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The article is devoted to the study of the influence of individual factors on the state of economic security of agricultural enterprises. The subject of the study is the theoretical and methodological aspects of the application of expert assessment to determine the influence of individual factors on the state of economic security of agricultural enterprises. The author presents and interprets the results of an expert survey conducted by the Method of expert assessment of the influence of individual factors on the state of economic security of agricultural enterprises, and also substantiates the advisability of using expert assessment methods in the context of a study of the economic security of agricultural enterprises. The stages of the expert assessment were disclosed. The survey was conducted by questioning a group of experts - leading scientists, economists and production representatives with practical experience in agricultural enterprises. It was revealed that none of the experts identified the level of economic security of their own enterprise as high. Key external and internal threats to economic security were systematized. The level of influence of individual functional components on the formation of economic security of agricultural enterprises was estimated. The proposed by the author peer review method meets the following requirements: the ability to obtain reliable results from a survey of experts; ease of use; clarity and consistency of presentation of the material; the possibility of automated data processing using computer devices; efficiency (obtaining survey results in a short time without losing their credibility); the ability of experts to use both quantitative and qualitative estimates. The results obtained and presented in the article are of exceptional theoretical and practical value, and therefore will be used in further studies, in particular, in developing a strategy for the development of economic security of the agricultural sector.

The object of research is the process of forming a collective expert assessment with increased reliability in making management decisions in business structures by an expanded team of experts. One of the most problematic places in the expert assessment of management decisions is the complexity of forming a competent expert team and the rather high cost of the expertise. In recent years, there has been a tendency for expert assessment with an expanded team of experts. In this case, not only professional experts are involved in the examination, but also all persons wishing to take part in solving the problem. In this case, the reliability of the examination raises doubts. In connection with the participation in expert assessment of persons who do not have experience in expert work, a wide range of expert assessments is possible. The analysis of the current state of the methods of expert assessment in business is carried out. It has been established that the Delphi method, which was most used until recently, does not meet modern requirements. More progressive methods are based on mathematical consensus theory. Consensus is understood as the degree of correlation of individual expert assessments performed in rank scales. In the course of the study, formalized mathematical approaches to the organization of collective expertise were used. A method for processing the results of an examination with an expanded composition of experts was developed. The developed methodology is focused on identifying experts with insufficient qualifications. The methodology allows for a step-by-step assessment of the reliability of the collective expert decision by assessing the Kendall concordance coefficient. It is shown that the phased exclusion of assessments by experts with insufficient qualifications allows increasing the level of consensus, the quality and reliability of the collective expert assessment. The developed methodology has been tested in a really functioning enterprise to make a decision on the exit strategy of the enterprise from their crisis. The use of the developed methodology has made it possible to significantly increase the reliability of the examination results, assessed by the concordance coefficient. The results are useful for practical application in business structures when conducting expert examinations involving a wide range of participants.

The essence of an expert assessment as a scientific method is a rational organization of experts analyzing the problem from a quantitative evaluation of judgments and results processing. A generalized opinion of the expert group is taken as the solution. The diversity of the problems solved by the experts is reduced to two types: a system analysis and a parametric analysis of the design proposal. The system analysis aims to confirm the feasibility (or non-expediency) of creating a new equipment model, to estimate its technical level and economic efficiency, taking into account requirements and possibilities of an upgraded technical system. The parametric analysis of the project proposal is to justify the validity of design parameters and characteristics of the considered technical system, their marketability, the importance of targets. Despite the relatively well-established and proven tools expertise methods, the expert assessment of complex technical systems project proposals still remains a challenge. The main difficulty is the decomposition of tasks, the definition of a hierarchical system of criteria (grounds on which project proposals are compared). The technique and software for the expert assessment of project proposals for the sake of assessing the quality and competitiveness of aviation and rocketry products are suggested in the article. The technique of expert assessment involves the comparative analysis of project proposals in accordance with the formed system of criteria of products quality. The method of analysis of hierarchies, which is currently one of the most powerful and effective methods of the expert assessment and the decision-making, is used. Thanks to the hierarchical representation of the expert assessment task and the relatively simple procedure for the pairwise estimation of project proposals at each stage of the expert procedure, there is a possibility operatively to carry out the comparative assessment of a large number of alternative design proposals, using arbitrarily complex system of criteria. An example of using the developed technique and software for the expert assessment of project proposals of aviation and rocketry products in the solution of the problem of choosing the rational option of constructive and technological patterns of a wing is given.

The article presents the results of an expert assessment of the thinning out of forest stands on the territory of the N district of the Kirov region based on field studies. Fieldwork consisted of recalculating and measuring the diameters of stumps left after felling trees, establishing their species composition and quality condition to determine the volume of harvested wood in the context of species. The stumps found were identified as pine (70 %), spruce, birch, and aspen.The authors reveal that the release forest cutting was carried out within the boundaries of the designated cutting area with an excess of the established volume of wood harvesting for the prime breed (pine). The volume of felled pinewood exceeded 2.5 times; for other species, these data is more than 70 % lower than declared. At the same time, the total actual volume of the withdrawn wood does not exceed the data of the forest declaration. Based on the revealed violation of the forest legislation and the relevant regulatory documents, the authors have calculated the amount of damage caused to the forest plantation due to illegal logging of pine wood in the volume of 297 m3. The damage amounted to more than 4 million rubles.

The economic categories and those of the financial and economic account: expenses, rationing, standard allowances, regulatory costs, general production and running costs have been established in order to determine the peculiarities of the monetary costs formation for the plant cultivars scientific and technical expert assessment. The regulatory costs for the expert assessment are determined annually as follows: the cvs favorability for spread, difference, homogeneity, stabil-ity, research of the varieties collection, post registration study, the cultivars certification investigation. The calculation of the regulatory costs are carried out in accordance with the classical scheme taking into account corresponding pecu-liarities as follows; salaries, deduction for the social measures, mineral fertilizers, plant protection means, fuels and lub-ricants, electrical energy, other expenses, the fundamental means restoration. The full cost also includes general produc-tion and running costs. The regulatory level has been established for both the general production costs from the total costs (5 %) and general running ones (10 %). The by-product costs when calculating the production costs are deducted from their total costs. The varieties testing is connected with the expert assessment risks. As a result, the unforeseen costs appear with the pur-pose that the field expert assessment can be guaranteed. The estimation of the actual costs structure which take place really in the process of the expert assessment has shown that the unforeseen costs are 10% of their total cost. In agricul-tural enterprises contrary to the expert assessment institutions instead of the unforeseen costs direct expenses include insurance payment. Taking into consideration the ratio between the overhead and direct manufacturing costs established in the expert assessment institutions when calculating the share of the overhead costs is considered to be 3.5% in the to-tal costs volume.

The article presents the data of analysis, synthesis and generalization of the results obtained in the provision of medical care by anesthesiologists. It has been demonstrated that the issues of choosing the type of pain relief and the occurrence of possible complications, including those injured as a result of road traffic accidents, are given a lot of attention. It has been shown that there are cases of complications, including fatal ones, during or after anesthesia - spinal anesthesia. It was emphasized that in order to clarify the circumstances that are important for criminal proceedings to establish a causal relationship between the proper / improper performance by medical workers / anesthesiologist, their professional duties during the examination and treatment of patients, as well as the onset of severe consequences (including lethal), special knowledge, therefore, there is always a need for forensic medical examinations. When solving these issues, an analysis of medical documentation, synthesis and generalization of the data obtained is necessarily carried out, therefore, high-quality maintenance of medical documentation by anesthesiologists, which objectively reflects the methods of anesthesia and the patient's condition, is of great importance. It is emphasized that in the absence of both absolute and relative contraindications in patients for this type of anesthesia such as spinal anesthesia, anesthesiologists correctly choose both the drug itself and its dose, infusion with body fluid (to increase the volume of circulating blood), and the like. However, there have been cases when deaths occur as a result of correctly performed (both from the point of view of the technique and from the point of view of preliminary preventive measures) medical manipulation - spinal anesthesia, which leads to the development of a collapse with implementation in heart failure. Somatic diseases in patients (ischemic heart disease, hypertension, etc.) can contribute to the development and intensify the course of heart failure. However, there are no defects in the provision of medical care with which the onset of death of patients was in a causal relationship. In these cases, you can focus on the kind of death of patients - an accident.

The object of research is the process of expert evaluation in planning the energy supply of buildings using renewable energy sources. The conducted research is based on the application of system analysis methods to formalize the process of expert evaluation in the planning of an energy system with renewable energy sources. Here were used methods of expert evaluation of characteristics of qualitative criteria, methods of the theory of fuzzy sets and fuzzy logic for the formation of the value of criteria, and methods of estimating the reliability of the expert evaluation. Methods of structural analysis and functional modelling of information systems are used to build structural and functional models of the expert evaluation process. The issue of creating an appropriate information system for planning a power system with renewable energy sources is considered. One of the components of the information system is the unit for evaluating candidate experts. A six-level algorithm of the hierarchical structure of expert selection is proposed. As a result of the algorithm, an expert group is formed. This paper shows the process of narrowing the circle of experts from twenty to three candidates. The list of criteria influencing the choice of experts is formed: length of service, availability of the certificate, the efficiency of decision-making, education. The process of assessing the stability of experts' opinions is shown. It is proposed to use the method of processing the opinions of experts to find the value of the membership functions of qualitative criteria. As a result of the study, a group of three experts was formed, whose opinions are taken into account when choosing alternatives to the energy system. In accordance with the proposed information technology of energy supply planning of buildings using renewable energy sources, an information system in the form of a web-oriented application is proposed. A separate part of the information system is a subsystem for working with experts. The diagram of sequence of actions of the expert and the interface of work with system is developed. The use of the information system allowed to increase the efficiency of questionnaires of experts and decision-making on the choice of the optimal structure of the power system as a whole.

Background Volumetric laser endomicroscopy (VLE) allows for near-microscopic imaging of the superficial esophageal wall and may improve detection of early neoplasia in Barrett’s esophagus (BE). Interpretation of a 6-cm long, circumferential VLE “full scan” may however be challenging for endoscopists. We aimed to evaluate the accuracy of VLE experts in correctly diagnosing VLE full scans of early neoplasia and non-dysplastic BE (NDBE). Methods 29 VLE full scan videos (15 neoplastic and 14 NDBE) were randomly evaluated by 12 VLE experts using a web-based module. Experts were blinded to the endoscopic BE images and histology. The 15 neoplastic cases contained a subtle endoscopically visible lesion, which on endoscopic resection showed high grade dysplasia or cancer. NDBE cases had no visible lesions and an absence of dysplasia in all biopsies. VLE videos were first scored as “neoplastic” or “NDBE.” If neoplastic, assessors located the area most suspicious for neoplasia. Primary outcome was the performance of VLE experts in differentiating between non-dysplastic and neoplastic full scan videos, calculated by accuracy, sensitivity, and specificity. Secondary outcomes included correct location of neoplasia, interobserver agreement, and level of confidence. Results VLE experts correctly labelled 73 % (95 % confidence interval [CI] 67 % – 79 %) of neoplastic VLE videos. In 54 % (range 27 % – 66 %) both neoplastic diagnosis and lesion location were correct. NDBE videos were consistent with endoscopic biopsies in 52 % (95 %CI 46 % – 57 %). Interobserver agreement was fair (kappa 0.28). High level of confidence was associated with a higher rate of correct neoplastic diagnosis (81 %) and lesion location (73 %). Conclusions Identification of subtle neoplastic lesions in VLE full scans by experts was disappointing. Future studies should focus on improving methodologies for reviewing full scans, development of refined VLE criteria for neoplasia, and computer-aided diagnosis of VLE scans.

The purpose of the study is to analyze and summarize the results of an expert assessment of the goals, needs, ways and methods of medical rehabilitation of rescuers in the emergency zone to preserve and maintain their professional health and high performance during emergency rescue operations. Materials and methods of research. The study was conducted by interviewing of 248 specialists of the All-Russian service for disaster medicine (VSMC) using three questionnaires developed by the author. The questionnaires included questions on the possibility of using and expediency of the field form of medical rehabilitation of rescuers in the emergency zone, the need for additional preparation and professional training of specialists of field teams, as well as the expected effectiveness of this form of work. The results of the research were analyzed using the STATISTICA V.8.0 application software package. Research results and their analysis. The provisions are formulated as based on the results of processing expert opinions on the possibility, significance and expediency of using modern technologies of medical rehabilitation in the emergency zone, the need to change the professional training of specialists in the field of medical rehabilitation and additional training of specialists of field teams working in the emergency zone.

Foresight research in management accounting should be aimed at solving long-term perspective issues. A set of systems and methods of expert assessment is selected or developed in the course of such studies. The managerial staff of an economic entity with the authority to make strategic decisions develop forecast scenarios taking into account the opinions of competent experts involved in the economic field under consideration. Based on the fact that there can be many options for an economic future, they jointly discuss and develop a coordinated idea of which option for future economic development is most preferable for an agricultural holding, taking into account the variability of the economic situation.The subject of the study is the improvement of management accounting in the part of Foresight research in agricultural holdings with a comprehensive assessment of the effectiveness of the management of the activities of its agricultural organizations. In modern times, agricultural holdings can change the situation through competent management accounting, since competent management accounting allows companies to consolidate their activities, thereby giving good development to agriculture, both financially and in attracting highly qualified specialists, as well as the country's food security. In accordance with this goal, the main task was determined: to develop the mechanisms of Foresight research of management accounting in agricultural holdings, for the purpose of assessing the effectiveness of management of the activities of agricultural organizations included in it. Foresight participants do not try to guess the future but build a comprehensive system of measures for the development of the agricultural holding, which allow it to be achieved; this distinguishes the difference between foresight and traditional methods of planning, forecasting and budgeting in agriculture.

The aim is to carry out a comparative analysis of the severity of bodily injuries in victims with fractures of the femur and tibia in the immediate post-traumatic period and in the outcome of trauma based on a retrospective study of acts of primary and commissioned forensic medical examinations. Object and research methods. The injury outcome was assessed in victims with 49 fractures of the femur and 112 fractures of the tibia, presented in 185 reports of commissioned forensic medical examinations for the period February-June 2018. Results of the work. Open fractures of the femur and tibia are classified as serious injuries regardless of the outcome of the injury. All closed fractures of the femoral shaft (40; 24.8%), as well as 70 (43.5%) fractures of the shaft and 7 (4.4%) intraarticular fractures of the tibia, were attributed to moderate bodily injuries. According to the trauma outcomes, 2 (1.3%) closed diaphyseal fractures of the tibia (development of chronic post-traumatic osteomyelitis, unresolved bone shortening and deformity) were reclassified as severe bodily injuries. All 5 (3.1%) intraarticular fractures of the femur and 10 (6.3%) – the tibia, treated conservatively, were re-qualified as severe bodily injuries as a result of a non-fused subcapital femoral fracture (1; 0.6%), post-traumatic arthrosis of the hip (1; 0.6%), knee (11; 6.8%) and ankle (2; 1.2%) joints with persistent contractures, pronounced limitation of the function of the joint and the act of walking. The field of application is forensic medicine, traumatology and orthopaedics. Conclusions. Conservative treatment of displaced intra-articular fractures of the lower extremities is a significant risk factor for an unfavorable outcome of injury and aggravating the severity of injuries. The lack of unification of open fractures of the femur and tibia in the provided medical documentation according to generally accepted classifications did not allow assessing the outcomes of the studied open fractures.

Lesions of the dento-alvelolar system, which develop in cases of traffic accidents, domestic, industrial or other traumatic injuries, leads to a sharp decrease in dental health, and consequently to the decrease in quality of life associated with post-traumatic changes in dental status. Purpose of work – to analyze the indicators of the integrated quality of life criterion associated with the state of dental health among dental prosthetically-rehabilitated patients with a history of maxillofacial (MF) traumatic injuries. The study sample was formed on the basis of the University Dental Clinic from a cohort of patients who sought dental care with the need for comprehensive prosthetic rehabilitation. According to the analysis of medical records of dental patients, 66 persons with a history of maxillofacial traumatic injuries were selected. In order to assess the integrated criterion of quality of life associated with dental health, among dental patients with a history of maxillofacial traumatic injuries, who received appropriate prosthetic treatment, surveys were conducted taking into account all domains of OHIP-14 (abbreviated to 14 questions version of the Oral Health Impact Profile questionnaire). Mandibular fractures and traumatic injuries of individual teeth (dislocations, fractures) were the most prevalent among study sample and corresponded to 31.8 % and 27.3 %, respectively. The main causes of maxillofacial traumatic injuries were domestic injuries (43.9 %), road traffic accidents (RTA) (37.9 %), criminal injuries (10.6 %), industrial-associated (4.5 %) and sports-associated injuries (3.0 %). Prosthetic rehabilitation of the vast majority of patients, which correspond to 56 persons (84.8 %), was performed using different types of fixed prosthetic constructions, such as crowns, bridges supported by natural teeth, or installed dental implants. Majority of patients 84.9-95.5 % demonstrated high indicators of the integrated criterion of quality of life associated with changes in dental health, despite the fact of previous surgical treatment of maxillofacial traumatic lesions. Thus, in the absence of secondary deformities after surgical treatment of maxillofacial traumatic lesions, prosthetic rehabilitation of patients with the use of fixed types of prosthetic constructions supported by natural teeth or installed dental implants helps to achieve high quality of life associated with changes in dental health. The use of complete or partial removable dentures for a similar purpose provokes a relative decrease within the integral criterion of quality of life in the structure of such domains, as physical pain, psychological discomfort and social incapacity, which is due to the peculiarities of removable prosthetic construction exploitation, retention and functioning.

The article presents a literature review on the assessment of defects and medical care, as well as the prevention of defects and conflict situations that arise during the treatment of patients with emergency surgical abdominal pathology. Unfortunately, mortality among urgent surgical patients and diseases of the abdominal organs is in the leading positions among all causes of death, despite the improvement of diagnostic methods, the emergence of new medical equipment and drugs, as well as the developed standards of approaches to the treatment of this category of patients. The paper presents statistics on the incidence of abdominal pathology and the mortality rate among the population of our country. We have studied clinical guidelines and standards for the provision of medical care to patients with acute abdominal pathology and analyzed the work on the assessment of medical care, medical errors, conflicts between the patient and the surgeon, as well as the works describing the individual characteristics of various diseases over the past decades. The article discusses in detail the causes of professional errors and defects in medical care, which include: information and deontological defects, defects in the organization of the treatment process, defects in diagnosis and defects in the treatment itself. Studied in detail the stages of the examination to assess the medical care provided. Examples of the course of the main surgical diseases of the abdominal organs in various groups of patients are described. The possible measures to prevent professional errors in doctors and patients have been studied in detail.

Carolin Hoyer,1 Patrick Stein,1 Anne Ebert,1 Hans-Werner Rausch,1 Simon Nagel,2 Philipp Eisele,1 Angelika Alonso,1 Michael Platten,1 Kristina Szabo1 1Department of Neurology, UniversitätsMedizin Mannheim, Heidelberg University, Mannheim, Germany; 2Department of Neurology, University Hospital, Heidelberg University, Mannheim, GermanyCorrespondence: Carolin HoyerDepartment of Neurology, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, Mannheim 68135, GermanyTel +49-621-383-2885Fax +49-621-383-3807Email carolin.hoyer@umm.deObjective: Referrals to neurology in emergency departments (ED) are continuously increasing, currently representing 15% of all admissions. Existing triage systems were developed for general medical populations and have not been validated for patients with neurological symptoms.Methods: To characterize neurological emergencies, we first retrospectively analyzed symptoms, service times and resources of the cohort of neurological referrals to a German interdisciplinary ED (IED) during 2017 according to urgency determined by final IED diagnosis. In a second step, we performed a retrospective assignment of consecutive patients presenting in April 2017 according to internal guidelines as either acute (requiring diagnostic/therapeutic procedures within 24 hrs) or non-acute neurological conditions as well as a retrospective classification according to the Emergency Severity Index (ESI). Both assessments were compared with the urgency according to the final ER diagnosis.Results: In a 12-month period, 36.4% of 5340 patients were rated as having an urgent neurological condition; this correlated with age, door-to-doctor time, imaging resource use and admission (p < 0.001, respectively). In a subset of 275 patients, 59% were retrospectively triaged as acute according to neurological expertise and 48% according to ESI categories 1 and 2. Neurological triage identified urgency with a significantly higher sensitivity (94.8, p < 0.01) but showed a significantly lower specificity (55.1, p < 0.05) when compared to ESI (80.5 and 65.2, respectively).Conclusion: The ESI may not take specific aspects of neurological emergency (eg, time-sensitivity) sufficiently into account. Refinements of existing systems or supplementation with dedicated neurological triage tools based on neurological expertise and experience may improve the triage of patients with neurological symptoms.Keywords: neurology, emergency

Aim. To assess the complexity of administrative-economic (auxiliary) business-processes in a medical organization based on functional work matrices. Methods. Using the process approach, the composition of auxiliary business-processes of a medical organization was determined and functional matrices were developed. These included the designation of the work (of the components of the process), the frequency, and the performers of the process. The assessment of the complexity of processes and the components (of the work) was carried out using expert methods and a method of functional-cost analysis. Questioning of the members of the working groups on the development of functional matrices of processes was carried out to assess the complexity of each process and its components. The final grade was based on the calculation of the arithmetic mean except for answers that lay outside three standard deviations from the originally calculated arithmetic mean. The work was carried out in the The Clinical Hospital of the Federal Public Health Institution The Medical Sanitary Unit of the Ministry of Internal Affairs of Russia for the city of Moscow, Moscow, Russia, in 20172019. Results. In the course of the research, 30 supporting business-processes were identified. For each auxiliary business-process, a functional matrix of the work was developed with an assessment of its labour intensiveness. This article provides a functional matrix for business-processes for the organization of internal meetings with an assessment of the labour-intensiveness of the work included in the business-processes, and the results of the assessment of the labour-intensiveness of all the identified business-processes (without working out the components of specific works in detail). Conclusion. A methodological processes approach using functional matrices of work and a functional-cost analysis expert method can be used to assess: the labour-intensiveness of a business-process; the appearance of the most labour-intensive areas of the work; the definition of the main directions for their optimisation. The main problem in studying methodological approaches in the daily practical work of medical organisations is their labour-intensiveness.

INTRODUCTION: Plasma kallikrein is a mediator of vascular leakage and inflammation. Activation of plasma kallikrein can induce features of diabetic macular edema (DME) in preclinical models. Human vitreous shows elevated plasma kallikrein levels in patients with DME. Because of the incomplete response of some patients to anti-VEGF agents, and the treatment burden associated with frequent dosing, there is still considerable need for VEGF-independent targeted pathways. AREAS COVERED: This review covers the role of plasma kallikrein in the pathogenesis of DME and the therapeutic potential of plasma kallikrein inhibitors. It discusses early clinical studies of plasma kallikrein pathway modulation for DME, which have been associated with some improvement in visual acuity but with limited improvement in macular edema. This review also highlights KVD001, which is furthest along the development pathway, THR-149, which has recently completed a phase 1 study, and oral agents under development. EXPERT OPINION: Plasma kallikrein inhibitors have a potential role in the treatment of DME, with mixed functional/anatomic results in early clinical trials. Given the large unmet need in DME treatment, further studies are warranted.

Verification tools can produce various kinds of results while checking programs against requirement specifications. Experts, who seek for errors and estimate completeness of verification, mostly appreciate verdicts, violation witnesses and code coverage reports. They need convenient tools for automating the assessment of verification results to apply verification tools in practice when many program configurations and versions are checked against various requirements. In this paper, we propose new methods for expert evaluation of verification results, covering all those problems that are most significant in accordance with our experience in verifying large programs for compliance with a large number of requirements specifications. Some ideas are borrowed from the areas of testing and static analysis. However, specific methods and technical solutions are unique, since the verification results provided by verification tools are either not found in other areas or have special semantics. The paper presents our approaches and their implementation in the Klever software verification framework.

The article is aimed at defining the methodological and practical aspects of conducting an expert assessment of the quality of electrical installation work on the assembly of electrical equipment in companies in the sphere of engineering services in order to improve the quality management systems and activities of enterprises in general. The article proves that modern approaches and methods of quality management at the enterprises in the sphere of engineering services are inextricably linked with the creation of holistic and effective quality management systems in the context of the requirements of the international standard ISO 9001:2015, which are built upon three components: assessment, monitoring and control, the most important among them being the assessment. It is noted that the performance of electrical installation work is one of the business processes in the engineering enterprise of the energy sector, so ensuring the proper quality and meeting the needs and expectations of the customers of the work is a priority for the company’s management. The algorithm for the assembly of electrical equipment has been defined, operational procedures have been developed at each stage of their implementation and in order to effectively assess the quality. An expert assessment of the quality of electrical installation work is carried out using the Ishikawa diagram, the checklist and the Pareto diagram; important information is obtained for the management of an engineering enterprise as to making managerial decisions directed towards improving the quality of work. The feasibility of applying the methodological and practical aspects of the expert assessment of quality concerning any work/services at the enterprises in the sphere of engineering services is substantiated.

Peatlands are impacted by climate and land-use changes, with feedback to warming by acting as either sources or sinks of carbon. Expert elicitation combined with literature review reveals key drivers of change that alter peatland carbon dynamics, with implications for improving models. The carbon balance of peatlands is predicted to shift from a sink to a source this century. However, peatland ecosystems are still omitted from the main Earth system models that are used for future climate change projections, and they are not considered in integrated assessment models that are used in impact and mitigation studies. By using evidence synthesized from the literature and an expert elicitation, we define and quantify the leading drivers of change that have impacted peatland carbon stocks during the Holocene and predict their effect during this century and in the far future. We also identify uncertainties and knowledge gaps in the scientific community and provide insight towards better integration of peatlands into modelling frameworks. Given the importance of the contribution by peatlands to the global carbon cycle, this study shows that peatland science is a critical research area and that we still have a long way to go to fully understand the peatland-carbon-climate nexus.

The results of the analysis of methodical literature are presented and the most informative methods and the optimal order of their implementation for the assessment of special professionally important physiological functions of persons associated with diving are recommended for practical application. The procedure of carrying out and criteria of an estimation of recommended tests is stated: checks of barofunction; estimations of stability to decompression intravascular gas formation; toxic action of oxygen, narcotic action of nitrogen, a functional condition of divers at carrying out hypoxic test. A promising technique for assessing resistance to hypercapnia is recommended. This is undoubtedly important for medical personnel providing medical care to persons working in conditions of high pressure. Th e proposed unification of expert test effects will improve the safety and efficiency of diving and caisson operations, will contribute to the prevention of professionally caused diseases.

STUDY QUESTION: Is there an association between maternal occupational exposure to solvents, pesticides and metals as assessed by expert-based assessment and congenital anomalies in the offspring? SUMMARY ANSWER: There is an association between maternal occupational exposure to solvents and congenital anomalies in the offspring, including neural tube defects, congenital heart defects and orofacial clefts. WHAT IS KNOWN ALREADY: One important environmental risk factor for development of congenital anomalies is maternal occupational exposure to chemicals in the workplace prior to and during pregnancy. A number of studies have assessed the association with often conflicting results, possibly due to different occupational exposure assessing methods. STUDY DESIGN, SIZE, DURATION: For this systematic review with meta-analysis, the search terms included maternal occupation, exposure, congenital anomalies and offspring. Electronic databases MEDLINE and EMBASE were searched for English studies up to October 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS: Two reviewers independently screened all citations identified by the search. Case-control studies and cohort studies were included if (I) they reported on the association between maternal occupational exposure to solvents, pesticides or metals and congenital anomalies, and (II) assessment of occupational exposure was performed by experts. Data on study characteristics, confounders and odds ratios (ORs) were extracted from the included studies for four subgroups of congenital anomalies. Methodological quality was assessed using the Newcastle-Ottawa Scale. In the meta-analysis, random effects models were used to pool estimates. MAIN RESULTS AND THE ROLE OF CHANCE: In total, 2806 titles and abstracts and 176 full text papers were screened. Finally, 28 studies met the selection criteria, and 27 studies could be included in the meta-analysis. Our meta-analysis showed that maternal occupational exposure to solvents was associated with neural tube defects (OR: 1.51, 95%CI: 1.09-2.09) and congenital heart defects (OR: 1.31, 95%CI:1.06-1.63) in the offspring. Also maternal occupational exposure to glycol ethers, a subgroup of solvents, was associated with neural tube defects (OR: 1.93, 95%CI: 1.17-3.18) and orofacial clefts (OR: 1.95, 95%CI: 1.38-2.75) in the offspring. Only one study investigated the association between maternal occupational exposure to solvents and hypospadias and found an association (OR: 3.63, 95%CI: 1.94-7.17). Results of the included studies were consistent. In our meta-analysis, we found no associations between occupational exposure to pesticides or metals and congenital anomalies in the offspring. LIMITATIONS, REASONS FOR CAUTION: A limited number of studies was included, which made it impossible to calculate pooled estimates for all congenital anomalies, analyse individual chemicals or calculate exposure-response relations. Bias could have been introduced because not all included studies corrected for potentially confounding factors. WIDER IMPLICATIONS OF THE FINDINGS: Employers and female employees should be aware of the possible teratogenic effects of solvent exposure at the workplace. Therefore, is it important that clinicians and occupational health specialist provide women with preconception advice on occupational solvent exposure, to reduce the congenital anomaly risk. STUDY FUNDING/COMPETING INTEREST(S): NSp was paid by the Graduate School of Medical Sciences (MD/PhD program), UMCG, Groningen, the Netherlands. EUROCAT Northern Netherlands is funded by the Dutch Ministry of Health, Welfare and Sports. There are no competing interests. REGISTRATION NUMBER: CRD42017053943.

Social entrepreneurship is a paradigm that can be seen as one of the solutions to reduce poverty, migration, depopulation and retention of the working population in Bulgaria.The aim of the article is to analyze the role of management skills and the training needs as a difference between the current and desired state of knowledge, skills and qualifications of business advisors to provide the necessary consulting services to social intermediaries and social enterprises. Professional profiles of social business consultants are presented on the basis of published job requirements in organizations providing business consulting to social enterprises and by some organizations outside the country due to the poor development of these activities at national level.Business advisors usually provide financial and strategic advice to small and mid-sized companies, cooperatives, social enterprises and other formats of company formations.

OBJECTIVE: Computer vision was used to predict expert performance ratings from surgeon hand motions for tying and suturing tasks. SUMMARY BACKGROUND DATA: Existing methods, including the objective structured assessment of technical skills (OSATS) have proven reliable, but do not readily discriminate at the task level. Computer vision may be used for evaluating distinct task performance throughout an operation. METHODS: Open surgeries were videoed and surgeon hands were tracked without using sensors or markers. An expert panel of three attending surgeons rated tying and suturing video clips on continuous scales from 0 to 10 along three task measures adapted from the broader OSATS: motion economy, fluidity of motion, and tissue handling. Empirical models were developed to predict the expert consensus ratings based on the hand kinematic data records. RESULTS: The predicted v. panel ratings for suturing had slopes from 0.73 to 1, and intercepts from 0.36 to 1.54 (Average R(2) = 0.81). Predicted v. panel ratings for tying had slopes from 0.39 to 0.88, and intercepts from 0.79 to 4.36 (Average R(2) = 0.57). The mean square error among predicted and expert ratings were consistently less than the mean squared difference among individual expert ratings and the eventual consensus ratings. CONCLUSIONS: The computer algorithm consistently predicted the panel ratings of individual tasks, and were more objective and reliable than individual assessment by surgical experts.

It is known that it is possible to affect the extent of myocardial damage and, as a result, mortality only in the first hours of its development. Therapeutic tactics in ACS with elevation of the ST segment involves the restoration of coronary blood flow, the main method is the reperfusion of the coronary artery by systemic thrombolysis or PCI in a specialized hospital. The effectiveness of treatment is inversely related to the time spent. The aimof the study was to examine the opinion of specialists on the feasibility of implementing the items of the protocol of emergency medical care for patients with ACS at the place of call. Materials and methods.During the study the method of expert evaluations, which consisted of gathering information by interviewing experts and summarizing the individual opinions of experts into a general concept was used. The experts were 48 emergency physicians. The method of expert evaluation included the following stages: development of the questionnaire; survey of experts; summary of examination materials; calculation of statistical indicators; interpretation of the obtained results and formulation of conclusions. Results. In order to assess the actions of the emergency team, depending on the need to conduct them for diagnosis and emergency care for patients with ACS at the scene, we calculated the feasibility indexes for each item of the protocol. In the future, we divided the treatment and diagnostic measures for ACS with ST segment elevation according to the level of expediency at the scene into four groups (n): n1– high level, n2– sufficient level and n3– low level and n4– very low level. According to the results of the ranking, the scope of measures to be implemented by the head of the emergency team at the ACS with elevation of the ST segment on arrival on call, as well as measures that, according to interviewed experts, are not required at this stage and can be carried out during transportation of the patient to a specialized hospital. Conclusions.Based on the results of the calculation of feasibility indices and subsequent ranking of treatment and diagnostic measures for the relevant groups (n1, n2, n3, n4) from 37 items of the study, to assist patients with ACS with ST segment elevation at the scene, it is recommended to perform 16

The paper aims to examine the problem of integration of the opinions of a group of experts regarding a certain probabilistic distribution for the purpose of its evaluation by an analyst. It is implied that the decision-maker will use the result to evaluate the target risks and take according decisions. This problem may arise in many areas of risk analysis. For the purpose of this paper, the stability of various structures (buildings, railways, highways, etc.) against external mechanical effects, e.g. earthquakes, is chosen as the application object domain. As the primary research tool it is suggested to use the probabilistic method of decision-making risk calculation associated with involving experts into the analysis of risk of roadbed and other structures destruction in case of earthquakes. The evaluation of the seismic stability of rail structures using expert opinions is based on the Bayesian approach. The proposed method of estimation by analyst of the probabilistic distribution (fragility curve) on the basis of the opinions of a group of experts allows, using the obtained results, formalizing and explicitly expressing the latent risk of expert assessment. The procedure developed subject to a number of limitations allowed obtaining an explicit expression for the latent risk of expert assessment. The theoretical constructs presented in this paper can be easily implemented as software that will enable interactive input of parameters and data of the model under consideration and obtaining the desired distribution and the value of “risk in risk”. Such system, on the one hand, will allow verifying some intuitive assumptions regarding the behavior of results depending on the variation of parameters, and on the other hand, will be able to be used as the tool of expert assessment automation and analysis of its quality that helps making grounded decisions under risk. Further development of the proposed method may involve the elimination of the dependence of the value of “risk in risk” from the expert assessment. Implicitly, this dependence is present in the final expression, while ideally this risk is to be determined only by the expert ratings. The proposed approach can serve as the foundation of some practical optimization problems, e.g. the selection of the best group of involved experts from the point of view of minimization of this share of risk in cases of restricted funding of expert assessment (obviously, the higher the expert’s competence, the more accurate his/her estimates are and, subsequently, the lower is the risk, yet the higher is the cost of such expert’s participation). An associated problem can be considered as well. It consists in the optimal selection of experts for the purpose of minimization of assessment costs under the specified maximum allowable level of “risk in risk”. As a whole, the proposed method of evaluation of an unknown distribution and calculation of risk is sufficiently universal and can be used in the context of mechanical stability of structures, but also a wide class of problems that involve the assessment of a certain probabilistic distribution on the basis of subjective data about it.

Forensic examination of a gunshot injury is the most difficult problem of domestic and foreign forensic medicine. A large amount of knowledge and practical observations on damage from standard samples of handguns has been accumulated. The emergence of new unique samples of special-purpose weapons requires forensic physicians and forensic experts to conduct a complex of morphological, spectral, forensic chemical, medico-forensic, radiological and other special laboratory studies of damage caused by such weapons. The article presents a case of forensic medical examination commission with the issue solution of differential diagnosis of causing a mortal fire wound injuries by a specific sample of special-purpose handgun.Судебно-медицинская экспертиза огнестрельной травмы является наиболее сложной проблемой отечественной и зарубежной судебной медицины. Накоплен большой объем знаний и практических наблюдений о повреждениях из штатных образцов ручного огнестрельного оружия. Появление новых уникальных образцов оружия специального назначения требует от судебных медиков и криминалистов проведения комплекса морфологических, спектральных, судебно-химических, медико-криминалистических, радиологических и других специальных лабораторных исследований повреждений, причиненных таким оружием. Представлен случай выполнения комиссионной судебно-медицинской экспертизы с решением вопроса дифференциальной диагностики причинения смертельного огнестрельного ранения конкретным образцом ручного огнестрельного оружия специального назначения.

As a result of the analysis, we have demonstrated that the implementation of the main provisions of the Istanbul Protocol in Ukraine is at a sufficiently high level, is a national strategy for the protection of human rights, however, the question remains regarding the implementation of certain provisions in the prevention of torture and ill-treatment. The main standards of the regulatory framework of Ukraine comply with the Istanbul Convention. Today in Ukraine, there are still cases of violations of Article 3 of the Convention for the Protection of Human Rights and Fundamental Freedoms on Human Rights, including those concerning the unsatisfactory state of fixing bodily injuries, refusal to provide adequate medical care and inadequate provision of medical care to persons in places of detention. Therefore, an important aspect is to ensure the organization of timely and adequate provision of medical care to persons in places of detention. At the same time, it is necessary to conduct a detailed record of maintaining medical records on the prisoner’s state of health, fixing the existing injuries, the timeliness and correctness of the diagnostic and treatment methods that the prisoner received while in custody, indicating which types of diagnostics and treatment were prescribed for the detainees and which ones he actually received, where/when/by whom were carried out, etc. To establish the fact of presence/absence, mechanism and prescription of occurrence, severity of injuries, proper/inappropriate provision of medical assistance to persons in places of detention, when providing legal assistance, it is necessary to prescribe forensic medical examinations. Timely identification of cases of violations of Article 3 of the Convention for the Protection of Human Rights and Fundamental Freedoms of Human Rights, with subsequent response, plays an important role in the development of a system of measures to prevent, promote and prevent torture and ill-treatment in places of detention.

The article highlights the issues of establishing cause-and-effect relationships in cases of death and injury to human health in the provision of medical care. The theoretical foundations and practical problems of determining the severity of harm to the patient's health in severe infectious diseases and the development of complications caused by surgical infection are considered. The article presents a brief description of the main provisions of the legislation and methods of forensic medical expert assessment of infectious processes in the patient's body associated with both the disease and the consequences of medical interventions, including improper medical care. It is noted that the fact of occurrence of infectious complications cannot be regarded as harm to the patient's health in the absence of data confirming the presence of a direct cause-and-effect relationship between the admitted defects (shortcomings) of medical care and the adverse outcome of the disease or injury. An example from practice is given and a rare case of a combination of botulism with a brain infarction is analyzed. Simultaneous ischemic and toxic damage to the nervous system caused difficulties both in the clinical diagnosis during the patient's lifetime and in the process of expert evaluation of the medical care after his death. The authors of the article come to the conclusion that the procedure for establishing causal relationships and the severity of harm to human health caused during medical care needs to be further improved from the standpoint of legislation and methods of conducting forensic medical examination. Special attention should be paid to fatal cases of nosocomial infection, as well as infectious complications of surgical interventions. Determining the severity of a patient's health injury should be based on an analysis of the causal relationship between deficiencies in medical care and an adverse outcome.

This article explores the principles of synsets in the RuWordNet thesaurus and synonyms in the classical dictionaries of Russian synonyms (N = 10) to identify discrepancies and improve the principles of organising synsets in RuWordNet. The relevance of the study is determined by the demand for WordNet resources in natural language processing tasks. The authors selected 102 RuWordNet thesaurus synsets, including nouns (N = 34), adjectives (N = 34) and verbs (N = 34). The meanings of the lexemes were correlated according to the data given in Russian language thesauri (N = 2). The comparative method and an independent expert assessment of RuWordNet revealed a number of discrepancies and inaccuracies in the representation of synsets concerning polysemy, hypo-hyperonymic relationships, lexical meanings of words and parts-of-speech synonymy. On the basis of this study, the authors recommend the elimination of individual shortcomings in the construction of the RuWord-Net synsets, in particular the polysemy and parts-of-speech synonymy.

The present article deals with two key drivers of social acceptance of wind energy: procedural justice and distributional justice. It is based on a comparative expert assessment carried out in the frame of the Horizon 2020 project WinWind covering six European countries. The focus of the paper is on procedural and financial participation of citizens and local stakeholders in wind energy projects. The first part covers institutional arrangements for public engagement in two areas of the decision-making process—wind turbine zoning/siting in spatial plans and authorization procedures. Here, three levels of public involvement—information, consultation and participation—were analyzed. The second part examines active and financial participation of citizens and local stakeholders. Here, we distinguish between two different modes of governance: institutionalized forms of public governance and voluntary forms of corporate governance. The outcomes suggest that concrete paths to the social acceptance of wind energy are fostered via appropriate institutional spaces for public engagement. Furthermore, missing opportunities for active and passive financial participation can have strong negative consequences for community acceptance

The quality management systems compliant with the ISO 9001:2009 have been thoroughly researched and described in detail in the world literature. The accredited management systems used in the testing laboratories and compliant with the ISO/IEC 17025:2005 have been mainly described in terms of the system design and implementation. They have also been investigated from the analytical point of view. Unfortunately, a low number of studies concerned the management system functioning in the accredited testing laboratories. The aim of following study was to assess the management system functioning in the accredited testing laboratories in Poland. On 8 October 2015, 1,213 accredited testing laboratories were present in Poland. They investigated various scientific areas and substances/objects. There are more and more such laboratories that have various problems and different long-term experience when it comes to the implementation, maintenance and improvement of the management systems. The article describes the results of the conducted expert assessment (survey) carried out to examine the conditions for the functioning of a management system in an accredited laboratory. It also focuses on the characteristics of the accredited research laboratories in Poland. The authors discuss the selection of the external and internal conditions that may affect the accredited management system. They show how the experts assessing the selected conditions were chosen. The survey results are also presented.

The purpose of the study is to identify typical problems in medical treatment of patients with bronchial asthma and to assess how it effects the future course of the disease. Experts in «general medical practice», «pulmonology», «therapy» conducted an examination. On the basis of the expert examinations, typical problems in medical treatments have been identified and classified. The most significant violations affecting the course of the disease and the formation of adverse outcomes in bronchial asthma have been identified. The results of the study can be used to develop a methodology for assessing the quality of medical care and predicting the future course of the disease in patients with bronchial asthma.

Objective To evaluate the usefulness of a Doppler technology highly sensitive for low-velocity flow in the antenatal imaging of the torcular herophili (TH) in the second trimester of pregnancy. Design Prospective study. Setting Referral Fetal Medicine Unit. Population Non-consecutive series of singleton pregnancies submitted to antenatal neurosonogram between 20 and 28 weeks of gestation. Methods A midsagittal section of the fetal brain was obtained by insonating through the anterior fontanelle, then the MV-Flow™ and LumiFlow™ presets were selected to visualise the TH as the posterior confluence of the superior sagittal sinus and the straight sinus. Main outcome measures Evaluation of the anatomic relationship of the TH with the 'transpalatal line' joining the upper bony palate to the fetal skull. Results A total of 99 pregnant women were recruited, including one fetus with open spina bifida, one with Dandy-Walker malformation (DWM) and two with Blake's pouch cysts. In normal fetuses, the TH appeared to lie on or just below the 'transpalatal line'. In the cases of Blake's pouch cyst, the position of the TH appeared normal if compared with controls, whereas in DWM a supra-elevated position of the TH in respect of the transpalatal line was demonstrated. Finally, in the fetus with Chiari II malformation the TH was identified below the 'transpalatal plane'. Conclusions Prenatal ultrasound visualisation of the TH by means of newly developed Doppler technologies characterised by high sensitivity for low-velocity flow is feasible and allows the indirect evaluation of the insertion of cerebellar tentorium in the second trimester. Tweetable abstract Prenatal imaging of the torcular herophili using a Doppler technology highly sensitive for low-velocity flow.

Risk assessment models (RAMs) for venous thromboembolism (VTE) and bleeding in hospitalized medical patients inform appropriate use of thromboprophylaxis. Our aim was to use a novel approach for selecting risk factors for VTE and bleeding to be included in RAMs. First, we used the results of a systematic review of all candidate factors. Second, we used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of the evidence for the identified factors. Third, we using a structured approach to select factors to develop the RAMs, by building on clinical and methodological expertise. The expert panel made judgments on whether to include, potentially include, or exclude risk factors, according to domains of the GRADE approach and the Delphi method. The VTE RAM included age >60 years, previous VTE, acute infections, immobility, acute paresis, active malignancy, critical illness, and known thrombophilia. The bleeding RAM included age ≥65 years, renal failure, thrombocytopenia, active gastroduodenal ulcers, hepatic disease, recent bleeding, and critical illness. We identified acute infection as a factor that was not considered in widely used RAMs. Also, we identified factors that require further research to confirm or refute their importance in a VTE RAM (eg, D-dimer). We excluded autoimmune disease which is included in the IMPROVE (International Medical Prevention Registry on Venous Thromboembolism) bleeding RAM. Our results also suggest that sex, malignancy, and use of central venous catheters (factors in the IMPROVE bleeding RAM) require further research. In conclusion, our study presents a novel approach to systematically identifying and assessing risk factors to be included or further explored during RAM development.

The paper presents a protocol of medical record review used for control of adequate medical history taking, diagnostics, care and rehabilitation thus improving the quality of dental care in patients undergoing oral surgery procedures.

On the basis of the existing methods of creation process of innovation projects there were defined the basic directions by innovation project management in technology park. Also, scientific problems of subject area and option of the projects were chosen. Depending on the defined scientific problems in the paper, the process of innovative project management in the departments of the technology park in higher educational schools of Azerbaijan was considered. On the basis of the prior scientific directions and scientific profiles of scientific technology park in Sumgait State University (SSU) solutions of problem of innovative project management have been defined. The algorithm for executing all procedures of innovative project management on the stages of its creation, experiments, manufacture and business was worked out. By means of this algorithm, the block-scheme of management functions and their programming by establishment of new innovation project in the technology park beginning from the registration till assessment of the project were developed.

Modern methods and means for conducting a group expert assessment are researched. The improved method of group expert assessment, which takes into account the competence of the experts involved on the basis of previously established criteria is proposed. This is important, since for the purpose of obtaining reliable estimates by a group expert assessment, it is first of all necessary to correctly approach the selection of both the method and the experts involved in the study. The improved software tools on the basis of the developed method are proposed. They are based on the integration of the element of competence assessment of the experts involved into the software tools, has no restrictions on the number of experts and the number of questions (factors) that need to be analyzed, and also allows, if necessary, adjusting the applied evaluation criteria. This contributes to the improvement of the accuracy and reliability of the results of group expert assessment, as well as the elimination of errors in calculating the results. An estimation of the state of metrological assurance for different types of measurements (by the improved method) is carried out. The analysis of the state of metrological assurance for all types of measurements has shown that 34 % of the sub-questions are prioritized for further detailed analysis, and 66 % do not have a priority or any significance at all for their further analysis. An examination of the consistency of the expert estimates obtained using the Kendall’s coefficient of concordance and the Pearson’s chi-squared test is carried out

Methodology for visualization of software quality expert assessment by different criteria with radar charts using has been elaborated. Under visualization of software quality expert assessment means showing of information in the graphical view for maximal usability and understanding. The algorithm for calculation of sectoral polygons area in the polar coordinate system has been elaborated, with using of its relative software quality by corresponding criteria can be calculated and assessed. Diagram's sectoral areas help to define part of software quality by whole criteria according to one expert at the moment and part of software quality which should be achieved for completeness. Summarized software quality indicators for each expert and general quality indicator were defined.

This paper discusses the method of expert assessment based on the probabilistic approach of the paired comparisons method. This mathematical apparatus is the basis for special software integrated into the universal stand for prototyping the cockpit, which allows for a systematic expert assessment at this stand according to pre-selected criteria with the control of the consistency of the answers. Using this method, the task of determining the feasibility of displaying layers of synthetic and enhanced vision on the flying frame is solved, but in general, the method allows evaluating any elements of the displays and controls.

One of the most complex forensic examinations is the determination of the correct medical care. The aim of the study was an analysis of medical records of patients in the cases of divergence of clinical and forensic diagnoses on the main complications and to identify the main causes of incorrect diagnosis established in a hospital of ambulance medical care for the 2006- 2012. Expert assessment of mortality General Hospital was carried out after statistical data processing, including a more detailed study of patient care. In particular, stood out the reasons of incorrectly clinical diagnosis, cases of discrepancy of the main clinical diagnosis with forensic diagnosis were compared in cases of injury, disease or poisoning. After that evaluated medical care, including medical treatment, which was prescribed by a doctor. These data were compared with those which medical aid was really necessary in patients with considering the immediate cause of death.