El uso de métodos de análisis estadístico multivariante como una herramienta efectiva para el atractivo de la inversión

In the terms of sanctions and the need to strengthen the import substitution policy, the issues of effective investment attraction in the agrarian-oriented republics of the North Caucasus are especially relevant. Due to the underinvestment of the agro-industrial complex in these depressed republics, diversified enterprises of the agro-industrial complex sectors generated a large amount of physically and morally worn-out equipment, economic entities of the industry are not able to function efficiently and develop properly, which ultimately does not allow them to produce competitive products. Undoubtedly, we need new practical recommendations and directions to improve the management of investment attractiveness to mobilize various sources of investment. There are many methods for assessing the rating attractiveness of enterprises. But all of them have a common drawback - rating evaluations are usually given simultaneously for the entire data set, which, in general, significantly complicates and even excludes the possibility of an objective assessment of the investment attractiveness for an economic entity not previously included in the list of enterprises under study (Dougherty, 1997; Roizman et al, 2001). Another significant drawback is the lack of validity for the selected indicators of the final rating.En términos de sanciones y la necesidad de fortalecer la política de sustitución de importaciones, los temas de atracción efectiva de inversiones en las repúblicas orientadas a la agricultura del norte del Cáucaso son especialmente relevantes. Debido a la baja inversión del complejo agroindustrial en estas repúblicas deprimidas, las empresas diversificadas de los sectores del complejo agroindustrial generaron una gran cantidad de equipos desgastados física y moralmente, las entidades económicas de la industria no pueden funcionar de manera eficiente y desarrollarse adecuadamente, lo que finalmente no les permite producir productos competitivos. Sin lugar a dudas, necesitamos nuevas recomendaciones prácticas y direcciones para mejorar la gestión del atractivo de la inversión para movilizar diversas fuentes de inversión. Existen muchos métodos para evaluar la calificación de atractivo de las empresas. Pero todos tienen un inconveniente común: las evaluaciones de calificación generalmente se realizan simultáneamente para todo el conjunto de datos, lo que, en general, complica significativamente e incluso excluye la posibilidad de una evaluación objetiva del atractivo de la inversión para una entidad económica no incluida previamente en el lista de empresas en estudio (Dougherty, 1997; Roizman et al, 2001). Otro inconveniente importante es la falta de validez de los indicadores seleccionados de la calificación final

El uso de un enfoque estructural-institucional para el análisis del desarrollo de un complejo económico regional

Enhancement of efficiency and competitiveness of the industrial complex requires changing the existing methods and improving the used methods for forming and implementing industrial policy. Particularly acute is the task of ridding the industrial enterprises of the dependence on foreign technologies and components and the transition to total import substitution under the sanctions of the Western powers and the United States of America.La mejora de la eficiencia y la competitividad del complejo industrial requiere cambiar los métodos existentes y mejorar los métodos utilizados para formar e implementar políticas industriales. Particularmente aguda es la tarea de librar a las empresas industriales de la dependencia de tecnologías y componentes extranjeros y la transición a la sustitución total de importaciones bajo las sanciones de las potencias occidentales y los Estados Unidos de América

Substantiation of the Priorities and Factors of the Formation of Competitive Advantages of the Process Industries of the Regional Agroindustrial Complex

Among the many distinctive features of the modern technical and economic situation of the reclamation industry, such as financial volatility, inconsistency of regulatory documents, there is also no effective mechanism for ensuring the country’s food security, there are flaws in the organizational, financial and credit policy, which brought down the technical level of production and technological processes ...In view of this, there is a need to mainstream a detailed study of the key problems of the agroindustrial complex (AIC) and the development of new theoretical and methodological principles and approaches to the organization of agroindustrial production. Such an approach should ensure the development of modern systems of resource-saving technologies, which will make it possible to carry out timely and deep processing of agri supplies, advance the facilities for attracting investments in priority production and agroprocessing, improve the quality and competitiveness of food and process industries, etc.The protracted transition in the agrarian sector to market relations can be explained by a narrow understanding of the essence of the market economy, measures and methods of their state regulation, which led to undesirable tendencies, ignoring national-historical features in the agrarian sector, etc., which makes it necessary to find an appropriate economic mechanism capable of guaranteeing the production of competitive products and ensuring high quality of production.On account of insufficient elaboration of many theoretical and methodological, methodical and practical aspects, the need for further research in the field of forecasting the sustainable development of the processing industry, complexity and non-systemic knowledge of the competitive functioning of the processing industries of the agroindustrial complex, we have determined its purpose and objectives

Anticoagulation after typical atrial flutter ablation

The specifics of the anticoagulant therapy after radiofrequency ablation of the cavotricuspid isthmus have not been sufficiently studied, therefore, the recommendations for prescribing the anticoagulant therapy usually do not distinguish between atrial flutter and atrial fibrillation. In contrast to the case of atrial fibrillation, the effectiveness of the interventional treatment for typical atrial flutter reaches 90%. This procedure may save the patient from a long-term anticoagulant therapy in the absence of recurrence of typical atrial flutter. The decision to stop the anticoagulant therapy after successful radiofrequency ablation of the cavotricuspid isthmus should take into account the potential induction of atrial fibrillation in patients undergoing the interventional treatment. In addition to the CHA2DS2-VASc scale, which characterizes the patient's comorbidity, it is important to take into account the echocardiographic morphofunctional criteria to assess the risk of atrial fibrillation. Currently, this protocol is not regulated in the clinical guidelines. The analysis of the literature data and the authors' own experience allow us to conclude that the optimal time for stopping the anticoagulant therapy is a relapse-free period of 34 months after the radiofrequency ablation of the cavotricuspid isthmus, since it is at this time that the effectiveness of the interventional treatment can be objectified

ГИБРИДНЫЕ ТЕХНОЛОГИИ ЛУЧЕВОЙ ДИАГНОСТИКИ ИШЕМИЧЕСКОЙ БОЛЕЗНИ СЕРДЦА: СОВРЕМЕННЫЕ ВОЗМОЖНОСТИ И ПЕРСПЕКТИВЫ

FederalStateBudgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases,Kemerovo,RussiaThe article considers the role of modern non-invasive techniques in the diagnosis of coronary heart disease (CHD), in particular multislice computed tomography (MSCT) and myocardial perfusion scintigraphy (MPS), as well as prospects for the use of hybrid technologies such as SPECT / CT and PET / CT. It provides information about indications for use and features of methods, gives research data on the sensitivity and specificity of each technique and about their changes at the hybrid approach.В статье рассмотрена роль современных неинвазивных методов в диагностике ишемической болезни сердца (ИБС), в частности мультиспиральной компьютерной томографии (МСКТ) и перфузионной сцинтиграфии миокарда (ПСМ), а также перспективы использования гибридных технологий, таких как ОФЭКТ/КТ и ПЭТ/КТ. Представлены показания к применению и возможности методов, приведены данные исследований по чувствительности и специфичности каждого метода в отдельности и их изменения при гибридном подходе.

Рентгенологические аспекты диагностики церебральной гиперперфузии. Лекция

Several aspects of diagnostic radiology are considered, particularly concerning the occurrence of stroke and cerebral hyperperfusion after carotid and coronary artery revascularization.Hypoperfusion is the main subject of concern for neurologists and neuroradiologists in the clinical practice, even though hyperperfusion also has an important clinical and prognostic value. Acute pathological hyperperfusion after carotid endarterectomy and venous stroke following cerebral venous sinus thrombosis with a two- or three-fold increase in regional cerebral blood flow have a high risk of hemorrhage. A more favorable condition is benign hyperperfusion with moderate (up to 30%) plethora. It develops during venous stroke as element of the pathogenesis of brain tissue injury after secondary ischemia. Often patients who have undergone the simultaneous carotid and coronary surgery or CABG in the early postoperative period showed signs of neurological deterioration in the form of moderate postischemic hyperperfusion. Timely diagnosis can prevent severe cerebral complications during cerebral venous sinus thrombosis or postoperative adverse events in patients with coronary and carotid artery injuries. CT perfusion is the fastest and most adapted tool for emergency diagnostics, whereas SPECT provides a non-invasive assessment of perfusion and brain tissue metabolism with less radiation and fewer negative effects, such as allergic reactions.Рассмотрены аспекты лучевой диагностики гиперперфузии головного мозга после реваскуляризирующих операций на каротидных и коронарных артериях, а также при инсульте.Наиболее часто в клинической практике неврологов и нейрорадиологов предметом беспокойства является гипоперфузия, но и гиперперфузия имеет немаловажное клиническое и прогностическое значение. Острая патологическая гиперперфузия, встречающаяся после каротидной эндартерэктомии, а также при венозном инсульте вследствие церебрального венозного синустромбоза с двух- и трехкратным увеличением регионарного мозгового кровотока характеризуется высоким риском кровоизлияния. Более благоприятным состоянием является доброкачественная гиперперфузия с умеренным (до 30%) полнокровием, развивающаяся при венозном инсульте и являющаяся элементом патогенеза застойного повреждения ткани мозга с вторичной ишемией. У больных, перенесших коронарные шунтирования или симультанные операции на сонных и венечных артериях, в раннем послеоперационном периоде нередко отмечается негативная динамика неврологического статуса как проявление реперфузионного синдрома в виде умеренной постишемической гиперперфузии. Своевременная диагностика этих состояний может предотвратить тяжелые осложнения церебрального синустромбоза, а также неблагоприятные события послеоперационного периода у пациентов с поражением коронарных и каротидных артерий. Перфузионная компьютерная томография является наиболее быстрым, адаптированным к неотложной диагностике методом исследования. Однофотонная эмиссионная компьютерная томография обеспечивает неинвазивную оценку перфузии и метаболического статуса ткани головного мозга при меньших лучевой нагрузке и риске побочных действий, включая аллергические реакции

Clinical and biochemical markers of coronary artery calcification progression after elective coronary artery bypass grafting

Aim. To assess the relationship of various clinical and biological markers of bone metabolism with the progression of coronary artery calcification (CAC) in patients with stable coronary artery disease (CAD) within 5 years after coronary artery bypass grafting (CABG).Material and methods. This single-center prospective observational study included 111 men with CAD who were hospitalized for elective CABG. In the preoperative period, all patients underwent duplex ultrasound of extracranial arteries (ECA) and multislice computed tomography (MSCT) to assess CAC severity using the Agatston score, as well as densitometry with determination of bone mineral density in the femoral neck, lumbar spine and T-score for them, In all participants, the following bone metabolism biomarkers were studied: calcium, phosphorus, calcitonin, osteopontin, osteocalcin, osteoprotegerin (OPG), alkaline phosphatase, parathyroid hormone. Five years after CABG, ECA duplex ultrasound, MSCT coronary angiography and bone metabolism tests were repeated. Depending on CAC progression (>100 Agatston units (AU)), patients were divided into two groups to identify significant biomarkers and clinical risk factors associated with CAC progression.Results. For 5 years after CABG, contact with 16 (14,4%) patients was not possible; however, their vital status was assessed (they were alive). Death was recorded in 4 (3,6%) cases (3 — due to myocardial infarction, 1 — due to stroke). In 18 (19,7%) cases, non-fatal endpoints were revealed: angina recurrence after CABG — 16 patients, myocardial infarction — 1 patient, emergency stenting for unstable angina — 1 patient. There were no differences in the incidence of events between the groups with and without CAC progression. According to MSCT 5 years after CABG (n=91 (81,9%)), CAC progression was detected in 60 (65,9%) patients. Multivariate analysis allowed to create a model for predicting the risk of CAC progression, which included following parameters: cathepsin K <16,75 pmol/L (p=0,003) and bone mineral density <0,95 g/cm3 according to femoral neck densitometry before CABG (p=0,016); OPG <3,58 pg/ml (p=0,016) in the postoperative period 5 years after CABG.Conclusion. Within 5 years after CABG, 65,9% of male patients with stable coronary artery disease have CAC progression, the main predictors of which are low preoperative cathepsin K level (<16,75 pmol/L) and low bone mineral density (<0,95 g/cm3) according to femoral neck densitometry, as well as a low OPG level (<3,58 pg/ml) 5 years after CABG

АТЕРОКАЛЬЦИНОЗ И ОСТЕОПОРОЗ. СВЯЗИ И УСЛОВИЯ ВЗАИМНОГО ВЛИЯНИЯ. ОБЗОР

The most commonly atherosclerosis affects the aorta, coronary, iliac and extracranial arteries. Calcification is a pathological manifestation of vascular changes in atherosclerosis. At the pathologic development of atherosclerotic plaques and increasing the proportion of calcium compounds, included in its composition. Study on the relationship of calcification of the coronary and carotid arteries subject of many studies. The calcium deposits found arterial wall proteins specific to bone matrix. No one was surprised by the deterioration of bone tissue with age, and this is due to close biological and pathogenetic links atherosclerotic calcification and bone formation. They could not washed out components of the bone matrix "settle" in atherosclerotic plaques?This assumption is the subject of many studies. On the one hand, it is proved that a significant bone loss correlates with a more rapid progression of vascular calcification, increased risk of mortality from coronary heart disease and other forms of atherosclerosis. At the same time marked by mixed results with regard to gender differences in osteoporosis in patients with coronary artery disease, usually associated with low physical activity, the volume of adipose tissue, the number of pregnancy, lactation and menopause. Diabetes highlighted especially among the factors influencing the decline in bone mineral density and degree of calcification of the vascular wall with an increased risk of vascular events by 150% to 400%. But on the impact of violations of carbohydrate metabolism in the bone mineral density, as well as its "quality" with an increased risk of fractures according to world literature among scientists disagree.Thus, the predictive scale FRAX prized highly informative method for predicting fracture risk in the general population, but also noted that in patients with diabetes type 2 FRAX type significantly underestimates the risk of fracture, which is associated with a transforming bone microarchitecture with an increase in density and thickness cortical layer, resulting in a false increase in bone mineral density."Gold" standard for diagnosing osteoporosis is considered to be an X-ray dualenergy densitometry and quantitative assessment of coronary calcification how and brachiocephalic arteries - multislice computed tomography using Agatson scale.To date, it is clear that atherosclerotic calcification and bone mineralization process, of course, have a number of similar parts of the pathogenetic process, however, a clear answer to the question about the presence or absence of a direct relationship calcification and changes of mineral bone density is not obtained.Наиболее часто атеросклероз поражает аорту, коронарные, подвздошные и экстракраниальные артерии. Атерокальциноз является одним из патоморфологических проявлений изменения сосудистой стенки при атеросклерозе. Вместе с патоморфологическим развитием атеросклеротической бляшки увеличивается и доля соединений кальция, входящих в ее состав. Изучению вопроса о взаимосвязи кальциноза коронарных и сонных артерий посвящено немало исследований. В кальциевых депозитах артериальной стенки обнаружены белки, характерные для костного матрикса. Никого не удивляет ухудшение состояния костной ткани с возрастом, и объясняется это тесными биологическими и патогенетическими связями атеросклеротической кальцификации и остеогенеза. Не могут ли вымывающиеся компоненты костного матрикса «оседать» в атеросклеротических бляшках?Этому предположению посвящено немало исследований. С одной стороны, доказано, что значительная потеря костной массы коррелирует с более быстрым прогрессированием кальцификации сосудов, увеличением риска смертности от ишемической болезни сердца и других форм атеросклероза. При этом отмечены неоднозначные результаты в отношении гендерных различий остеопороза у больных с ИБС, связанных с обычно низкой физической активностью, объемом жировой ткани, количеством беременностей, лактацией и менопаузой. Сахарный диабет выделен особо среди факторов, влияющих на снижение минеральной плотности костной ткани и выраженность кальциноза сосудистой стенки с повышением риска развития сосудистых катастроф от 150% до 400%. Но в отношении влияния нарушений углеводного обмена на минеральную плотность кости, а также на ее «качество» с повышенным риском переломов по данным мировой литературы мнения ученых расходятся.Так, прогностическая шкала FRAX признана ценным высокоинформативным методом по прогнозированию риска переломов в общей популяции, но также отмечается, что в отношении пациентов с сахарным диабетом 2-го типа FRAX существенно недооценивает риск развития переломов, что связывают с трансформацией микроархитектуры кости с увеличением плотности и толщины кортикального слоя, приводящей к ложному увеличению минеральной плотности костной ткани.«Золотым стандартом» диагностики остеопороза принято считать рентгеновскую двухэнергетическую денситометрию, а количественную оценку кальциноза как коронарных, так и брахиоцефальных артерий − мультиспиральную компьютерную томографию с использованием шкалы Agatson.На сегодняшний день понятно, что атеросклеротическая кальцификация и процесс минерализации костей, безусловно, имеют ряд схожих звеньев патогенетического процесса, однако однозначного ответа на вопрос о наличии или отсутствии прямой взаимосвязи атерокальциноза и изменения минеральной плотности костей скелета пока не получено

Air Pollen Monitoring in a Specific Region as a Part of the Pollinosis Prevention

Background: The prevalence and severity of allergic diseases, including pollinosis, are increasing worldwide. Hay fever develops due to the complex interaction of genes and manifests itself due to exogenous factors. The main environmental etiology of allergy is plant pollen. Continuous study and analysis of the air pollen spectrum constitute the basis of air monitoring and are important in developing preventive measures for allergic diseases.   Objective: To perform an air pollen monitoring in Kr snodar and to assess the treatment of patients with pollinosis in various cities and districts of the Krasnodar Region according to the Krasnodar Regional Allergy Center data.   Materials and methods: We retrospectively analyzed the patients seeking medical care due to allergy in the Krasnodar Region using the statistical data obtained in 2022 from the Krasnodar Regional Allergy Center. We assessed the effects of air pollen pollution according to the data of air pollen monitoring in Krasnodar during the main activity of herbaceous plants’ taxa (from April 1, 2022 to October 31, 2022). We used AeRobiology and Microsoft Excel 2010 tools for data processing and development of the main parameters of the pollen season.   Results: According to the Krasnodar Regional Allergy Center data, there were 37,212 people diagnosed with J45.0, J46 and 20,012 people diagnosed with J30.1-30.4 in 2022. We identified 8 allergenic taxa of herbaceous plants in the Krasnodar air. We found that the total seasonal pollen concentration increased by an average of 1.8 in 2022 compared to previous monitoring periods in 2018-2021.   Conclusions: Comparative assessment of the prevalence of pollinosis and the air pollen monitoring are important for effective medical care