МЕТОДИЧНІ ЗАСАДИ ЗАБЕЗПЕЧЕННЯ ФІНАНСОВО-ЕКОНОМІЧНОЇ БЕЗПЕКИ СУБ’ЄКТІВ МАЛОГО ТА СЕРЕДНЬОГО ПІДПРИЄМНИЦТВА

The article examines the essence of the concept of «financial and economic security» of small and medium-sized enterprises. Approaches to ensuring financial and economic security of enterprises are described. Application of basic approaches to evaluation and provision financial and economic security of enterprises has its advantages and shortcomings due to the peculiarity of their use. However, exactly using an integrated approach allows to synthesize all approaches to a single model of financial and economic security.It is established that the most complete and acceptable definition ofthe essence of financial and economic security in the small and mediumbusiness sector should be considered a state of protection of financial andeconomic interests of the entity from potential or real threats, whichensures financial stability, balance and flexibility of the financial system the subject of functioning. And this security should be understood as theorganization and implementation of a system of measures of various kinds in order to prevent or eliminate internal and external threats and to achieve and maintain a safe state of viability of enterprises.Methodology of providing the financial and economic security of the enterprise functions as a set of interrelated techniques, methods andmanagement decisions to monitor and control the level of its financial andeconomic condition and prevent or eliminate threats.A number of standard measures has been developed to increase thelevel of financial and economic security of small and medium-sizedenterprises. The most important aspect is a need for integrated model offinancial and economic security of small and medium-sized enterprises, the effectiveness of which accordingly depends on the performance of relevant tasks, acceptance management decisions in conjunction with effective approaches to ensuring financial and economic security in each stages of the enterprise’s life cycle.В статье исследована сущность понятия «фінансово-экономическая безопасность» в деятельности субъектов малого и среднего предпринимательства. Охарактеризованы подходы обеспечения финансово-экономической безопасности предприятий. На основе интегрального подхода разработана модель обеспечения финансово-экономической безопасности в секторе малого и среднего предпринимательства на основе жизненного цикла предприятия.У статті здійснено дослідження сутності поняття «фінансовоекономічна безпека» суб’єктів малого та середнього підприємництва. Охарактеризовано підходи до забезпечення фінансово-економічної безпеки підприємств. На основі інтегрального підходу розроблено модель забезпечення фінансово-економічної безпеки у секторі малого та середнього підприємництва на основі життєвого циклу підприємства

АКТУАЛІЗАЦІЯ РЕКОМЕНДАЦІЙ ЩОДО ШКАЛИ РІВНІВ ВПЛИВУ НА БЮДЖЕТ ПРИ ОЦІНЦІ ЗАКУПІВЛІ ЛІКАРСЬКИХ ЗАСОБІВ В УКРАЇНІ ЗА ДАНИМИ 2019 РОКУ

The aim of the work. To update the budget impact scale when assessing the inclusion of medicines on the National List of Essential Medicines (National List) and central procurement programs at the expense of state and local budgets during the analysis of economic feasibility of medicines in assessing health technologies in 2019. Materials and Methods. The analysis was updated using the published methodological recommendations for assessing the budget impact scale of medicines in the case of their inclusion on the National List or central programs, which were developed using ABC-analysis. The study used data provided by the Pharmexplorer market research system and open data of the National Health Service of Ukraine as for 2019. Results and Discussion. The budget impact scale for the purchase of medicines is an important tool designed to assess the financial burden caused by the inclusion of medicines on the National List or central programs. According to the results of the study, we established that if the cost of one medicine, which is evaluated during the health technology assessment with the aim of inclusion on the National List, when purchased at the expense of state and local budgets, exceeds 44 million UAH per year, the budget impact will be excessive. If the costs per one INN are in the range of 21 to 44 million UAH, the impact on the budget will be large, if the costs are from UAH 13 to 21 million - moderate, and less than UAH 13 million - insignificant. Provided that medicines are included in the central procurement programs, the budget impact scale has the following gradation: if the costs per one INN exceed 55 million UAH per year, the impact on the budget will be excessive, within 29-55 million UAH - large, in the range from 16 to 29 million UAH - moderate, less than 16 million - insignificant. Comparing the obtained results with the indicators calculated according to the results of 2018, it was found that in 2019 the threshold values of the budget impact scale for the purchase of medicines included on the National List increased by an average of 15%. Conclusions. Based on the analysis of procurement data of medicines from the National List and central programs, we updated the recommendations of the levels of budget impact as for 2019 in Ukraine and identified two scenarios, depending on the level of procurement and regulatory list. We found that the budget impact is excessive when yearly costs per INN exceed 44 million UAH in the case of inclusion of a new medicine on the National List and more than 55 million UAH in the case of inclusion in central programs. This scale is recommended for use in the health technology assessment and as an additional tool for the decision-making process in the inclusion of new drugs on the regulatory lists in Ukraine - the National List and Central Procurement Programs.Мета роботи. Оновлення шкали рівнів впливу на бюджет при оцінці включення лікарського засобу (ЛЗ) до Національного переліку основних лікарських засобів (Національного переліку) та програм центральних закупівель за кошти державного та місцевого бюджетів під час аналізу економічної доцільності ЛЗ при оцінці медичних технологій за даними 2019 року. Матеріали і методи. Актуалізація аналізу проведена з використанням  опублікованих методологічних рекомендацій щодо оцінки шкали рівнів впливу на бюджет ЛЗ у разі його включення до Національного переліку або центральних програм, які розроблені із застосуванням АВС-аналізу. В дослідженні  використано  дані,  представлені системою дослідження  ринку  ЛЗ «Фармексплорер» та відкритими даними Національної служби здоров'я України за 2019 рік. Результати й обговорення. Шкала рівнів впливу на бюджет є важливим інструментом, який використовується при проведенні оцінки медичних технологій щодо фінансування  включення ЛЗ до регуляторних переліків. За результатами аналізу нами встановлено, якщо витрати на один ЛЗ, який оцінюється для включення до Національного переліку, перевищують 44 млн грн на рік при  закупівлі  за  кошти  державного  та  місцевих  бюджетів, то вплив на бюджет буде надмірний. Якщо витрати на один ЛЗ за МНН знаходяться в межах від 21 до 44 млн грн, то вплив на бюджет – великий, якщо витрати становлять від 13 до 21 млн грн – помірний, а менше 13 млн грн – незначний. При умові включення ЛЗ до програм центральних закупівель, шкала рівнів впливу на бюджет має таку градацію: якщо витрати на одну МНН перевищують 55 млн грн на рік, то вплив на бюджет буде надмірний, в межах 29 від  до 55 млн грн – великий, в межах від 16 до 29 млн грн – помірний, менше 16 млн – незначний. При порівнянні отриманих результатів із показниками шкали, розрахованої за результатами 2018 року, встановлено, що у 2019 році граничні значення шкали рівнів впливу на бюджет при закупівлі лікарських засобів, які включені до Національного переліку, збільшились в середньому на 15%. Висновки. На основі проведеного аналізу закупівель ЛЗ із Національного переліку та центральних програм нами актуалізовано рекомендації щодо шкали рівнів впливу на бюджет за даними 2019 року в Україні та виділено два сценарії, залежно від  рівня закупівель і регуляторного переліку. Нами встановлено, що рівень впливу на бюджет є надмірним при витратах понад 44 млн. грн у разі включення нового ЛЗ у Національний перелік та понад 55 млн. грн у разі включення до центральних програм. Дана шкала рекомендована для використання при оцінці медичних технологій та як допоміжний інструмент для процесу прийняття рішень щодо включення нових ЛЗ до регуляторних переліків в Україні

Drivers of tropical forest loss between 2008 and 2019

During December 2020, a crowdsourcing campaign to understand what has been driving tropical forest loss during the past decade was undertaken. For 2 weeks, 58 participants from several countries reviewed almost 115 K unique locations in the tropics, identifying drivers of forest loss (derived from the Global Forest Watch map) between 2008 and 2019. Previous studies have produced global maps of drivers of forest loss, but the current campaign increased the resolution and the sample size across the tropics to provide a more accurate mapping of crucial factors leading to forest loss. The data were collected using the Geo-Wiki platform (www.geo-wiki.org) where the participants were asked to select the predominant and secondary forest loss drivers amongst a list of potential factors indicating evidence of visible human impact such as roads, trails, or buildings. The data described here are openly available and can be employed to produce updated maps of tropical drivers of forest loss, which in turn can be used to support policy makers in their decision-making and inform the public

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)

Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.

AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Study of measurement errors of diaphragm gas meters after six years of operation

Omówiono statystyczne wyniki badań dokładności liczników membranowych gazu, czyli gazomierzy miechowych, wykonane na Ukrainie po sześciu latach ich eksploatacji. Parametry techniczne, warunki wzorcowania i dokładność gazomierzy ujęte są w przepisach ukraińskich podobnie jak w międzynarodowych i polskich standardach.. Okresowa kalibracja gazomierzy jest niezbędna do poprawy wiarygodności dostaw gazu ziemnego. Przeprowadzono ją dla trzech reprezentatywnych zbiorów gazomierzy membranowych typu G4 wyprodukowanych we Francji, Polsce i Ukrainie. Zmierzono ich błędy pomiarowe dla trzech wartości przepływów. Liczniki podzielono wg otrzymanych wartości błędów w pięciu zakresach i wyznaczono dla nich podstawowe parametry statystyczne. Analiza uzasadnia konieczność stosowania nowego podejścia metrologicznego, tj. odpowiednio częstej okresowej kalibracji gazomierzy dla małych przepływów, wykonywanej w laboratorium wzorcowym lub w miejscu instalacji.Description of the accuracy of diaphragm gas meters according to international standards and standards of Ukraine is given. Values of their measurement errors are classified in five ranges. The periodic calibration of these meters is proposed to improve the accuracy of the calculation of the natural gas supply. Statistical parameters of measurement of G4 gas meters manufactured in France, Poland and Ukraine were experimentally identified after six years of operation and their quantitative characteristics were determined. Research results justify the purpose of developing a new methodological approach involving the implementation of periodic calibration of the gas meter for low flow of natural gas, made in situ, also without dismantling

Effect of humidity of method error for determining the calorific value of natural gas

W pracy opisano autorską metodę wyznaczania ciepła spalania gazu ziemnego. Metodę tę porównano ze znanymi w literaturze metodami pomiarowymi. Przeprowadzono symulacje wpływu wilgotności gazu oraz wilgotności względnej powietrza dostarczanego w procesie spalania, na względną różnicę wyznaczania ciepła spalania gazu ziemnego. Praca zawiera wyniki symulacji wraz z analizą wpływu wilgotności powietrza i gazu na wartość ciepła spalania gazu ziemnego.The paper presents the original method of determining the CALORIFIC VALUE of natural gas, which does not require drying the gas. The method consists in measuring the combustion temperature in a gas burner while maintaining a constant stream of gas mixture with air. This method was compared with methods known in the literature. Many currently used measuring methods that allow to determine the heat of combustion require the use of dry gas, which under industrial conditions is very often troublesome. The work discusses the basics of the natural gas combustion process based on which the simulations of the influence of water vapor contained in both natural gas and air supplied to the burner on the calorific value of gas were carried out. The results of the simulation were used to determine the errors of the proposed measurement method. Simulations were carried out for diversified chemical composition of natural gas and various water vapor content. Based on the conducted simulations, it was found that the relative difference error is within 0.5% to 1.7% for different values of moisture contained in both the gas and air involved in the combustion process

Study of metrological properties of thermo-anemometric method of natural gas energy measurement

Przedstawiono termoanemometryczną metodę bezpośredniego pomiaru wartości energetycznej przepływającego gazu ziemnego. Jest ona oparta na zastosowaniu dwu przetworników: termoanemometrycznego i różnicy ciśnień. Opisano konstrukcję i działanie laboratoryjnego stanowiska przeznaczonego do badania tej metody. Na podstawie wyników badań doświadczalnych wyznaczono charakterystykę kalibracyjną przetwornika termoanemometrycznego i zależność jego sygnału wyjściowego od zmian wartości energetycznej gazu naturalnego dla zakresu wartości opałowej (7759–8538) kcal/m3 i przepływów do 0,6 m3/h. Przeprowadzono analizę składowych niepewności pomiarów typu B tą metodą i oszacowano jej niepewność standardową. Jest to przykład metody pośredniej, która polega na pomiarze innego parametru gazu, zależnego od zmian jego składu, gdy parametr właściwy jest trudny do określenia, lub nie można go zbadać bezpośrednio. Taka metoda może znaleźć wiele innych zastosowań.The thermo-anemometric method of direct measurement of the energy value of the flowing natural gas is presented. It is based on two transducers: thermo-anemometric (hot-wire) and differential pressure. The design and operation of the laboratory stand for testing this method has been described. Based on the experimental results, the calibration characteristics of the thermoanemometric transducer and the dependence of its output on the calorific value of the natural gas for the range of (7759–8538) kcal/m3 and flows to 0.6 m3/h were determined. An analysis of uncertainty components of B-type measurements was carried out using this method and its standard uncertainty was assessed. This is an example of an indirect method for examining changes of the tested parameter dependent on the composition of the gas if its direct measurements are difficult or impossible to perform. Instead, another parameter is measured, which depends in a known manner on the composition of the gas as a mixture. Such method can find many other different applications