as a powerful learning environment in primary schools mathematics classrooms is provided. Focus is placed on the applicability of the modelling-based learning environment on the South African mathematics curriculum and on study orientation as a key component to help develop an understanding of why learners perform or do not perform in mathematics. A mixed method research design, in which quantitative and qualitative are combined to achieve the outcomes of the research problem, is chosen for this research study project to provide a purposeful research framework. The findings of the research include not only learners’ improvement in dealing with non-routine, mathematical word problems but also in general-routine, mathematical word problems. A second finding shows that the overall SOM pre/post/retention showed good reliability, acceptable construct validity, good practical significance, and large effect but had low to medium effect in individual fields. The univariate analysis for the Crossover design used indicated that the problem solving field had statistical significance and practical significance, and the study milieu and mathematical confidence field might have statistical significance and practical significance. The third finding provided evidence concerning teacher administration, teacher and learner interaction, assessment and homework. The findings from the quantitative and qualitative data-analysis and interpretations, and literature review, guided the researcher in proposing a construct for a modelling-based learning environment as a means to improve learners’ mathematics performance in grade 6 mathematics classes in the John Toalo Gaetswe (JTG) District. The contribution that this study makes is to propose a construct for a modelling-based learning environment to improve learner performance in grade 6 mathematics. / PhD (Mathematics Education), North-West University, Potchefstroom Campus, 2014

<p>Ova disretacija bavi se korpusnom<br />IZ lingvistikom, ali iz perspektive teorijskih<br />metodolo&scaron;kih i praktičnih aspekata<br />koncipiranja kursa korpusne lingvistike koji<br />je utemeljen na principima interaktivne<br />nastave. Glavni cilj ovog istraživanja jeste<br />da se u njemu formuli&scaron;u principi<br />projektovanja interaktivnih kurseve koji su<br />usklađeni sa sadržajima studijskih programa<br />i sadržaja ostalih kurseva, ali i koji su<br />pedago&scaron;ki efikasni i orijentisani na studenta.<br />Drugi cilj istraživanje jeste da se u skladu<br />sa ovim principima koncipira kurs korpusne<br />lingvistike koji je optimalno prilagođen<br />uvođenju korpusne lingvistike i interaktivne<br />natave na diplomske akademske studije<br />anglistike u Srbiji. Treći cilj istraživanja je<br />da proveri inicijalnu hipotezu da će kurs<br />korpusne lingvistike projektovan u skladu sa<br />principima koncipiranja interaktivne natave i<br />sproveden u hibridnom okruženju biti<br />superioran u odnosi na kurs istih sadržaja ali<br />sproveden isključivo primenom<br />tradicionalnih metoda nastave.</p> / <p>This thesis deals with corpus linguistics, but<br />AB from the point of view of theoretical,<br />methodological and practical aspects of<br />designing a course in corpus lingusitics<br />which is based on the principles of<br />interactive teaching and learning. The main<br />aim of the research is to formulate principles<br />of designing interactive courses which are<br />alligned with curricula and syllaby, but<br />which are also pegogically efficient and<br />student-friendly. The secondary aim is to<br />design a course in accordance with these<br />principles which is optimally suitable for<br />introducing corpus linguistic and interactive<br />teaching methods to MA studies of English<br />language and linguistics in Serbia. The third<br />aim of the research is to test the initial<br />hypothesis that a course designed in accordance with interactive principles of course design and realized as a hybrid course will be superior to the same course based entirely on traditional teaching methods.</p>

<p>Увод: Објективна процена оперативног ризика кардиохируршких болесника и процена потребне постоперативне ангажованости медицинских сестара у јединици интензивног лечења могу допринети брзом увиду у тежину здравственог стања болесника , осигурању оптималног броја сестара, омогућавању квалитетне здравствене неге болесника, олакшању организације рада , аргументованом уговарању потреба за сестринским кадром. Најчешће коришћени физиолошки скорови, за процену обима ангажованости медицинских сестара су: Nine Equivalent of Nursing Use Manpower Score (NEMS)и Nursing Activities Score (NAS). Током 2010. године, за процену ризика у кардиохирургији, креиран је модел European System for Cardiac Operative Risk Evaluation (EuroSCORE II). Циљеви истрађивања: 1.Испитати повезаност EuroSCORE II, и активности медицинских сестара у јединици интензивног лечења. 2.Утврдити утицај релевантних фактора ризика из EuroSCORE II, на активности медицинских сестара у јединици интензивног лечења. 3.Испитати повезаност EuroSCORE II, и специфичних интервенција медицинских сестара јединице интензивног лечења. Методе:У студију je била укључена консекутивна серија од 809 болесника, оперисаних на Клиници за кардиоваскуларну хирургију Института за кардиоваскуларне болести, у периоду од 01.02. 2014-30.11.2014. године. Подаци о вредностима EuroSCORE II и релевантним факторима ризика преузети су болничког информационог система.Подаци о сестринским активностима у јединици интензивног лечења, након кардиохируршке интервенције, регистровани у одговарајућим листама. Испитивање повезаности нивоа оперативног ризика и активност медицинских сетра вршено је помоћу линеарне корелације. Утицај појединих фактора из модела EuroSCORE II на активност медицинских сестара испитиван је мултиваријантном линеарном регресијом. Зависност специфичних интервенција медицинских сестара од нивоа EuroSCORE II и других параметара оцењивана је помоћу бинарне логистичке регресије. Квалитет предиктивног модела, одређиван је помоћу ROC кривих, укључујући одређивање оптималног пресека, сензитивности и специфичности. Резултати: EuroSCORE II је у позитивној корелацији са укупним NEMS (r=0,207;p&lt;0,0005) и NAS (r=0,242;p&lt;0,005). Ослабљена функција бубрега, ослабљена систолна функција леве коморе и плућна хипертензија, повезани су са повећаним активностима медицинских сестара (p&lt;0,0005). EuroSCORE II и укупна ангажованост медицинских сестра били су у корелацији (r=0,098; p=0,005 за NEMS, односно r=0,100; p=0,004 за NAS). Mултиваријантна бинарна логистичка регресија показује да на повећани NAS утичу комбинована кардиохиршка процедура (p=0,005), претходне операције (p=0,009), oслабљена функција бубрега (p&lt;0,0005), NYHA класа (p=0,007) и плућна хипертензија (p &lt; 0,0005). Модел има добру моћ дискриминације односно, добар је маркер за разликовање болесника код којих се, после операције на срцу, очекује повећан укупан NAS (area=0,702, p&lt;0,0005). Прeсечна тачка (cut-off) је 23, сензитивност 0,624 а специфичност 0,688. Закључак: Постоји позитивна корелација између нивоа EuroSCORE II и укупне активности медицинских сестара у јединици интензивног лечења. Ослабљена функција бубрега, ослабљена систолна функција леве коморе и плућна хипертензија, повезани су са повећаним активностима медицинских сестара израженим помоћу NEMS и NAS. EuroSCORE II и збир специфичних интервенција, односно укупна ангажованост медицинских сестара и EuroSCORE II били су у корелацији. Могуће је направити Модел за предикцију вероватноће повећаног укупног ангажовања медицинских сестара у јединици интензивног лечења кардиохируршких болесника.</p> / <p>Uvod: Objektivna procena operativnog rizika kardiohirurških bolesnika i procena potrebne postoperativne angažovanosti medicinskih sestara u jedinici intenzivnog lečenja mogu doprineti brzom uvidu u težinu zdravstvenog stanja bolesnika , osiguranju optimalnog broja sestara, omogućavanju kvalitetne zdravstvene nege bolesnika, olakšanju organizacije rada , argumentovanom ugovaranju potreba za sestrinskim kadrom. Najčešće korišćeni fiziološki skorovi, za procenu obima angažovanosti medicinskih sestara su: Nine Equivalent of Nursing Use Manpower Score (NEMS)i Nursing Activities Score (NAS). Tokom 2010. godine, za procenu rizika u kardiohirurgiji, kreiran je model European System for Cardiac Operative Risk Evaluation (EuroSCORE II). Ciljevi istrađivanja: 1.Ispitati povezanost EuroSCORE II, i aktivnosti medicinskih sestara u jedinici intenzivnog lečenja. 2.Utvrditi uticaj relevantnih faktora rizika iz EuroSCORE II, na aktivnosti medicinskih sestara u jedinici intenzivnog lečenja. 3.Ispitati povezanost EuroSCORE II, i specifičnih intervencija medicinskih sestara jedinice intenzivnog lečenja. Metode:U studiju je bila uključena konsekutivna serija od 809 bolesnika, operisanih na Klinici za kardiovaskularnu hirurgiju Instituta za kardiovaskularne bolesti, u periodu od 01.02. 2014-30.11.2014. godine. Podaci o vrednostima EuroSCORE II i relevantnim faktorima rizika preuzeti su bolničkog informacionog sistema.Podaci o sestrinskim aktivnostima u jedinici intenzivnog lečenja, nakon kardiohirurške intervencije, registrovani u odgovarajućim listama. Ispitivanje povezanosti nivoa operativnog rizika i aktivnost medicinskih setra vršeno je pomoću linearne korelacije. Uticaj pojedinih faktora iz modela EuroSCORE II na aktivnost medicinskih sestara ispitivan je multivarijantnom linearnom regresijom. Zavisnost specifičnih intervencija medicinskih sestara od nivoa EuroSCORE II i drugih parametara ocenjivana je pomoću binarne logističke regresije. Kvalitet prediktivnog modela, određivan je pomoću ROC krivih, uključujući određivanje optimalnog preseka, senzitivnosti i specifičnosti. Rezultati: EuroSCORE II je u pozitivnoj korelaciji sa ukupnim NEMS (r=0,207;p&lt;0,0005) i NAS (r=0,242;p&lt;0,005). Oslabljena funkcija bubrega, oslabljena sistolna funkcija leve komore i plućna hipertenzija, povezani su sa povećanim aktivnostima medicinskih sestara (p&lt;0,0005). EuroSCORE II i ukupna angažovanost medicinskih sestra bili su u korelaciji (r=0,098; p=0,005 za NEMS, odnosno r=0,100; p=0,004 za NAS). Multivarijantna binarna logistička regresija pokazuje da na povećani NAS utiču kombinovana kardiohirška procedura (p=0,005), prethodne operacije (p=0,009), oslabljena funkcija bubrega (p&lt;0,0005), NYHA klasa (p=0,007) i plućna hipertenzija (p &lt; 0,0005). Model ima dobru moć diskriminacije odnosno, dobar je marker za razlikovanje bolesnika kod kojih se, posle operacije na srcu, očekuje povećan ukupan NAS (area=0,702, p&lt;0,0005). Presečna tačka (cut-off) je 23, senzitivnost 0,624 a specifičnost 0,688. Zaključak: Postoji pozitivna korelacija između nivoa EuroSCORE II i ukupne aktivnosti medicinskih sestara u jedinici intenzivnog lečenja. Oslabljena funkcija bubrega, oslabljena sistolna funkcija leve komore i plućna hipertenzija, povezani su sa povećanim aktivnostima medicinskih sestara izraženim pomoću NEMS i NAS. EuroSCORE II i zbir specifičnih intervencija, odnosno ukupna angažovanost medicinskih sestara i EuroSCORE II bili su u korelaciji. Moguće je napraviti Model za predikciju verovatnoće povećanog ukupnog angažovanja medicinskih sestara u jedinici intenzivnog lečenja kardiohirurških bolesnika.</p> / <p>Introduction: Objective assessment of operative risk of cardiac surgery patients and assessment of the necessary postoperative nursing engagement in the intensive care units can contribute to rapid insight into the health status of the patients, ensuring optimal number of nurses, enabling quality health care, facilitating the work organization, providing the basis for contracting adequate number of personnel. The most commonly used physiological scores for assessment of the extent of involvement of nurses are: Nine Equivalent of Nursing Manpower Use Score (NEMS) and the Nursing Activities Score (NAS). In 2010, risk assessment model for cardiac surgery was developed - European System for Cardiac Operative Risk Evaluation (EuroSCORE II). Objectives of the research: 1. To examine the relationship between EuroSCORE II and the activities of nurses in the intensive care unit. 2. To determine the influence of relevant risk factors of EuroSCORE II model, to the activities of nurses in the intensive care unit. 3. To examine the relationship between EuroSCORE II and specific nursing interventions in intensive care unit. Methods: The study included consecutive series of 809 patients surgically treated at the Clinic for Cardiovascular Surgery, Institute of Cardiovascular Diseases in Sremska Kamenica, from 01:02. 2014 to 30.11.2014. Data on EuroSCORE II values and relevant risk factors were taken from the hospital information system. Nursing activities in the intensive care unit after cardiac surgery were registered using the relevant lists. Correlation between operative risk and activity of the nursing staff was performed using linear correlation. The influence of certain factors from the EuroSCORE II model to the activity of nurses was investigated by multivariate linear regression. Dependence of specific nursing interventions on the level of EuroSCORE II and other parameters was evaluated using binary logistic regression. Quality of the predictive model was determined using ROC curves, including the determination of the optimum cross-section of sensitivity and specificity. Results:The EuroSCORE II was positively correlated with the total NEMS (r= 0.207; p &lt;0.0005) and NAS (r=0.242; p&lt;0.005). Impaired renal function, impaired left ventricular systolic function and pulmonary hypertension, were associated with increased activity of nurses (p&lt;0.0005). EuroSCORE II and the total involvement of nurses were correlated (r=0.098; p=0.005 for NEMS, respectively r =0.100; p = 0.004 for the NAS). Multivariate binary logistic regression showed that there is influence on the increased NAS by the following factors: combined cardiac suregry (p=0.005), previous surgery (p=0.009), impaired renal function (p&lt;0.0005), NYHA class (p=0.007) and pulmonary hypertension (p&lt;0.0005). Model showed good discriminative power, and is a good marker for distinguishing patients in whom, following the heart surgery, increased overall NAS might be expected (area=0.702, p &lt;0.0005). Intersection point (cut-off) is 23, the sensitivity and specificity 0.624 0.688. Conclusion: There is a positive correlation between the level of EuroSCORE II and the entire work of nurses in the intensive care unit. Impaired renal function, impaired left ventricular systolic function and pulmonary hypertension, are associated with increased activity of nurses expressed using NEMS and NAS. EuroSCORE II and the sum of specific interventions, and the engagement of nurses and EuroSCORE II were correlated. It is possible to make a model to predict the probability of increased overall engagement of nurses in the cardiac surgery intensive care unit.</p>

<p>&Scaron;tavelj (Rumex crispus, Polygonaceae) je vi&scaron;egodi&scaron;nja zeljasta biljka, koja predstavlja bogat izvor fenolnih komponenti. Iako se smatra invazivnim korovom, mlado li&scaron;će &scaron;tavelja je jestivo i često se koristi kao salata. Dalje, upotreba plodova &scaron;tavelja opisana je u srpskoj i turskoj narodnoj medicini u lečenju gastrointestinalnih tegoba. Cilj ovog rada bio je procena in vitro i in vivo antioksidantne/prooksidantne i citotoksične aktivnosti, i određivanje eventualnog in vitro antiinflamatornog efekta vodenog ekstrakta ploda Rumex crispus. Ukupan sadržaj flavonoida određen je spektrofotometrijskom metodom. Kvalifikacija i kvantifikacija flavonoida potvrđena je visokoefikasnom tečnom hromatografijom (HPLC). Antioksidantna aktivnost vodenog ekstrakta ploda &scaron;tavelja procenjena je na osnovu in vitro testova: Ferric-reducing antioxidant power (FRAP), sposobnosti ekstrakta da neutrali&scaron;e slobodne radikale NO&bull;, OH&bull; i DPPH&bull; i uticaja na lipidnu peroksidaciju u lipozomima. Citotoksičnost ispitivanog ekstrakta je određena in vitro na tumorskim ćelijskim linijama: humani karcinom cerviksa (HeLa), adenokarcinom (HT-29) i adenokarcinom dojke (MCF7). Takođe, moguća in vivo hepatoprotektivna i antioksidantna svojstva ekstrakta određena su kod oksidativnog stresa izazvanog CCl4 kod eksperimentalnih životinja. Pored toga, proverena je hipoteza u kojoj testiran ekstrakt pokazuje in vivo antiproliferativnu aktivnost kod Ehrlich-ovih (EAC) i Hepatoma AS30D ćelija, merenjem zapremine ascitesa, procenta vijabilnih ćelija i nivoa nekoliko antioksidantnih enzima. Optimizovan in vitro test za određivanje potencijala inhibicije ciklooksigenaze-1 (COX-1) i 12-lipooksigenaze (12-LOX) preduzet je u svrhu procene antiinflamatornog efekta vodenog ekstrakta ploda R. crispus. HPLC analiza otkrila je da je mikvelianin najdominantniji flavonoidni konstituent ekstrakta. Testirani ekstrakt pokazao je potencijalnu antioksidantnu aktivnost rezultujući velikom moći u neutralizaciji slobodnih radikala, i sposobno&scaron;ću da smanji lipidnu peroksidaciju u lipozomima. Rezultati su ukazali na tkivno-selektivnu citotoksičnost ekstrakta ploda R. crispus in vitro. Najizraženija antitumorska aktivnost primećena je prema HeLa i MCF7 ćelijskim linijama. Podaci sugeri&scaron;u da bi se ispitivani ekstrakt mogao smatrati potencijalnim in vivo hepatoprotektivnim i antioksidantnim agensom, sprečavajući oksidativna o&scaron;tećenja jetre. S druge strane, pomenuti ekstrakt može pokazati in vivo prooksidantna svojstva, uzrokujući oksidativni stres u maligno transformisanim EAC i AS30D ćelijama i smanjujući zapreminu ascitesa i udeo vijabilnih ćelija, u poređenju sa kontrolnom grupom. Promene u aktivnosti antioksidantnih enzima su verovatno posledica indukovanog oksidativnog stresa u EAC i AS30D ćelijama, naročito kod pretretiranih životinja. Vodeni ekstrakt ploda &scaron;tavelja pokazao je COX-1, kao i 12-LOX inhibitornu aktivnost, navodeći da bi ispitivani ekstrakt mogao biti antiinflamatorni agens. Vodeni ekstrakt ploda R. crispus ima potencijalnu antioksidantnu, citotoksičnu i antiinflamatornu aktivnost. Ispoljavanje prooksidantnih svojstava predstavlja mogući mehanizam antiproliferativnog efekta ekstrakta.</p> / <p>Curly dock (Rumex crispus, Polygonaceae) is a wild perennial herbaceous plant, which products are described as a rich source of phenolic compounds. Apart from being considered a seriously invasive weed, young leaves of curly dock are edible and often used as salad. Furthermore, the use of its fruits has been described in Serbian and Turkish traditional medicine against stomach complaints. The objectives of this study were to evaluate in vitro and in vivo antioxidant/prooxidant and cytotoxic activities, and to determine an eventual in vitro anti-inflammatory effect of the aqueous extract of Rumex crispus fruits. Total flavonoid content was determined by spectrophotometric method. Qualification and quantification of flavonoids were confirmed using High performance liquid chromatography (HPLC). The aqueous extract of curly dock fruits was evaluated for its antioxidant activity by in vitro assays for Ferric-reducing antioxidant power (FRAP), NO&bull;, OH&bull; and DPPH&bull;-free radical scavenging activities and the influence on lipid peroxidation in liposomes. The cytotoxicity of tested extract was examined in vitro in human cervix carcinoma (HeLa), colon adenocarcinoma (HT-29) and breast adenocarcinoma (MCF7). Also, the potential in vivo hepatoprotective and antioxidant properties of investigated extract were determined on CCl4-induced oxidative stress in experimental animals. Furthermore, the hypothesis that the examined extract might show in vivo antiproliferative activity in Ehrlich carcinoma (EAC) and Hepatoma AS30D cells was tested by measuring volume of ascites, percentage of viable cells and level of several antioxidant enzymes. The optimized in vitro test for determination of cyclooxygenase-1 (COX-1) and 12-lipoxygenase (12-LOX) inhibition potency was undertaken in order to estimate an anti-inflammatory effect of aqueous extract of R. crispus fruits. HPLC analysis revealed miquelianin as the most abundant flavonoid constituent of the extract. The tested extract might have an antioxidant activity resulting in scavenging of free radicals and ability to decrease lipid peroxidation in liposomes. The results could indicate tissue-selective cytotoxicity of R. crispus fruit extract in vitro. The most prominent antitumor activity was observed towards HeLa and MCF7 cell lines. The data suggested that investigated extract may be considered as potential in vivo hepatoprotective and antioxidant agent due to prevention of the liver injuries induced by oxidative damage. On the other hand, mentioned extract could exhibit in vivo prooxidant property, causing the oxidative stress in malignant transformed EAC and AS30D cells and reducing volume of ascites and percentage of viable cells, in comparison with control group. Changes in activities of antioxidant enzymes might be the results of induced oxidative stress in EAC and AS30D cells, especially in the pretreated animals. The aqueous extract of curly dock fruits showed COX-1, as well as 12-LOX inhibitory activity, suggesting that tested extract might be an anti-inflammatory agent. It could be concluded that aqueous fruit extract of R. crispus might have antioxidant, cytotoxic and anti-inflammatory activities. The prooxidant properties of examined extract could be the mechanism of potential antiproliferative effect of extract.</p>

<p>Akutno bubrežno o&scaron;tećenje je česta i ozbiljna komplikacija nakon hirur&scaron;ke rekonstrukcije abdominalne aorte. Ona produžuje, poskupljuje bolničko lečenje i povećava morbiditet i mortalitet bolesnika. &Scaron;to ranije prepoznavanje bolesnika koji su pod povi&scaron;enim rizikom uz pomoć prediktivnih faktora, kao i identifikovanje akutnog bubrežnog o&scaron;tećenja od velikog je značaja za pravovremeno započinjanje preventivnih i terapijskih mera i smanjenje mortaliteta ovih bolesnika. Cilj istraživanja: Utvrditi incidencu akutnog bubrežnog o&scaron;tećenja, najznačajnije preoperativne i intraoperativne prediktivne faktore za nastanak akutnog bubrežnog o&scaron;tećenja i utvrditi da li serumski cistatin C ranije i preciznije ukazuje na akutno bubrežno o&scaron;tećenje u odnosu na serumski kreatinin 72 sata nakon elektivnih operacija na infrarenalnom segmentu aorte. Metodologija: Na Klinici za anesteziju, intenzivnu terapiju i terapiju bola i Klinici za vaskularnu i transplantacionu hirurgiju Kliničkog centra Vojvodine sprovedeno je prospektivno opservaciono istraživanje u trajanju od 18 meseci, od oktobra 2017. do aprila 2019. godine. U istraživanje je uključeno 140 pacijenata koji su podvrgnuti elektivnom operativnom zahvatu na infrarenalnom segmentu aorte. Preoperativni i intraoperativni potencijalni prediktivni faktori identifikovani su iz medicinske dokumentacije: istorije bolesti, protokoli anestezije, dnevne terapijske liste, liste vitalnih parametara i liste laboratorijskih parametara. Nastanak ABO je potvrđivan pomoću AKIN klasifikacionog sistema. Tokom postoperativnog perioda lečenja od 72 sata obraćana je pažnja na vreme i stepen nastanka ABO. Za statističku obradu podataka kori&scaron;ćen je program SPSS, verzija 21 (IBM SPSS, Čikago, Ilinois). Rezultati su predstavljeni tabelarno i grafički, a statistički značajnim su se smatrale vrednosti nivoa značajnosti p&lt;0,05. Podaci su obrađivani standardnim statističkim testovima. Za dobijanje modela predikcije primenjena je multivarijantna logistička regresija. Rezultati: Incidenca akutnog bubrežnog o&scaron;tećenja nakon elektivnih operacija na infrarenalnom segmentu aorte na Klinici za anesteziju, intenzivnu terapiju i terapiju bola i Klinici za vaskularnu i transplantacionu hirurgiju Kliničkog centra Vojvodine iznosi 28,56%. Prema ROC analizi granična vrednost koncentracije cistatina C od 1,14 mg/l ima najvi&scaron;u senzitivnost (82,5%), i specifičnost (76%) u diferenciranju bolesnika koji će dobiti akutno bubrežno o&scaron;tećenje. Kompletan model predikcije ABO nakon elektivnih operacija na infrarenalnom segmentu aorte sadrži sledeće faktore: prisustvo hronične bubrežne slabosti, preoperativna serumska koncentracija cistatina C &gt;1,14 mg/l, primena koloida u volumenu &gt;500 ml u toku operacije, ukupni volumen nadoknade u intraoperativnom periodu &gt;59 ml/kg. Zaključak: Incidenca akutnog bubrežnog o&scaron;tećenja nakon elektivnih operacija na infrarenalnom segmentu aorte na Klinici za anesteziju, intenzivnu terapiju i terapiju bola i Klinici za vaskularnu i transplantacionu hirurgiju Kliničkog centra Vojvodine je ne&scaron;to vi&scaron;a u odnosu na literaturne podatke. Cistatin C je bolji prediktor i pokazatelj akutnog bubrežnog o&scaron;tećenja u odnosu na kreatinin. Bolesnici koji imaju hroničnu bubrežnu slabost, preoperativni nivo cistatina C&gt;1,14 mg/l, koji tokom operacije dobiju preko 500 ml koloidnih rastvora, i ukupni volumen nadoknade &gt;59 ml/kg imaju veću &scaron;ansu da dobiju akutno o&scaron;tećenje bubrega u postoperativnom periodu.</p> / <p>Acute kidney injury is frequent and serious complication after aortic surgery which increases length of hospital stay, costs, morbidity and mortality. Earlier recognition of patients at risk by predictive factors and identification of acute kidney injury could have important role on right timing of preventive and therapeutic measures and lower mortality of these patients. Aims: to investigate the incidence of acute kidney injury, the most important preoperative and intraoperative predictive factors for acute kidney injury, and check whether cystatin C indicates acute kidney injury earlier and more accurately than creatinine 72 hours after elective infrarenal aortic surgery. Methodology: This prospective observational study was performed at Clinic of Anesthesia, Intensive Care and Pain Therapy and Clinic of Vascular and Transplantation Surgery, Clinical Centre of Vojvodina, during the period of 18 months, from October 2017 till April 2019. It includes 140 adult patient who underwent elective infrarenal aortic surgery. Potential predictive factors were identified out of medical records such as: patient history, anesthesia lists, daily therapeutic lists, vital parameters and laboratory values lists. The occurrence of acute kidney injury was noted according to AKIN criteria. IBM SPSS version 21 (Chicago, Illinois) was used for statistical analysis. The results were presented in tables and graphs, statistical significance was set at p value of less than 0,05. Standard statistical tests were applied. Multivariate logistic regression model was used for potential predictive factors. Results: The incidence of acute kidney injury at Clinic of Anesthesia, Intensive Care and Pain Therapy and Clinic of Vascular and Transplantation Surgery, Clinical Centre of Vojvodina, was 28,56%. The cut off value of cystatin C serum concentration of 1,14 mg/l has the highest sensitivity (82,5%), and specificity (76%) in the differentiation of patients who will develop acute kidney injury. The final model for predicting acute kidney injury in patients who underwent elective infrarenal aortic surgery contains the following variables: presence of chronic kidney failure, preoperative serum concentration of cystatin C&gt;1,14 mg/l, application of colloid solutions in volume&gt;500 ml during the operation and total intravascular fluid replacement volume&gt;59 ml/kg in intraoperative period. Conclusion: The incidence of acute kidney injury at Clinic of Anesthesia, Intensive Care and Pain Therapy and Clinic of Vascular and Transplantation Surgery, Clinical Centre of Vojvodina, is somewhat higher comparing to world literature data. Patients who are more likely to develop acute kidney injury have: chronic kidney failure, preoperative serum concentration of cystatin C&gt;1,14 mg/l and get colloid solutions in volume&gt;500 ml and total intravascular fluid replacement volume&gt;59 ml/kg during intraoperative period.</p>