The Integral Indicator of the Evaluation of the General State Severity in Patients With Inflammatory Processes of the Mandibular Bone According to the Data of Peripheral Clinical Blood Analysis

To study the possibility of using a clinical blood analysis for the mathematical determination of the severity level in patients with inflammatory processes in the maxillofacial area. Materials and Methods. Under our supervision were 150 patients with acute (50), subacute (50) and chronic (50) inflammatory processes in the lower jaw area. 170 blood tests were analyzed for 11 signs: Blood sedimentation rate, white blood cells (cytosis and leukopenia), myelocyte, juvenile, stub, segmented neutrophil, eosinophile, lymphocyte, monocytes, plasma cell, which are conditionally divided according to the degree of severity from 0 to 3 points in the form of a table. Results and Discussion. From the archive were selected 300 case histories of patients hospitalized in the clinic for acute, subacute and chronic stages of odontogenic and traumatic osteomyelitis of the mandible (50 patients for each nosology). Laboratory analyses of peripheral blood were taken from the patient upon admission to the department. 300 blood analyses were analyzed in accordance with the scale of patients developed by us in assessing the severity of the patient’s condition with the inflammatory processes of the maxillofacial area by peripheral blood analysis. As a result, sum of points were obtained that corresponded to three degrees of severity in patients with odontogenic and traumatic osteomyelitis of the mandibular bone: mild stage from 1 tо 7; medium stage from 8 to 15 and severe stage from 16 to 27 points. Conclusion. The proposed methodology for the integral calculation of the evaluation of the degree of severity of general status in terms of indicators of peripheral blood in patients with inflammatory processes of the maxillofacial area allows for early diagnosis of the severity of the pyoinflammatory process of the maxillofacial area

Budget Policy of Social Development

The monograph is devoted to the development of methodological and institutional framework for the formation of fiscal policy to ensure social development. The essence and role of budget regulation in supporting the processes of endogenous economic growth are revealed. The experience of the implementation of fiscal policy in countries with developed and transformational economies is systematized. The directions of increasing the efficiency and strengthening the regulatory potential of the state tax policy are proposed. An assessment of the tax burden on labor and consumption in 2001–2017 is carried out; a comparative analysis of the values of the corresponding indicators in Ukraine and the European Union member countries is carried out. The factors that affect the fiscal significance of the value added tax, excise tax, income tax, personal income tax are identified. Provisions for enhancing the effectiveness of the institutional architectonics of the budget system are improved. Directions for improving the efficiency of budget expenditures are substantiated. The analysis of the influence of the main factors on the dynamics of changes in the ratio of public debt to GDP is carried out; it is established that inflation affected the most, and the exchange rate influenced the increase. An approach to assessing the state of debt security of the country is proposed, the conceptual framework for managing the budget deficit and public debt is defined. Provisions for the implementation of long-term budget planning and forecasting are developed. Institutional framework for the formation of the budget strategy is improved. The conceptual foundations of state financial support for human development are defined. A long-term budget strategy is developed, taking into account the cyclical nature of economic development. The conducted scientific research allows identifying the possibilities of positive influence of the budget policy on social development in the context of improving the quality of the institutional environment

Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

ВПЛИВ БЮДЖЕТНОЇ ПОЛІТИКИ НА ЕКОНОМІЧНЕ ЗРОСТАННЯ КРАЇНИ

The article describes the essence of budget policy. Determined its role in ensuring macroeconomic stability and accelerating economic growth. The quantitative and qualitative impact of the budget regulation system on the economic environment has been characterized. It is substantiated that purposeful budget regulation allows accelerating or slowing social and economic processes, ensuring achievement of certain strategic goals and objectives. An estimation of the impact of budget policy on economic growth, in particular, on the justification of the interrelation of the share in the GDP of income, including direct and indirect taxes; expenses, including social protection and social security, economic activity; direct state and guaranteed debt with real GDP in Ukraine. For 2009—2019, the share of gross income and expenditure, deficit and debt in the countries of the European Union in the GDP was determined; income, expenses, deficit of the consolidated budget, direct state and guaranteed debt in Ukraine. The substantiation of the provision on the development of institutional foundations for fiscal policy-making based on the necessity of adapting the set of mechanisms of functioning of the budget regulation system to the conditions of development of the financial and economic environment and the cyclical nature of economic processes; the position regarding the formation of budget policy based on a forecast assessment of budgetary parameters, based on the projected macroeconomic indicators of socio-economic development of the country, tools and levers of tax policy. The priority directions of budget policy in the conditions of economic transformations are determined, in particular, to strengthen the investment and innovation budget component, to improve the structure of tax revenues, to maintain a safe level of public debt and budget deficit, to improve the quality of public debt management and to determine strategic guidelines for the structure of the debt portfolio.Розкрито сутність бюджетної політики. Визначено її роль у забезпеченні макроекономічної стабільності та прискорення темпів економічного зростання. Охарактеризовано кількісний та якісний вплив системи бюджетного регулювання на економічне середовище. Обґрунтовано, що цілеспрямоване бюджетне регулювання дозволяє прискорити або сповільнити соціально-економічні процеси, забезпечити досягнення визначених стратегічних цілей і завдань. Здійснено оцінку впливу бюджетної політики на економічне зростання, зокрема в частині обґрунтування взаємозв’язку частки у валовому внутрішньому продукті доходів, у тому числі прямих і непрямих податків; витрат, у тому числі на соціальний захист і соціальне забезпечення, економічну діяльність; прямого державного і гарантованого боргу з реальним валовим внутрішнім продуктом в Україні. За 2009—2019 роки визначено частку у валовому внутрішньому продукті державних доходів і витрат, дефіциту і боргу в країнах Європейського Союзу; доходів, витрат, дефіциту зведеного бюджету, прямого державного і гарантованого боргу в Україні. Обґрунтовано положення щодо розвитку інституційних засад формування бюджетної політики виходячи із необхідності адаптації сукупності механізмів функціонування системи бюджетного регулювання до умов розвитку фінансово-економічного середовища та циклічності економічних процесів; положення щодо формування бюджетної політики виходячи із прогнозної оцінки бюджетних параметрів, яка базується на прогнозних макроекономічних показниках соціально-економічного розвитку країни, інструментів та важелів податкової політики. Визначено пріоритетні напрями бюджетної політики в умовах економічних перетворень, зокрема щодо посилення інвестиційно-інноваційної бюджетної складової, удосконалення структури податкових надходжень, підтримання на безпечному рівні державного боргу і дефіциту бюджету, підвищення якості управління державним боргом та визначення стратегічних орієнтирів щодо структури боргового портфеля.&nbsp

Международный трансфер знаний в условиях глобализации мировой экономики

В условиях перехода глобальных экономических систем к экономике знаний путем  внедрения  инновационных  моделей  хозяйствования  знания  приобретают  статус  ключевого  товара  и  превращаются  в  важнейший  фактор  формирования  конкурентных  преимуществ  субъектов  мировых  рынков.  С  развитием  научной  сферы интенсифицировалась торговля инновациями и инновационными продуктами, основой которых являются результаты НИОКР. При этом не все субъекты рынков научно-технической продукции располагают достаточными финансовыми ресурсами для проведения фундаментальных исследований, способных обеспечить появление принципиально новых разработок, что становится причиной интенсификации процесса трансфера знаний