Institutions Of Various Levels Research Articles

Real-world efficacy of the first line therapy with prolgolimab in patients with metastatic melanoma: interim results of the FORA (FOrteca Real practice Assessment) observational study

Background. Novel agents immune checkpoint inhibitors fundamentally changed the prognosis for life in patients with metastatic and/or inoperable melanoma. The development, studies, and approval of a new original PD1 inhibitor in Russia in 2020 prompted the professional community to conduct a prospective observational study in the Russian Federation to assess the real-world efficacy and safety of prolgolimab, as real-world patients differ from the refined population in clinical trials.
 Aim. To evaluate the real-world efficacy and safety of prolgolimab in patients with metastatic and/or inoperable melanoma.
 Materials and methods. From October 2020 to October 2022, the study enrolled 700 patients with metastatic and/or inoperable melanoma receiving prolgolimab in real clinical settings in oncological institutions of various levels in the Russian Federation. The main inclusion criteria were: pathology-confirmed diagnosis of melanoma, metastatic and/or inoperable type, use of prolgolimab outside of clinical trials, and signed informed consent by the patient. Objective response rate (ORR) was considered the main criterion for evaluating the efficacy of therapy, and the safety criterion was the incidence of grade 34 adverse events. Statistical analysis was performed using the SPSS 20.0 software package.
 Results. The ORR for patients with skin melanoma treated with prolgolimab in the first line therapy (n= 207/337) was 48.3% (n=100), the disease stabilization was reported in 30.4% (n=63), and progression in 21.3% (n=44) of patients. There were no significant differences in response to therapy between patients with/without BRAF mutation, although ORR was higher in patients with BRAF mutation: the ORR for patients with BRAF mutation was 57.9% (n=33), and for BRAF non-mutated patients, 44.4% (n=52; p=0.222). At a median follow-up of 5 months, the median PFS was 10 months (95% confidence interval 7.3512.64). The incidence of grade 34 treatment-related adverse events according to CTCAE 5.0 was 2% (n=12), and 12% (n=82) for grade 12 adverse events.
 Conclusion. The results confirm the high efficacy and satisfactory tolerability of prolgolimab in patients with metastatic and/or inoperable melanoma in real-world settings. There were no significant differences in ORR between patients with or without BRAF mutation.

ФОРМИРОВАНИЕ 120-Й СТРЕЛКОВОЙ ДИВИЗИИ В КОНТЕКСТЕ СОЗДАНИЯ КРАСНОЙ АРМИИ

The purpose of the article is to consider the process of creating the Red Army on the example of the 120th Rifle Division. This process has been actively going on since the beginning of the Civil War and foreign military intervention until the beginning of the Great Patriotic War. During this time, several approaches to the formation of the army have changed. Finally, they settled on the idea of creating a mass regular army, formed on new principles of compulsory military service, by conscription and mobiliza-tion. The systematic construction of the regular army start-ed in 1918, when, along with the new type of units, the Red Guard detachments continued to function, which became a school for training command and political personnel for the Red Army. The author analyzes the process of forming the command army staff of a new type by attracting the old military intelligentsia, as well as through educated command courses and military educational institutions of various levels. The quantitative growth of the Red Army at different stages of its creation is traced. The process of creating the army took place within the framework of the military districts being formed, starting in the spring of 1918. The author analyzes the creation of new management bodies of the armed forces of the country, the formation of a unified command structure of the troops. At the end of the 30s, the construction of the Red Army was carried out on the basis of a Plan for the development and reorganization of the Red Army ground forces by creating personnel divisions of triple deployment. The basis of the Red Army was rifling divisions. As a result, the author concludes that the 120th Rifle Division was a typical example of a military structure being created as part of the armed forces of the Soviet State.

STATE OF ORGANIZATION OF PROVIDING ONCOLOGICAL MEDICAL CARE TO THE POPULATION OF UKRAINE.

Aim: The purpose of this work is to study the state of organizational factors in the provision of oncology care to the population of Ukraine and to determine the needs of the population in oncology care. Materials and Methods: The following materials were used in study: a report on diseases of malignant neoplasms; report on medical personnel; report on contingents of patients with malignant neoplasms. The used methods were: bibliosemantic, content analysis, analytical, statistical and graphical methods. Conclusions: The oncological control system in Ukraine is represented by institutions of various levels. The number of specialized beds is increasing from 8,587 in 2015 to 9,088 in 2021. there is a tendency to decrease the total number of medical personnel by 12% and the number of general practitioners - family medicine by 1.5%. During the period from 2015 to 2021, the contingent of patients with neoplasms increased by 21-24%. The rate of neglect of cases of malignant neoplasms registered in Ukraine during 2022 was 22.4%, which is 1.4% more than in 2021. The system of oncology medical care of Ukraine is at a sufficient level, but there are certain difficulties caused by certain difficulties of the primary health care sector due to the decrease in the number of medical specialists. In the modern context, there are difficulties caused by the difficult migration situation of the population against the background of Russia's military aggression against Ukraine.

Management of logistics transformation of the educational process

The article examines the peculiarities of logistics systems in modern military conditions. An analysis of the structure of the concept of “logistics systems” by many authors was made. This analysis includes the selection of: the essence of the phenomenon, the content of the phenomenon and its result. A classification of existing approaches to defining the concept of “logistics systems” has been carried out. Conducted critical evaluation of different approaches to the concept of “logistics systems” on a five-point scale, which made it possible to identify the definition with the highest rating. The results of the conducted research made it possible to determine that the logistics system is a system that has variable and constant elements in its composition, which changes over time under the influence of management decisions, which are based on the analysis of the internal and external environment in order to increase the efficiency and profitability of the enterprise. Restoration of the educational process in schools and educational institutions of various levels during the period of Russian military operations on the territory of Ukraine is one of the priority areas. Many students and teachers are outside Ukraine, but they should not lose contact with their educational institutions and the opportunity to study/work. However, the main condition for the restoration/continuation of the educational process is the safety of all its participants. There are a number of educational institutions in Ukraine that were moved from the temporarily occupied territory to other regions of Ukraine. The article provides a list of relocated higher education institutions as of October 2023. As a result of the conducted research, the components of the logistic transformation of the educational process were formed in the article, which will make it possible to optimize the logistic systems of the educational process, identify "bottlenecks" and eliminate them in a timely manner. As of October 2023, 31 higher education institutions were relocated on the territory of Ukraine.

ДОСЛІДЖЕННЯ ДИНАМІКИ ЗАХВОРЮВАНОСТІ НА COVID-19 В УКРАЇНІ ПІД ЧАС ВІЙСЬКОВОГО СТАНУ

COVID-19 has seriously affected various aspects of our lives, and above all the health of people around the world. The high level of transmission and so far, the lack of effective therapeutic agents have challenged all mankind. COVID-19 is an infectious disease that was first detected in December 2019 in Wuhan, China, after which the virus quickly spread around the world. On January 30, 2020, the World Health Organization (WHO) declared an international public health emergency outbreak, and on March 11, 2020, a global pandemic. Compared to other acute respiratory diseases, such as SARS or MERS, COVID-19 is spreading faster due to increased globalization. According to reports of the first 40 cases of COVID-19, the majority of infected patients (73%) were males, and less than half (i.e., 32%) had comorbidities such as diabetes, hypertension, and cardiovascular diseases. It is also reported that the average age of patients was 49 years. The mortality rate in this group was almost 2%. In Ukraine, the first cases date back to March 3, 2020. Since the beginning of the epidemic in Ukraine, the average mortality rate was almost 3.5%, and the average age of patients was 41 years. On the night of February 24, 2022, after the Russian leader addressed his citizens, Russia launched a large-scale offensive on the territory of Ukraine. Martial law was declared by presidential decree at 05:30 on the same day throughout the controlled territory of Ukraine. Following the declaration of martial law, most businesses, food and entertainment establishments were forced to suspend operations due to the threat of airstrikes. Educational institutions of various levels were forced to close on vacation, and later open only for distance learning to prevent the accumulation of large masses of people in one place. As for the incidence statistics for COVID-19, at the beginning of the war, they didn't update at all or were limited updated. Therefore, it is now very important to know what the dynamics of the disease should be expected. To study these dynamics, we will use the SIR model, based on the results of which it will be possible to forecast what to expect from COVID-19.

The Concept of Zone of Proximal Development and its Derivatives: Problems and Prospects of Modern Interpretations

The study is devoted to the theoretical and methodological analysis of the concept of zone of proximal development, which is of great practical importance for education since it explains the mechanism of the influence of learning on the development of a student. Therefore, the purpose of the study is to analyse the current content and trends in the development of this concept and its derivatives. In this context, the classical ideas of L.S. Vygotsky on the zone of proximal development and the zone of present development, their indicators, and essential characteristics, including the evolution of the methodological status of the concept of zone of proximal development in psychology and pedagogy are analysed. Modern derivatives of the concept of zone of proximal development (scaffolding, zone of free movement, zone of prompted actions, zone of negative development, zone of variable development, zones of intermental development in the dialogue between teachers and students, etc.), its connections and correlation with these related and interrelated concepts are analysed. Based on the theoretical analysis, the psychological, didactic, and heuristic potential of the concept zone of proximal development is determined, in particular, its use as a methodological tool for developing projects in various fields of practice and branches of psychology. The latter is demonstrated by the example of student learning. The problem points and paradoxes of the modern understanding of the concept of zone of proximal development are also identified. The problem analysis is organised around the following subjects: the potential of the dual-plane zone of proximal development, the problem of its individualisation, the problem of social competence of interaction subjects that creates this zone, the zone of proximal development in the context of symmetrical-asymmetric learning and the quality of communication with peers in the group, the problem of the specific features of the zone of proximal development of an adult or an elderly person, the problem of moral competence and the inconsistency of the phenomenon of learning as a potential to change under external guidance. The obtained scientific results will be useful both for modern theorists of teaching and educating young people, and for teachers and psychologists working in educational institutions of various levels

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Abstract. Introduction. Changes occurring in the political space of Ukraine, military actions, economic crisis have a significant impact on the activities of educational institutions of various levels, which require new approaches to management. In today's world, soft skills in addition to hard skills are gaining more and more importance in professional activities. Critical and creative thinking, emotional intelligence, time management, oratorical skills, flexibility, ability to solve problems, etc. are singled out among the important soft skills in educational activities. However, as scientific research and practical experience show, leadership and team building are the key ones, because in order to achieve high final results in education, an effective leader and a successful team are needed. Purpose. The purpose of the study is to analyze the development of leadership and team building in the activities of educational institutions, to evaluate their role and to find ways to solve existing problems. Results. The importance of soft skills in the activities of managers and employees of educational institutions is considered. The concepts of �hard skills� and �soft skills� are clarified. A comparative characterization of hard skills and soft skills is carried out. The interpretation and essence of the concepts of �leadership� and �team building� in educational activity are analyzed. The results of a sociological survey of managers and employees of educational institutions of various levels regarding the state and development of leadership and team building are summarized. Based on the results of the survey, the presence of leadership qualities among the employees of educational institutions is evaluated, the leadership qualities are evaluated according to a 5- point scale of the heads of educational institutions, the presence of an informal leader in the team, the influence of leadership qualities on the final work results, the presence of teamwork in the professional activities of the respondents and the feeling teams The main ways of achieving leadership in the educational sphere are given and ways of building a successful team in an educational institution are suggested. Conclusions. In order to ensure the effective operation of educational institutions of various levels, considerable attention should be paid to the development of leadership and team building, which will enable the achievement of all set goals and formed missions. In the course of the conducted research, the positive influence of the leadership qualities of both the manager and the employees of educational institutions, as well as the presence of effective teams on the final results of activities, is established.

Exploring the construction of clinical trial research unionsin China

<p indent="0mm">A clinical trial is a key step in the process of pharmaceutical research and development (R &amp; D). It is a key indicator of the innovative potential of the pharmaceutical industry. ClinicalTrials.gov shows that the average annual growth rate of the total number of clinical trials globally in the past decade (2012–2021) was 20.7%, mainly distributed in Europe and the United States, and the total number of clinical trials registered in China accounted for 6% of the world. According to the statistics of IQVIA Institute for Human Data Science, the global proportion of early-stage R &amp; D pipelines from China-headquartered companies increased from 1% in 2005 to 12% in 2020, which was still far behind that of European and American companies. Among 871 new active substances approved for marketing globally in the past two decades, 522 were for marketing in China, with the high number driven by regulatory acceleration mechanisms from National Medical Products Administration, such as breakthrough and orphan designations and priority reviews. Considering the gap in clinical research strength between China and developed countries such as Europe and the United States, the clinical trial research capacity and level should be improved to assist China in the R &amp; D of innovative drugs. According to the Registration and Information Disclosure Platform for Drug Clinical Studies and the clinical trial institution filing management information platform in China, in the last five years (2017–2021), the average annual growth rates of the total number of new drug clinical trial registration and clinical trial units in China reached 26.9% and 12.6%, respectively. However, clinical trial resources are mainly concentrated in major institutions, municipalities, or provincial capital cities in the eastern and central regions of China, with distributions becoming increasingly polarised. Under the background of China’s new medical reforms, the strategic direction of national political support is to motivate equitable access to high-quality clinical trial resources and cross-regional collaborative development of medical institutions by means of medical unions, national clinical medical research centres, Chinese national major projects for new drug innovation and so on. In the context of this background, clinical trial research unions (CTRUs) have been built in China. A CTRU is defined as a consortium formed by medical institutions, sponsors and third-party service institutions of various levels and functions, led by a national clinical medical research centre or clinical trial medical institutions undertaking major national science and technology projects or supporting projects of national key R &amp; D plans, radiating and driving the improvement of clinical trial research capacity in multiple regions. CTRUs develop a multi-level clinical research centre system and collaborative network by vertically and horizontally combining multi-level medical institutions, sponsors and third-party service institutions. All participants of CTRUs are crucial. The leading clinical trial research medical institution, as the core, is responsible for establishing institutional system standards in CTRUs, designing and leading high-quality multi-centre clinical trials, central ethics and personality training. The major clinical trial research medical institutions are responsible for implementing high-quality, multi-centre, complex and high-risk clinical trials. The other member institutions are responsible for implementing basic clinical trials. The sponsors, contract research organizations (CROs), site management organizations (SMOs) and other enterprises are responsible for funding, supporting and promoting the construction of a clinical trial centre system and collaborative network. The specific construction contents of CTRUs include building a clinical trial research resource sharing platform, homogenising clinical trial quality management, constructing a rapid clinical trial process platform, diversified multi-level and multi-form talent training, information interconnection, deepening strategic cooperation and designing and leading high-level trials. CTRUs have established the selection criteria and assessment exit mechanism and conducted work performance assessments from the dimensions of organisation and implementation, division of labour and cooperation, the connection of clinical trial resources from top to bottom, efficiency and benefit and sustainable development to ensure their good and sustainable development. Through CTRUs, we can achieve high-quality clinical trial resource sharing, improve the clinical trial research capability of member institutions, cultivate high-level skills, such as principal investigators (PIs), sub-investigators, institutional managers and clinical research coordinators (CRCs), and promote the development of clinical trials, economically and with high-quality. Through the trial operation with one member of CTRUs, it was found that the key points should be strengthened in deepening resource sharing, implementing central ethics review, interconnecting information platforms and leading high-quality clinical trials. The construction of CTRUs is an effective means for China’s clinical trial research to solve the current problems and change from a ‘follow-on pattern’ to leading high-level and high-quality international multi-centre trials. However, the construction of CTRUs is a complex systematic project. In addition to performing an excellent job in the top-level design and overall planning, CTRUs’ specific implementation process and measures need to be continuously explored in the practice process.

A model of the professional field as the basis for an adaptive educational process

Objectives. The main purpose of the work is to study the advantages of an activity-based approach, or functional approach in comparison with a subject-based approach, or lecture-based approach for creating a model of a professional field for adaptive educational process. The relevance of the problem being solved is caused by due to the fact, that adaptive educational technologies, thanks to the extensive computerization and informatization of all spheres of human activity, as well as the innovative development of artificial intelligence, have become dominant in teaching systems at all levels, from preschool to higher education institutions. Without a highly effective model of the professional field, it is impossible to successfully implement adaptive learning.Methods. To achieve the goals and to prove the statements formulated, the method of comparative analysis of the most widely used ways for creating models of the professional field for adaptive learning in modern systems, was used. To do this, we studied: the effectiveness of using the traditional approach, which is based on subjectspecific or lecture-seminar signs of structuring educational material; as well as the effectiveness of using an activity-based approach based on the concept of "Modules of labor competencies" for the formation of educational material.Results. The analysis of the quality of educational material (a model of a professional field for an adaptive educational process) obtained using the traditional approach, and educational material (the same model for its intended purpose) obtained on the basis of an activity approach in accordance with the concept of "Modules of labor competencies". The results of the analysis are compared and theoretical statements are summarized, taking into account the examples of developed modular materials, as well as the pilot implementation of previously developed modular programs.Conclusion. The information given in the article can be useful for specialists, researchers and heads of educational institutions of various levels, when planning and creating adaptive learning systems. The conclusions and recommendations fully comply with the requirements of the development of the education system of the Republic of Belarus.

Quality audit of diagnostic colonoscopy protocols in the colorectal cancer screening program

AIM: to analyze the quality of primary colonoscopy protocols in patients included in the colorectal cancer screening program.PATIENTS AND METHODS: out of the 86 patients admitted for the removal of colon polyps detected during primary screening of colorectal cancer at medical institutions of various levels, 67 (77.9%) had colonoscopy protocols, which were analyzed in accordance with the study objectives.RESULTS: the informative value of colonoscopy protocols at the endoscopic stage of colorectal cancer screening in clinic institution of the 3rd level was significantly higher than in the 2nd and 1st levels (5 criteria out of 8).Comparison of protocols quality of two last medical institutions showed no significant differences. The optimal and acceptable quality of colonoscopy protocols, studied in accordance with the same criteria, was achieved by 3 (37.5%) at clinics of the 3rd level and by 1 (12.5%) at medical institutions of the 2nd and 1st levels.CONCLUSION: the quality of colonoscopy protocols at clinics of the 3rd level is significantly higher than at hospitals of the 1st and 2nd levels of medical care delivery. The audit of the diagnostic colonoscopy protocols for colorectal cancer screening of the entire cohort showed the loss of information compared to the standard protocol and in most of them there is a low quality of content.

Working conditions and health status of elderly teaching staff (a review)

This article reviews literature data on the working conditions, labor organization, health and psycho-emotional status, performance, and age composition of teaching staff. Population ageing is a global trend, primarily associated with increased life expectancy and decreased fertility rates. The reviewed publications note a steady increase in the number of elderly people employed in educational institutions of various levels. According to hygienic assessments, the working conditions of teaching staff can be distinguished as potentially harmful. High working, mental, emotional, and voice loads were found to be the key factors affecting teachers’ health, performance, and professional longevity. The accelerating pace of life, growing volumes of circulating information, spreading digitalization and robotization, adoption of online educational technologies – all these phenomena impose an additional psychological burden on teachers, elderly people in particular, becoming a source of distress and neuroticism. At the same time, the involvement of elderly people in intellectually stimulating professional activities and the respective adequate payment were shown to have a positive effect on the preservation of their cognitive functions and overall quality of life. These findings determine the relevance of investigating the occupational hygiene of elderly teaching staff in order to develop measures aimed at preserving their health, quality of life, and professional longevity.

Kurikulum Muatan Lokal Berbasis Pesantren Dengan Bī’ah Luġowiyyah ‘Arabiyyah

Curriculum is an important focus for educational institutions of various levels. Because it describes the vision, mission, and educational goals of the nation, there needs to be a good pattern and form of curriculum. To carry out the curriculum at an institution requires organized curriculum management, including concepts, planning, implementation and evaluation. MA Al-Ukhuwah sukoharjo is one of the educational institutions that has a structured curriculum management. The research method used is qualitatively descriptive, , by retrieving data through interviews and documentation from related parties. The results found are the curriculum concepts used in MA Al-ukhuwah covering the national and local pesantren curriculum, Seen how the planning carried out by all stakesholders, the implementation of curriculum structure and the equitable self-development of santri as well as curriculum evaluation that produces many achievements as well as alumni of Islamic character and has advantages in their fields.&#x0D; Keywords: Local Content Curicculum, Arabic Language

ECONOMIC POTENTIAL OF TOBOLSK PROVINCE (LATE XIX – EARLY XX CENTURIES)

The relevance of the topic under study is related to the problems of the uneven economic situation of the regions of modern Russia.&#x0D; The key purpose of the article is to consider the dynamics of the development of the region’s economy during the historical period, accompanied by modernization processes in the life of the entire state.&#x0D; Materials and methods. The research is based on various sources presented in the form of periodicals and reference and statistical publications. The theoretical basis of the work is the theory of modernization. The principle of historicism, comparative historical and descriptive methods are used.&#x0D; Results. The paper examines the state of the economic potential of the Tobolsk province in the last quarter of the XIX – early XX centuries. Various economic indicators are presented that make it possible to draw reasonable conclusions about the real situation of the economic life of the studied region. Separate categories of economic activity that were specific to the region are indicated, comparative characteristics of the economic potential of the Tobolsk province with other regions in the same period are given.&#x0D; The scope of the results. The conclusions presented in this article may have practical application in the process of teaching relevant disciplines in educational institutions of various levels.

SOME ASPECTS OF SOCIAL CHANGE IN THE TRADITIONAL ECONOMY OF THE NORTH OF YAKUTIA IN THE LATE 1980S - 1990S

Background. This problem requires a study and a comprehensive analysis of the social changes in the northern villages and how they affected the traditional economy of the indigenous peoples of Yakutia.&#x0D; Purpose. The purpose of the article is to study some aspects of social changes in the traditional economy of the North of Yakutia on the eve and during the post-Soviet transformations.&#x0D; Materials and methods. Archival sources and the results of research by Northern scientists of the 1990s on the study of general and local social problems of northern villages and indigenous workers were used. When studying the topic, a chronologically problematic approach was used. The analysis of the issues was carried out using comparative, retrospective, statistical methods.&#x0D; Results. From archival documents, specific examples of social changes in the farms of Northerners at the turn of the last decades of the twentieth century are highlighted, especially in terms of wages and housing. Some results of research by Northern scientists conducted in the 1990s are shown. They outlined the general social problems of the northern villages, the specific consequences of the activities of the new tribal communities of indigenous peoples. The necessity of further research of this problem is actualized.&#x0D; Practical implications. The results obtained are the basis for further interdisciplinary research. Also, conclusions and local examples can be used as local history material on humanitarian specialties in educational institutions of various levels. This problem requires a study and a comprehensive analysis of the social changes in the northern villages and how they affected the traditional economy of the indigenous peoples of Yakutia.

АГІТАЦІЙНИЙ РУХ ГРЕКО-КАТОЛИЦЬКОГО СВЯЩЕНСТВА СХІДНОЇ СЛОВАЧЧИНИ В ПЕРШІЙ ПОЛОВИНІ 1920-x рр.

The article analyzes the agitation of Greek Catholic priests in Eastern Slovakia in the 1920s to join Transcarpathian Ruthenia and introduce the Ukrainian language in schools and state institutions. The territory of propaganda distribution has been determined. The center of agitation was Presov, where the Ruthenian league union, which included Greek Catholic priests, operated. The article describes the course and requirements of the Rusyn/Ukrainian congresses: the annexation of Western Rusyn counties to autonomous Subcarpathian Rus, the introduction of the Russian written language in schools and governments, and the admission of local residents to public service. Along with educational requirements, the idea of annexing the ethnic Ruthenian territories of eastern Slovakia to Subcarpathian Rus became a significant direction of agitation. It was found out that the propaganda movement contributed to consolidation, politicization, and caused opposition from the authorities. The article describes the official government position on the Propaganda Movement. It is determined that 1921–1923 is a period of active agitation, and the decline of the movement begins in 1924. The holding of the Ruthenian people’s Congress in Presov on September 7, 1925, demonstrated an attempt at National Unification of Ukrainians. Delegates and guests discussed the socio-economic situation of the Ruthenian people, the political situation, and the requirements for education. The resolution adopted by the Congress notes the need to increase the number of educational institutions of various levels for the Ruthenian population in Slovakia, equalize the rights of teachers of Greek Catholic schools with teachers of Public Schools. These attempts at ethnopolitical consolidation were leveled by the Czechoslovak press and evaluated skeptically. The author claims that the agitation movement of Greek Catholic clergy among Rusyns/Ukrainians in eastern Slovakia in the first half of the 1920s was the result of Slovak domestic policy and its practical idea of rapid assimilation of national minorities. The Propaganda Movement in eastern Slovakia developed in two directions: for joining/uniting Transcarpathian Ruthenia and demanding the introduction of national schools and, accordingly, the language of instruction.

Система традиционного образования в примечетской школе Дагестана: история и современное состояние

Introduction. In the post-Soviet period, powerful processes of religious revival were observed in Russia, which were of a rather complex and contradictory nature. Logical consequence of the Islamic revival was the emergence of need for knowledge of the professed doctrine, which contributed to emergence of Muslim educational institutions of different levels (maktabs, medreses, Islamic universities), that actualized the problem of studying this aspect. Theoretical justification. The emergence of the Islamic doctrine initially contributed to increasing interest in religious knowledge, intensified the need to obtain it, and there was historically strong argumentation for this: in particular, authority of the scientist in society, social status, material welfare of a person, etc. Research methods. The object of the research is Islamic education. The subject of the research is the initial segment of Muslim education in Dagestan in the pre-revolutionary and modern periods. A sociological survey on the study of the initial segment of Muslim education (schools at the mosque) was conducted in 2020 in cities (Makhachkala, Khasavyurt, Derbent) and districts (Botlikhsky, Buinaksky, Kazbekovsky, Khasavyurtovsky) of the Republic of Dagestan. Within the framework of this project, three surveys were conducted (expert, parents and pupils): 1. Mass survey of parents whose children study and do not study at maktab; 2. Expert survey; 3. Survey of pupils of schools at the mosque. The questionnaires were discussed in the Department of Sociology and processed in the SSPS program - 25, for what 3 matrices were created: pupils, parents, experts. Calculations were performed as a descriptive statistics for each matrix separately. Also, a crostabulation (cross-over or conjugation) analysis was carried out according to socio-demographic parameters - gender, age, place of residence, attitude to religion. Among the respondents were parents N = 255, pupils N = 444, experts N = 59 persons. The research method is a mass standardized survey. Results and its discussion. For the Muslim republics (subjects) of Russia, both in the pre-revolutionary and in the modern period, Islam and Islamic education are of great importance. Therefore, in the wake of Perestroika and the expansion of the field for free expression of their attitude to religion, along with the population's appeal to religion, Islamic educational institutions of various levels began to appear widely. The interreligious situation and relationships depend on the quality of education, the used programs and the level of teacher training at these educational institutions – especially in the polyreligious region such as Dagestan.

Modeling of threats in the sphere of medical data storage

In medical institutions of various levels, a large amount of datais stored in electronic form, to ensure the safety of which arepresented with special requirements. Ensuring the safety of thestorage of medical data should begin with an analysis of existingthreats. This article provides a model of threats in thearea of data storage, which includes the following components:comunicative, spatial and destructive threat. It is shown that,to date, communicative and spatial threats have minor rates,which can be neglected. The destructive threat is considered inmore detail, its components are described. Recommendationsfor the development of medical data storage systems are given.

Algorithm of innovative medical and economic standards as a basis for the transformation of hypothetical predictions of the launch of insurance medicine

Introduction: Based of tht author's doctoral dissertation of tht problems of insurance medicine, relevant monographs and scientific articles, an attempt is presented to substantiate tht option of transforming our purely governmental national system of insurance medicine. Purpose: Using more than thirty of our innovative organizational and medico-economic standards, criteria and regulations, in tht process of their "activation" in the conditions of a full-scale experiment under the pilot project program in the Health Care institutions of various levels of medical district, to determine the level of their effectiveness to justify the specified transformation during the launch of our system of insurance medicine. Materials and methods: The object of the study was all residents (up to 2000) of the family physician's area of responsibility. On the basis of structural-logical analysis and the use of medical-economic standards, doctors' labor costs, distribution of otolaryngological diseases into clinical-statistical groups (CSG) and diagnosticrelated groups (DRG), as well as the degree of their complexity and the complexity of possible surgical interventions, thanks to the formula for calculating the labor costs of doctors and treatment process we obtained evidencebased information about real "budget" cost of treatment of diseases of a certain CSG. Results and discussion: At the first in trade part mental stage of insurance medicine, the main tool should be a system of medical and economic standards, which include the price of labor costs, in particular doctors, wage fund, rates of increasing coefficients for the treatment of complex diseases, the level of financial incentives for doctors and the like. The tables present a mechanism for calculating the evidence-based cost of treating diseases of varying degrees of complexity and physician salaries, as well as the possibilities of forming both an adequate amount of funds that "follow the patient" and forecasting the health improvement budget for the family physician's area of responsibility. Conclusions: Presented an algorithm for the implementation of our medical and economic standards, the feasibility of which has been proven in the "field" conditions of the field experiment in the process of professional management, can constitute, under conditions of its continuous improvement, the medical and economic basis for the start of our system of budgetary and insurance medicine.

Routing and Treatment of Patients with Hematogenous Vertebral Osteomyelitis on the Tyumen Region Example

Background. Currently, various algorithms of tactical classifications and treatment regimens for hematogenous vertebral osteomyelitis (HVO) are proposed. However, all proposed approaches are designed for the treatment of patients in specialized multidisciplinary clinics departments, although the initial treatment often occurs in municipal polyclinics, private medical centers and district hospitals. The question is what the appropriate scope of diagnostic and therapeutic measures in institutions with different material and resource bases and how to ensure continuity according to the existing three-level system of medical care remains open. The aim of this studyis to determine the probable routing and treatment options for patients with HVO on the example of the Tyumen region, depending on the existing three-level system of providing medical care to the population.Object and Methods.The current Orders of the Ministry of Health of the Russian Federation and the Resolutions of the Government of the Tyumen Region were studied, on which basis a three-level system of providing medical care to the population was organized and organizations providing emergency and elective medical care to patients with HVO were identified. The volume of medical and diagnostic measures in patients with HVO in institutions of various levels, as well as their routing to the regional clinical hospital No. 2 in case of impossibility or inexpediency of providing specialized medical care at the place of primary treatment, is analyzed on the example of the Tyumen region. The clinical material is presented by 267 patients with HVO who were treated in the Tyumen regional clinical hospital No. 2 from 2006 to 2019, 78.7% of whom were treated in the profile of traumatology and orthopedics, 18.7% — neurosurgery and 2.6% — surgery. Results.The list of medical institutions that provide emergency and planned care in traumatology and orthopedics, neurosurgery in the Tyumen region is defined, depending on the level of the institution and the available material and resource base. A block diagram is proposed that determines the scope of medical and diagnostic measures in institutions of I-III levels and specialized departments of multidisciplinary clinical hospitals. The principle of determining the patient profile (surgical, orthopedic, neurosurgical) depending on the type and severity of the inflammatory lesion according to the classification E. Pola (2017) is proposed.Conclusion. The need for effective use of medical and diagnostic resources starting from level I is determined by clear routing of the patient to ensure the continuity of medical care. A full-fledged diagnosis is possible in institutions not lower than the third level with the mandatory determination of the lesion type and the severity of the inflammatory process. HVO treatment is advisable in level III institutions, specialized departments of regional clinical hospitals and federal institutions.

A Method for Assessing the Severity of Obstructive Jaundice of Non-Neoplastic Origin

AIM OF STUDY To develop a method for assessing the severity of obstructive jaundice (OJ) of non-neoplastic orogin on the basis of functional parameters of the liver and the activity of pathogenetic agents of hepatodepression.MATERIAL AND METHODS Clinical and laboratory studies of 142 patients with breast cancer of non-tumor origin. The indicators of the functional state of the liver, the index of plasma toxicity for albumin, and the content of malondialdehyde (MDA) were evaluated.RESUlTS Based on the assessment of a number of blood parameters - the content of total bilirubin (TB), the plasma toxicity index for albumin, the MDA level — the severity index of obstructive jaundice of non-neoplastic origin (SIOJ) was developed:SIOJ = IT1/ITn + TB1/TB + 5(MDA1/MDAn)where IT 1 is the plasma albumin toxicity index at the current moment, ITn is the normal albumin plasma toxicity index, TB1 is the current bilirubin content, TBn is the normal bilirubin content, MDA1 is the current malondialdehyde content, MDAn is the normal value. The index less than 13 indicates a mild severity, 14–21 is moderate severity, 22 and higher indicates a severe degree of OJ. The method increases the objectivity of determining the severity of non-neoplastic origin by establishing the severity of liver damage and the processes underlying it.CONClUSiON The suggested clinical and laboratory index allows the severity of obstructive jaundice to be objectively and quickly determined upon admission of a patient to the hospital and also adequate therapy to be initiated in case of severe degree for anticipation of possible post-operative complications, so the treatment should be focused on managing triggers of hepatodepression. The method is simple and available in medical institutions of various levels. The method is especially valuable when used in the dynamics of the early postoperative period.