The innovative technologies of education in the higher economic education of Ukraine

The article deals with the problem of professional training of future specialists in economics to work in the foreign exchange market based on the MetaStock computer program. The aim of the article is to reveal the peculiarities of the technical methods of preparing future economists for the testing of trading systems based on the software product such as MetaStock. The algorithms of students work with the MetaStock computer program with the aim of acquiring skills in the currency market based on computer technologies are determined. It is determined that the prerequisite for successful professional activity in the foreign exchange market is the mastery by future economists of their professional knowledge, skills and skills of trading systems testing while using the MetaStock computer program. It was proved with the help of experiments that the implementation of these methods of training of future economic specialists for testing trading systems based on the computer program MetaStock has led to a significant increase of their readiness to work in the currency market on the basis of computer technology.peer-reviewe

ОБЗОР ИНФОРМАЦИОННЫХ СИСТЕМ ДЛЯ РЕШЕНИЯ ЗАДАЧ СТРАТЕГИЧЕСКОГО МЕНЕДЖМЕНТА

The article contains survey of information systems for strategic management. There is a numeration and description of the IT-system classes that may be applied in strategic management; survey and analytics for computer-based corporate performance management system; the scope of problems which is unsettled in CPM systems.Рассматриваются классы систем для решения задач стратегического управления предприятием, проводится анализ рынка автоматизированных систем управления эффективностью бизнеса, определяется круг еще не решенных зада по автоматизации процесса стратегического управления, приводится сравнительная характеристика наиболее популярных систем класса CPM

Electrodynamic Model of the Heart to Detect Necrotic Areas in a Human Heart

To diagnose the conditions and diseases of the cardiovascular system is the main task of electrocardiology. The problem of the cardiovascular system diagnostics is caused by a complex multi-level mechanism of its functioning, and only experienced specialists are able to establish a correct diagnosis. Since the working heart is inaccessible to direct observations in real life, diagnostics of diseases is based on noninvasive methods such as electrocardiography. By assumption, weak "bursts" (micropotentials) of electrocardiographic signals in different areas are the precursors of dangerous arrhythmias. The amplitude of these signals on the body surface is insignificant and tends to be commensurate with the noise level of the measuring system. Advances in electrocardiography make it possible to generate a high resolution ECG signal and to detect the heart micropotentials. The method of modeling helps to understand causes of micropotentials in the ECG signal by selecting the model parameters. The model of the heart should allow generating a signal close to the high resolution ECG signal. The research aims to find a numerical model that allows solving the inverse problem of the heart tissue characteristics recovery using a high resolution ECG signal and CT data on the heart geometry. The proposed computer model and highly sensitive methods for the ECG measurement are the part of the hardware-software complex to detect dangerous precursors of cardiac arrhythmias

The development of methods of calculating the concession fees

Developed and advanced way of calculation concession fee than provided by the Government Methodology from 04.02.2016. It based on the critical review of existing legal regulation in Ukraine, considering the inflation factor according to international requirements (UNIDO). This approach provides a reduced risk of members of concession agreement, protection of the project member’s interests and the financial viability of the project. Ukraine should follow international practice and rely on concession fee as an instrument of regulation, not only as a fiscal instrument. During the concession contest, where the criteria for selection of the winner is a concession fee, the Government should provide the object to concession if the amount of the payment will be higher than the maximum profit that can get a monopoly. Fee may take the form of a single or an annual payment. In the latter case, reasonable discount rate must be set to calculate the present value of the stream of payments. Confirmed: the need pre-planning examination of normative documents, the use of sentences of the international experience of evaluation of projects, the revised rate of interest a concession payment, the desirability of calculating asset values using their average annual cost, taking into account the special conditions of the project

ВЛИЯНИЕ ПРОДЛЕННОЙ ТЕРАПИИ ЭНОКСАПАРИНОМ НА РИСК РЕЦИДИВА ВЕНОЗНЫХ ТРОМБОЭМБОЛИЧЕСКИХ ОСЛОЖНЕНИЙ И РЕКАНАЛИЗАЦИЮ ТРОМБИРОВАННЫХ ВЕН

The article presents the results of its own study of the effect of long-term (not less than 30 days) enoxa-parin therapy (1 mg/kg administered subcutaneously every 12h) on the risk of recurrent venous thromboembolic complications (VTC) and recanalization of thrombosed deep veins. The enoxaparin therapy was compared with a standard approach to treatment (unfractionated heparin for not less than 5 days followed by the administration of warfarin). The extended enoxaparin therapy was significantly more effective than standard treatment due to its impact on the risk of recurrent deep vein thrombosis (DVT) and recanalization of thrombosed deep veins. On top of that, the effect of enoxaparin in the first month of treatment of VTC episodes last for the next 11 months. As a result, the extension of enoxaparin therapy was associated with an 88% reduction in the risk of DVT recurrence during 12 months of anticoagulant therapy and a 2.5-fold increase in the probability of recanalization of venous occlusions by the end of the first year of treatment compared with the standard therapy with unfractionated heparin and warfarin.В статье представлены результаты собственного исследования, посвященного изучению влияния продленной (не менее 30 дней) терапии эноксапарином (1 мг/кг подкожно каждые 12 часов) на риск рецидива венозных тромбоэмбо-лических осложнений (ВТЭО) и реканализацию тромбированных глубоких вен. Для этого терапию эноксапарином сравнили со стандартным подходом к лечению (нефракционированный гепарин не менее 5 дней с переходом на прием варфарина). Продленная терапия эноксапарином оказалась значительно эффективнее стандартного лечения по влиянию на риск рецидива тромбоза глубоких вен (ТГВ) и реканализацию тромбированных глубоких вен. При этом эффект от применения эноксапарина в первый месяц лечения эпизода ВТЭО сохранялся на протяжении последующих 11 месяцев. Так, продление терапии эноксапарином ассоциировалось со снижением риска рецидива ТГВ в течение 12 месяцев анти-коагулянтной терапии на 88% и с увеличением вероятности реканализации венозных окклюзий к концу первого года лечения в 2,5 раза по сравнению со стандартной терапией нефракционированным гепарином и варфарином

Prognostic value of subclinical atherosclerosis in patients with a SCORE risk <5%: data from a 10-year follow-up

Aim. To evaluate the contribution of subclinical atherosclerosis to the stratification of patients with a SCORE risk of cardiovascular events (CVEs) &lt;5% based on a 10-year follow-up.Material and methods. The study included 379 patients with SCORE risk of CVEs &lt;5% (82 men, 297 women). In 2009, all patients underwent clinical examination, carotid artery (CA) ultrasound with the detection of plaques, total CA occlusion, intima-media thickness (IMT) of the common carotid artery (CCA). The plaque number was determined as the total number of all plaques in 6 following segments: both CCAs, both CCA bifurcations and both internal carotid arteries. The total stenosis was calculated as the sum of stenoses in 6 CA segments in %. In 2019, a telephone survey of patients was conducted with a questionnaire assessing the following CVEs: all-cause death, cardiovascular death, myocardial infarction (MI), stroke, myocardial revascularization, cardiovascular hospitalizations, and composite endpoint.Results. The initial patients’ age ranged from 35 to 67 years (51,1±7,5 years). Plaques from 20% to 50% were detected in 303 participants (79,94%). Over the past 10 years, there have been 5 cardiovascular deaths (1,3%), 7 MIs (1,8%), 5 cases of unstable angina (1,3%), 12 cases of myocardial revascularization (3,2%), 15 strokes (4,0%), 51 cardiovascular hospitalizations (13,5%). The proportion of patients with registered endpoints (CVE+) was 22,4% (n=85). The groups of patients with and without CVEs differed in the level of systolic blood pressure (BP) and blood triglycerides, and did not differ in the level of diastolic BP, lipid profile, glucose, heart rate, smoking status, sex, and age. In the CVE+ group, there were higher values of CCA IMT (0,65 (0,64; 0,70) mm vs 0,62 (0,62; 0,66) mm, p&lt;0,05), total CA stenosis (102,5 (88,1; 120,8)% vs 80 (72,5; 88,1)%, p=0,01), and the CA plaque amount (4,0 (2,8; 3,9) vs 3,0 (2,6; 3,1), p=0,01), respectively. Total CA stenosis was an independent predictor of CVEs when adjusted for sex, age, systolic and diastolic BP (β=0,149; p&lt;0,05), but not for lipid profile. A ROC-analysis revealed a cut-off point for total CA stenosis of 82,5% (AUC=0,598, 95% confidence interval 0,5243-0,673, p&lt;0,05).Conclusion. The total CA stenosis has shown itself to be an independent predictor of CVEs in patients with a SCORE risk &lt;5%

Analysis of radial artery occlusion causes and methods of its prevention after interventions using radial access. Results of the APRIORI study

Aim. To study predictors of radial artery occlusion (RAO) and ways to prevent it after interventions using radial access.Material and methods. The study consisted of prospective and retrospective parts. The total number of included patients was 2284. Patients undergoing interventions by radial access in various medical organizations were retrospectively considered. The prospective study included 1284 patients who were subject to interventional treatment. Patients were randomized into two groups as follows: in group 1, hemostasis was performed within 4 hours, in group 2 — &gt;6 hours. All patients underwent a bedside Barbeau test with a pulse oximeter and an ultrasound of access arteries to determine the radial artery patency/occlusion.Results. The RAO rate in the retrospective part was 21,8%, while in the prospective one — 10,1% with long-term hemostasis and 1,4% with short-term hemostasis (p&lt;0,001). Predictors of RAO were type 2 diabetes (odds ratio (OR), 1,9, 95% confidence interval (CI), 1,1-3,4, p=0,03) and an increase in hemostasis duration by 1 hour (OR, 1,2, 95% CI, 1,1-1,3, p&lt;0,001). When analyzing the retrospective part, the predictors of RAO were body mass index (OR, 1,06, 95% CI, 1,02-1,09, p=0,002), female sex (OR, 0,6, 95% CI, 0,4-0,9, p=0,02), smoking (OR, 1,38, 95% CI, 1-1,91, p=0,047). The administration of statins in different dosages, as well as antihypertensive and anti-ischemic agents, did not have a significant effect on the RAO rate.Conclusion. The main predictors of RAO were type 2 diabetes, an increase in hemostasis duration, female sex, smoking, and the artery-to-introducer diameter ratio. Taking statins, anti-ischemic and antihypertensive agents does not have a protective effect on RAO rate

Кардиомиопатия и множественный артериальный тромбоз у пациента с тахиформой фибрилляции предсердий, перенесшего COVID-19 тяжелого течения

We present a case of cardiomyopathy with a reduced left ventricular ejection fraction of up to 18%, multivessel arterial thrombosis in a patient who had undergone severe COVID-19 3.5 months earlier. The cardiopathy was initially considered as an outcome of SARSCoV2-induced myocarditis, but MRI with delayed gadolinium contrast revealed no fibrosis or evidence of active myocarditis. A detailed collection of the medical history showed that the duration of tachyform atrial fibrillation exceeded the 4 months indicated in the medical records. Oligosymptomatic manifestation of arrhythmia occurred 8 months earlier, the patient did not consult a physician due to epidemic conditions. Coronary angiography revealed subtotal stenosis of the anterior descending artery. Most probably, the cardiopathy was arrhythmogenic and ischemic. After achieving normosystole and coronary stenting, the left ventricular ejection fraction was 25-27%. At the first hospitalization 4 months ago, left atrial auricular thrombus was detected. After COVID-19 the patient received inadequately low dose of apixaban 5 mg per day. Three weeks after COVID-19, the patient was diagnosed with infarction of the right kidney, wall thrombosis in the abdominal aorta, thrombosis of the superficial femoral, deep femoral, popliteal, anterior tibial arteries on the left, right popliteal artery; thrombotic complications could have developed both in situ and as a result of cardioembolism. Administration of dabigatran 300 mg per day and aspirin helped to dissolve the thrombus in the left atrial auricle, improve the course of intermittent claudication, and avoid recurrent thrombotic complications. COVID-19 could contribute to the progression of atherosclerosis, more malignant course of atrial fibrillation, development of thrombosis, but coronavirus infection is not the only cause of severe disease in a patient. СOVID-19 can not only be the cause of direct lesions of the heart and vessels, but also have an indirect negative effect - to delay the detection of cardiac pathology and be the cause of its hypodiagnosis under the mask of “postcovid”.Представлен случай кардиомиопатии со снижением фракции выброса левого желудочка до 18%, многососудистым артериальным тромбозом у пациента, перенесшего COVID-19 тяжелого течения 3,5 мес. назад. Изначально кардиопатия расценивалась как исход миокардита, вызванного SARS-CoV2, однако МРТ с отсроченным контрастированием гадолинием не выявила ни фиброза, ни признаков активного миокардита. Подробный сбор анамнеза показал, что давность тахиформы фибрилляции предсердий превышает 4 мес., указанные в медицинской документации. Малосимптомная манифестация аритмии произошла на 8 мес. раньше, пациент не обращался к врачу в связи с эпидобстановкой. По данным коронароангиографии был выявлен субтотальный стеноз передней нисходящей артерии. Наиболее вероятно, кардиопатия носит аритмогенный и ишемический характер. После достижения нормосистолии и коронарного стентирования фракция выброса левого желудочка составила 25–27%. При первой госпитализации 4 мес. назад выявлен тромб ушка левого предсердия. После COVID-19 пациент получал неадекватно низкую дозу апиксабана 5 мг в сутки. Через 3 нед. после COVID-19 у пациента был выявлен инфаркт правой почки, пристеночные тромбы в брюшной аорте, тромбоз поверхностной бедренной, глубокой бедренной, подколенной, передней большеберцовой артерий слева, подколенной артерии справа; тромботические осложнения могли развиться как in situ, так и быть следствием кардиоэмболии. Назначение дабигатрана 300 мг в сутки и аспирина позволило добиться растворения тромба в ушке левого предсердия, улучшения течения перемежающейся хромоты, избежать повторных тромботических осложнений. COVID-19 мог способствовать прогрессированию атеросклероза, более злокачественному течению фибрилляции предсердий, развитию тромбозов, однако коронавирусная инфекция не является единственной причиной тяжелого заболевания у пациента. СOVID-19 не только может быть причиной прямого поражения сердца и сосудов, но и оказывать косвенное негативное влияние – отдалять выявление кардиальной патологии и быть причиной ее гиподиагностики под маской «постковида»

Маркеры повреждения эндотелия, активации гемостаза и неоангиогенеза у больных активным раком и мультифокальным атеросклерозом: общие черты и особенности

Introduction. Thrombotic complications (TC) in different vascular systems dictate the fate of high-risk patients. In cardiological practice, patients with advanced atherosclerotic vascular disease (MFA) represent the most vulnerable group. Malignant neoplasm (MN) is one of the most significant risk factors for developing TCs, especially in the context of antineoplastic therapy. The presence of significant differences in the mechanisms of thrombogenesis in malignant neoplasms and atherosclerosis determines the appropriateness of a comparative study of markers of coagulation activation and endothelial damage in order to identify common features and differences specific to each pathology. Aim. To examine markers of coagulation activation and growth factors in active cancer and advanced atherosclerotic vascular disease, to identify their common features and differences specific to each pathology.  Materials and methods. A total of 22 patients with MN (Group 1) and 58 patients with MFA (Group 2) were enrolled in the study. The assessed biomarkers included: von Willebrand factor (VWF), D-dimer, growth differentiation factor-15 (GDF-15) and vascular endothelial growth factor A (VEGF-A).  Results. Patients with MN had an increased likelihood of disease progression within 6 months at D-dimer level &gt; 1121 ng/mL (OR = 10.5; 95% CI 1.4–81.0, p = 0.014) or VWF &gt; 189% (OR 10.5, 95% CI 1.36–81.0, p = 0.014); the likelihood of death within two years of follow-up at D-dimer level &gt; 1121 ng/mL (OR = 7.0; 95% CI 0.97–50.57, p = 0.04), or VWF &gt; 203% (OR = 10, 5, 95% CI 1.36–81.06, p = 0.014). In patients with MFA, the likelihood of prognosis determining events within one-year of follow-up was determined by increased levels of VWF &gt; 157% (OR = 9.2, 95% CI 1.02–82.8, p = 0.048) and GDF-15 &gt; 1548 pg/ml (OR = 5.7; 95% CI 1.09–29.5, p = 0.04).  Conclusions. Endothelial damage and coagulation activation are more pronounced in patients with MN than in patients with MFA. In patients with malignant neoplasms, the outcomes were associated with D-dimer and VWF levels, and in patients with MFA – with VWF and GDF-15 levels.Введение. Тромботические осложнения (ТО) в различных сосудистых бассейнах определяют судьбу больных высокого риска. В кардиологической практике наиболее уязвимая группа – больные с распространенным атеросклеротическим поражением (МФА). Злокачественное новообразование (ЗНО) является одним из наиболее значимых факторов риска ТО, особенно в условиях медикаментозного противоопухолевого лечения. Наличие существенных различий в механизмах тромбообразования при ЗНО и атеросклерозе определяет целесообразность проведения сравнительного исследования маркеров активации свертывания крови и повреждения эндотелия для выявления общих признаков и особенностей, характерных для каждой патологии.Цель. Изучить маркеры активации свертывания крови и факторы роста при активном раке и распространенном атеросклеротическом поражении, найти их общие черты и особенности, характерные для каждой патологии.  Материалы и методы. В исследование было включено 22 пациента с ЗНО (группа 1) и 58 больных с МФА (группа 2). Определялись биомаркеры: фактор фон Виллебранда (ФВ), Д-димер, фактор дифференцировки роста-15 (GDF-15) и фактор роста эндотелия сосудов А (VEGF-A).  Результаты. У пациентов с ЗНО повышается вероятность прогрессирования заболевания в течение 6 мес. при уровне Д-димера &gt; 1121нг/мл (ОШ = 10,5; 95% ДИ 1,4–81,0, p = 0,014), или ФВ &gt; 189% (ОШ 10,5; 95% ДИ 1,36–81,0, p = 0,014); вероятность смерти за два года наблюдения при уровне Д-димера &gt; 1121нг/мл (ОШ = 7,0; 95% ДИ 0,97–50,57, р = 0,04), или ФВ &gt; 203% (ОШ = 10,5; 95% ДИ 1,36–81,06, р = 0,014). У больных МФА вероятность развития прогноз-определяющих событий за год наблюдения определяется повышением уровней ФВ &gt; 157% (ОШ = 9,2, 95% ДИ 1,02–82,8, р = 0,048) и GDF-15 &gt; 1548 пг/мл (ОШ = 5,7; 95%ДИ 1,09–29,5, р = 0,04).  Выводы. У больных ЗНО повреждение эндотелия и активация свертывания крови выражены в большей степени, чем у пациентов с МФА. Связь с исходами у больных ЗНО была обнаружена с уровнями Д-димера и ФВ, а у больных с МФА – ФВ и GDF-15