Regional Socio-economic System of Krasnodar Territory: The Current State and Development Trends

Control Strategy of socio-economic development of Krasnodar region - a system of government measures, based on the long-term priorities of the regional socio-economic policies that are in indissoluble unity, and the relationship with the national strategic priorities. However, in the Krasnodar region retained extensive, inefficient management and use of resources. In general, the existing methods and developed the governance structure of socio-economic development of Krasnodar region in many respects do not meet the changed conditions of its functioning, that it becomes an obstacle to its further successful development of more. Currently existing strategy of socio-economic development of Krasnodar region made its developers in the logic of the traditional strategic and scenario planning is not. Strategic management of socio-economic development of Krasnodar region must take into account the assessment of the degree of satisfaction of the population's needs in material goods and a variety of services compared with rational norms of consumption. Given prevailing in the society differentiation of living standards need to prioritize strategic management. Defining features of strategic management of development of the Krasnodar Territory is based on a study of it as a system and organization. Keywords: region, socio-economic systems, development trends, strategic priorities JEL Classifications: G11, I28, R3

Pathogenesis of hallucinations in sleep paralysis

Sleep paralysis is a state of involuntary immobility that occurs during REM sleep, which is accompanied by “ghostly” hallucinations and strong reactions of fear and anxiety. This article presents the neuropharmacological mechanisms of these hallucinatory experiences. Attention is drawn to the role of the serotonin 5HT 2A R receptor in their implementation Studies have shown that activation of 5‑HT2AR can cause visual hallucinations, mystical, subjective states and out‑of‑body experiences. Hallucinatory experiences caused by serotonin tend to be “dreamlike” when the experiencer has an understanding that he is hallucinating. Presumably, there is a mechanism by which serotonin can be functionally involved in the creation of hallucinations of sleep paralysis and fear reactions through the activation of 5‑HT2AR. In addition, this article discusses the influence of the orbitofrontal cortex, rich in 5‑HT2A receptors, on the visual pathways during sleep paralysis, in fact, on the formation of hallucinations. Also information is provided on how this process can become a vicious circle, through the formation of feedback “fear — serotonergic system”.Сонный паралич — это состояние непроизвольной неподвижности, возникающее во время быстрого сна, который сопровождается «призрачными» галлюцинациями и сильными реакциями страха и тревоги. В данной статье описываются нейрофармакологические механизмы этих галлюцинаторных переживаний. Обращается внимание на роль рецептора серотонина 5‑HT2AR в их реализации. Исследования показали, что активация 5‑HT2AR может вызывать зрительные галлюцинации, мистические, субъективные состояния и внетелесные переживания. Галлюцинаторные переживания, вызванные серотонином, имеют тенденцию быть «сноподобными», когда у переживающего появляется понимание, что он галлюцинирует. Предположительно существует механизм, посредством которого серотонин может быть функционально вовлечен в создание галлюцинаций сонного паралича и реакций страха посредством активации 5‑HT2AR. Кроме того, в данной статье приводятся рассуждения о влиянии орбитофронтальной коры, богатой рецепторами 5‑HT2A, на зрительные пути во время сонного паралича, по сути, на формирование галлюцинаций. Также приводится информация о том, как данный процесс может стать порочным кругом, посредством формирования обратных связей «страх — серотонинергическая система»

Quality of colonoscopy in an emerging country: A prospective, multicentre study in Russia

Background: The quality of colonoscopy has been related to a higher risk of interval cancer, and this issue has been addressed extensively in developed countries. The aim of our study was to explore the main quality indicators of colonoscopy in a large emerging country. Methods: Consecutive patients referred for colonoscopy in 14 centres were prospectively included between July and October 2014. Before colonoscopy, several clinical and demographic variables were collected. Main quality indicators (i.e. caecal intubation rate, (advanced) adenoma detection rate, rate of adequate cleansing and sedation) were collected. Data were analysed at per patient and per centre level (only for those with at least 100 cases). Factors associated with caecal intubation rate and adenoma detection rate were explored at multivariate analysis. Results: A total of 8829 (males: 35%; mean age: 57 + 14 years) patients were included, with 11 centres enrolling at least 100 patients. Screening (including non-alarm symptoms) accounted for 59% (5188/8829) of the indications. Sedation and split preparation were used in 26% (2294/8829) and 25% (2187/8829) of the patients. Caecal intubation was achieved in 7616 patients (86%), and it was ≥85% in 8/11 (73%) centres. Adenoma detection rate was 18% (1550/8829), and it was higher than 20% in five (45%) centres, whilst it was lower than 10% in four (33%) centres. At multivariate analysis, age (OR: 1.020, 95% CI: 1.015–1.024), male sex (OR: 1.2, 95% CI: 1.1–1.3), alarm symptoms (OR: 1.8, 95% CI: 1.7–2), split preparation (OR: 1.4, 95% CI: 1.2–1.6), caecal intubation rate (OR: 1.6, 95% CI: 1.3–1.9) and withdrawal time measurement (OR: 1.2, 95% CI: 1.6–2.1) were predictors of a higher adenoma detection rate, while adequate preparation (OR: 3.4: 95% CI: 2.9–3.9) and sedation (OR: 1.3; 95% CI: 1.1–1.6) were the strongest predictors of caecal intubation rate. Conclusions: According to our study, there is a substantial intercentre variability in the main quality indicators. Overall, the caecal intubation rate appears to be acceptable in most centres, whilst the overall level of adenoma detection appears low, with less than half of the centres being higher than 20%. Educational and quality assurance programs, including higher rates of sedation and split regimen of preparation, may be necessary to increase the key quality indicators

АЛГОРИТМ ДИАГНОСТИКИ И ЛЕЧЕНИЯ БОЛЬНЫХ ПОЖИЛОГО И СТАРЧЕСКОГО ВОЗРАСТА С ОСТРЫМ ХОЛЕЦИСТИТОМ, ХОЛЕДОХОЛИТИАЗОМ И МЕХАНИЧЕСКОЙ ЖЕЛТУХОЙ

We performed a retrospective analysis of treatment in 4,197 patients with acute cholecystitis. Destructive complicated cholecystitis was diagnosed in 658 (25.3%) patients . There were 431 (65.5%) patients of elderly and senile age. All patients had comorbidities. Cardiovascular insufficiency — 73.9%, respiratory diseases — 29.2%, diabetes — 26%. For urgent indications, 12 (2.8%) patients were operated, 2 (16.6%) of them died. In 419 (97.2%) patients, mini-invasive treatment was performed. Endoscopically, jaundice wasn’t managed in 86 (20.5%) cases. In 62 (14.8%) cases, percutaneous transhepatic microcholangiography was performed under ultrasound guidance. Laparoscopic cholecystectomy was performed in 183 (43.6 %) cases, traditional cholecystectomy was performed in 149 (35.6%) cases, and in 38 of them (23.9%) it was combined with Kerr’s drainage of choledoch. Mini-invasive cholecystectomy was performed in 87 (20.7%) cases. Postoperative complications were revealed in 21 (5.0%) patients, in 7 (2.9%) of elderly age and 14 (7.9%) of senile age. Postoperative mortality rate was 2.0%. The use of minimally invasive interventions in the complex treatment of this group of patients was the main goal and it was reasoned by the severity of the initial condition of elderly and senile patients.Проведен ретроспективный анализ лечения 4197 больных, страдавших острым холециститом. Деструктивный осложненный холецистит был обнаружен у 658 больных (25,3%). Пациентов пожилого и старческого возраста было 431 (65,5%). В последней группе коморбидные изменения наблюдались у 100% больных. Сердечно-сосудистая недостаточность имела место у 73,9% больных, заболевания органов дыхания — у 29,2%, сахарный диабет — у 26%. По экстренным и срочным показаниям оперированы 12 пациентов (2,8%), умерли 2 (16,6%). Мини-инвазивное лечение проведено 419 больным (97,2%). Эндоскопически желтуха не разрешена у 86 пациентов (20,5%), 62 больным (14,8%) произведена чрескожная чреспеченочная микрохолецистостомия под УЗ-наведением. Лапароскопическая холецистэктомия выполнена 183 больным (43,6%), традиционная холецистэктомия — 149 пациентам (35,6%) , из них с дренированием холедоха по Керу — 38 (23,9%). Холецистэктомия из мини-доступа произведена 87 пациентам (20,7%). Послеоперационные осложнения выявлены у 21 больного (5,0%): у 7 лиц (2,9%) пожилого и у 14 (7,9%) — старческого возраста. Послеоперационная летальность составила 2,0%. Использование мини-инвазивных вмешательств в комплексном лечении группы коморбидных больных при осложнениях желчнокаменной болезни позволило значительно улучшить результаты хирургического лечения

Система управління інформаційною безпекою «Матриця», що грунтується на системному підході

The new information security management system is presented in the aspect of introduction of international information security management standards. Scientific novelty of the development is stated. The solutions to problems of analogous products are listed. Structure and operation of the system are briefly described. Application of the product at enterprises is mentioned дуктов. Кратко описаны структура и функционирование системы. Упомянуто применение продукта на предприятияхПредставлена новая система управления информационной безопасностью в контексте внедрения международных стандартов управления информационной безопасностью. Указана научная новизна разработки. Перечислены решения проблем аналогичных продуктов. Кратко описаны структура и функционирование системы. Упомянуто применение продукта на предприятияхПредставлено нову систему управління інформаційною безпекою в світлі впровадження міжнародних стандартів управління інформаційною безпекою. Зазначено наукову новизну розробки. Перелічені вирішення проблем аналогічних продуктів. Коротко описані структура та функціонування системи. Зазначено застосування продукту на підприємства

Application of semi-markov processes in design and state description of information security systems

Состояние информационных систем и систем защиты информации смоделировано как полумарковский процесс. Применение полумарковских процессов в разработке систем защиты информации классифицировано при помощи матрицы связей составляющих. Сделано заключение о применимости моделей, основанных на полумарковских процессах, в разработке и описании состояния систем защиты информации для повышения точности оценки их эффективности, а также в их разработке.Стан інформаційних систем і систем захисту інформації змодельований як полумарковский процес. Застосування полумарковских процесів у розробці систем захисту інформації класифіковано за допомогою матриці зв'язків складових. Зроблено висновок про застосовність моделей, заснованих на полумарковских процесах, у розробці й описі стану систем захисту інформації для підвищення точності оцінки їхньої ефективності, а також у їх розробці.The Condition of the information systems and systems of protection to information simulate as semi-Markov process. Using semi-Markov processes in system development of protection information is classified at matrixes of the relationships of the component. Conclusion is Made about prima models, founded on semi-Markov process, in development and description of the condition of the systems of protection to information for increasing of accuracy of the estimation to their efficiency, as well as in their development

ALGORITHM OF DIAGNOSTICS AND TREATMENT OF ELDERLY AND SENILE PATIENTS WITH ACUTE CHOLECYSTITIS, CHOLEDOCHOLITHIASIS AND OBSTRUCTIVE JAUNDICE

We performed a retrospective analysis of treatment in 4,197 patients with acute cholecystitis. Destructive complicated cholecystitis was diagnosed in 658 (25.3%) patients . There were 431 (65.5%) patients of elderly and senile age. All patients had comorbidities. Cardiovascular insufficiency — 73.9%, respiratory diseases — 29.2%, diabetes — 26%. For urgent indications, 12 (2.8%) patients were operated, 2 (16.6%) of them died. In 419 (97.2%) patients, mini-invasive treatment was performed. Endoscopically, jaundice wasn’t managed in 86 (20.5%) cases. In 62 (14.8%) cases, percutaneous transhepatic microcholangiography was performed under ultrasound guidance. Laparoscopic cholecystectomy was performed in 183 (43.6 %) cases, traditional cholecystectomy was performed in 149 (35.6%) cases, and in 38 of them (23.9%) it was combined with Kerr’s drainage of choledoch. Mini-invasive cholecystectomy was performed in 87 (20.7%) cases. Postoperative complications were revealed in 21 (5.0%) patients, in 7 (2.9%) of elderly age and 14 (7.9%) of senile age. Postoperative mortality rate was 2.0%. The use of minimally invasive interventions in the complex treatment of this group of patients was the main goal and it was reasoned by the severity of the initial condition of elderly and senile patients