Sciences of Europe journal No 138 (2024)

No 138 (2024)
Sciences of Europe
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CONTENT
ECONOMIC SCIENCES
Akylbekova N., Ermekova A., Esenkulova Zh.,
Konokbai kyzy Zh., Eralkanova A.
DIGITIZATION AS A PLATFORM FOR THE
DEVELOPMENT OF THE VOCATIONAL EDUCATION
SYSTEM IN THE KYRGYZ REPUBLIC..............................3
Kostoreva A.
CHALLENGES IN THE ADVERTISING MARKET
FOLLOWING META'S DEPARTURE FROM RUSSIA......10
Zakharau A.
THE IMPACT OF FINTECH APPLICATION
IMPLEMENTATION ON IMPROVING CONSUMER
CREDIT RATINGS........................................................14
MEDICAL SCIENCES
Chonov V., Bivolarski I., Chonova E.,
Ermov D., Vangelov N., Stanchev D.
RECURRENT UNDIFFERENTIATED PLEOMORPHIC
SARCOMA..................................................................17
Rakhmetov Zh.
THE QUESTION ABOUT THE INFLUENCE OF
CHEMOTHERAPY DURING PREGNANCY ON THE
DEVELOPMENT OF CONGENITAL DISEASES IN A CHILD
..................................................................................21
Temirova V., Temirov N., Karataeva U.,
Dzhusupova A., Nurmukhammatova Kh.
EVALUATION OF THE WORK OF THE TESTING AND
VACCINATION POINT AGAINST PARENTAL VIRAL
HEPATITIS, IN FGP No. 4 FMC OF JALAL-ABAD CITY,
KYRGYZ REPUBLIC, AT THE RESULTS OF 2023 ...........24
PEDAGOGICAL SCIENCES
Tagiyeva E.
AUDIOVISUAL TECHNOLOGY FOR TRAINING BUSINESS
AND ACADEMIC COMMUNICATION IN RUSSIAN
LANGUAGE ON THE TOPIC “SPORTS COMMENTATOR”
..................................................................................28
PHILOLOGICAL SCIENCES
Ashrafova I.
TEACHING ENGLISH TO ECONOMY AND FINANCE
MAJORS AT NAKHCHIVAN STATE UNIVERSITY..........40
Kauza I., Kardashuk A.
CHARACTERISTICS OF LINGUISTIC EXPRESSIVE MEANS
IN MATT HAIG'S WORK "HOW TO STOP TIME"........47
PHYSICS AND MATHEMATICS
Vyshinsky V.
GENERAL THEORY OF PHYSICAL FIELD......................50
SOCIAL SCIENCES
Khomenko I., Fomenko V., Yelisovenko Y.,
Nabrusko V., Demchenko O.
VOICE AND TEXT: THE REVIVAL OF THE FORM OF
DIALOGICAL TREATISE AT A NEW CREATIVE AND
TECHNOLOGICAL LEVEL ............................................57
TECHNICAL SCIENCES
Mamatov N., Niyozmatova N., Erejepov K.,
Narzullayev I. Tojiboyeva Sh., Najmiddinov A.
ALGORITHMS FOR IMPROVING THE QUALITY OF
FACIAL IMAGES .........................................................64
Jabbarova K., Huseynov N.
SOLVING THE BEST PROJECT SELECTION PROBLEM BY
USING FUZZY MULTI-CRITERIA DECISION MAKING
METHOD....................................................................73
Konanets R., Stepova K.
KINETICS OF COPPER IONS ADSORPTION FROM
WASTEWATER BY NATURAL SORBENTS....................76

Sciences of Europe # 138, (2024) 3
ECONOMIC SCIENCES
DIGITIZATION AS A PLATFORM FOR THE DEVELOPMENT OF THE VOCATIONAL
EDUCATION SYSTEM IN THE KYRGYZ REPUBLIC
Akylbekova N.,
Kyrgyz National University named after Jusup Balasagyn,
Bishkek, the Kyrgyz Republic
Ermekova A.,
Esenkulova Zh.,
Konokbai kyzy Zh.,
Eralkanova A.
DOI: 10.5281/zenodo.10957267
ABSTRACT
The article examines trends in the development of the education sector of the Kyrgyz Republic in the context
of digitalization. The purpose of the study is a comprehensive analysis of the dynamics of development indicators
of vocational education organizations at both the secondary and higher levels and the state of digitalization of the
educational sector. Digitalization of vocational education is becoming part of the state strategy for the development
of the education sector and the economy as a whole. Digital technologies contribute to the creation of virtual
educational platforms for distance education and use throughout the educational process to improve the quality of
educational services.
Keywords: educational organizations of secondary vocational education, digitalization, educational organi-
zations of higher vocational education, number of students, number of personal computers in organizations of
higher and secondary vocational education.
Introduction
The education sector is the dominant factor in the
formation of human capital as a set of physical, intel-
lectual and spiritual components of the population of
any country. The formation of human capital in terms
of acquiring knowledge, skills, and necessary compe-
tencies for participation in social production is ensured
by the education sector. In the context of globalization
and involvement in world economic relations, it is nec-
essary to correspond to the level of development of hu-
man capital in developed countries to ensure the com-
petitiveness of the national economy [1]. The rapid de-
velopment of new technologies and the generation of
new knowledge in the global space requires mastering
them in order to be involved in the global economy and
create partnership economic relations. The education
sector acts as a platform for interaction of all stakehold-
ers to acquire the skills, knowledge, and competencies
necessary to participate in social production and pro-
vide benefits to society. Highly skilled human capital
becomes the driving force of innovation and economic
development. Education, regardless of age, helps peo-
ple adapt to rapidly changing conditions in technology
and labor market requirements, achieve professional
heights and build a career trajectory in accordance with
their capabilities and life goals. Based on the above, we
conclude that the role of education in the national econ-
omy and increasing its competitiveness is high and un-
deniable. In addition, the education sector is a driver for
the development of other industries. Therefore, an anal-
ysis of the education development system is necessary
to identify problems and determine priority directions
for its development [3].
Digitalization as a trend that has covered all as-
pects of human life almost all over the world has turned
out to be a key factor in improving communications be-
tween participants in the educational process and creat-
ing new teaching methods. The Kyrgyz Republic also
strives to achieve complete digitalization of the educa-
tional sector to improve the quality of educational ser-
vices and the competitiveness of the national education
system [2].
During the research process, quantitative methods
were used to analyze statistical information on indica-
tors of the development of vocational education organ-
izations at both the secondary and higher levels and the
state of digitalization of the educational sector, which
made it possible to assess trends in its development. To
analyze statistical information, statistical research
methods were used, such as constructing a grouping of
statistical data, constructing time series, graphical
methods for presenting time series and their analysis
[4].
Results
During 2018-2022, the number of educational or-
ganizations of secondary vocational education of state
ownership decreased by 16 units and in 2022 amounted

4 Sciences of Europe # 138, (2024)
to 98 units [7]. On the contrary, the number of educa-
tional institutions of higher professional education of
state ownership increased by 9 units (Figure 1).
Figure 1. Dynamics of the number of educational organizations
of state ownership in the Kyrgyz Republic for 2018-2022, units
Source: compiled according to data from the National Statistics Committee of the Kyrgyz Republic [7]
During 2018-2022, the number of educational or-
ganizations of secondary vocational education of pri-
vate ownership increased by 10 units and in 2022
amounted to 98 units [7]. The number of educational
institutions of higher professional education of private
ownership changed slightly, increasing by 1 unit (Fig-
ure 2).
Figure 2. Dynamics of the number of educational organizations
of private ownership in the Kyrgyz Republic for 2018-2022, units
Analysis of the dynamics of the number of stu-
dents in state educational institutions of secondary vo-
cational education in the Kyrgyz Republic for 2018-
2022 allowed us to determine an increase of 13.7%. So,
in 2022 it amounted to 90,204 people versus 79,364
people in 2018 [7].
An analysis of the dynamics of the number of stu-
dents in state educational organizations of higher pro-
fessional education in the Kyrgyz Republic for 2018-
114
112
105
105
98
34
38
40
42
43
0 20 40 60 80 100 120 140 160
2018
2019
2020
2021
2022
Educational organizations of secondary vocational education
Educational organizations of higher professional education
34
32
33
36
44
17
17
17
18
18
0 10 20 30 40 50 60 70
2018
2019
2020
2021
2022
Educational organizations of secondary vocational education
Educational organizations of higher professional education

2022 revealed an increase of 38.4%. Thus, in 2022 it
amounted to 195,522 people versus 141,223 people in
2018 [7] (Figure 3).
Figure 3. Dynamics of the number of students in state educational organizations of secondary and higher
vocational education in the Kyrgyz Republic for 2018-2022, people
dents in private educational institutions of secondary
vocational education in the Kyrgyz Republic for 2018-
2022 allowed us to determine a significant increase of
47.7% in contrast to the increase in the number of stu-
dents in state educational organizations. So, in 2022 it
2018 [7].
dents in private educational institutions of higher pro-
fessional education in the Kyrgyz Republic for 2018-
2022 revealed an increase of 37.2%. Thus, in 2022 it
2018 [7] (Figure 4).
79 364
79 146
83 310
84 668
90 204
141 223
159 573
185 202
199 614
195 522
0 50 000 100 000 150 000 200 000 250 000 300 000 350 000
2018
2019
2020
2021
2022
Number of students in state educational institutions of secondary vocational
education in the Kyrgyz Republic
Number of students in state educational organizations of higher professional

Figure 4. Dynamics of the number of students in private educational institutions of secondary and higher
vocational education in the Kyrgyz Republic for 2018-2022, people
Digitalization of professional education improves
the quality of educational services, contributes to the
development of relevant competencies among students
and depends largely on the technical equipment of the
educational process [9].
An analysis of the dynamics for 2018-2022 of the
number of personal computers in organizations of
higher professional education of the Kyrgyz Republic
used for educational purposes showed an increase of
91.2%. Thus, in 2022 it amounted to 31,006 units ver-
sus 16,219 units in 2018 [7].
In turn, an analysis of the dynamics for 2018-2022
of the number of personal computers in secondary vo-
cational education organizations of the Kyrgyz Repub-
lic used for educational purposes showed an increase of
26.6%. So, in 2022 it amounted to 7936 units versus
6269 units in 2018 [7] (Figure 5).
12 171
12 385
12 290
13 398
17 982
23 362
24 205
28 955
30 592
32 060
0 10 000 20 000 30 000 40 000 50 000 60 000
2018
2019
2020
2021
2022
Number of students in private educational institutions of secondary vocational
Number of students in private educational organizations of higher professional

Figure 5. Dynamics of the number of personal computers in organizations of higher and secondary vocational
education of the Kyrgyz Republic, used for educational purposes for 2018-2022, units
This positive trend reflects the management’s at-
tention to improving the quality of educational services
and the desire to bring the level of graduates’ training
into line with the requirements of employers and the la-
bor market. This trend is confirmed by such relative in-
dicators as the number of personal computers used for
educational purposes per organization and per 1000
students.
If we present a statistical series of indicators for
2018-2022, we can state that in organizations of higher
professional education of the Kyrgyz Republic, the
number of personal computers used for educational
purposes per organization increased by 190 units or by
59.7%, while the number personal computers used for
educational purposes per 1000 students increased by 86
units or 60.6% [7] (Figure 6).
Figure 6. Dynamics of the number of personal computers used for educational purposes in organizations of
higher professional education of the Kyrgyz Republic, units
Similarly, let’s analyze the number of personal
computers in organizations of secondary vocational ed-
ucation of the Kyrgyz Republic, used for educational
purposes per organization, it can be noted that in 2018-
2022, which did not increase so significantly, by only
14 units or 33.3 % [7] (Figure 7).
16 219
33 320
22 792
24 158
31 006
6 269
6 801
6 578
7 217
7 936
0 10 000 20 000 30 000 40 000 50 000
2018/2019
2019/2020
2020/2021
2021/2022
2022/2023
Number of personal computers in higher education institutions used for
educational purposes
Number of personal computers in secondary vocational education organizations
used for educational purposes
318
606
400
403
508
142
266
161
171
228
0 200 400 600 800 1000
2018/2019
2019/2020
2020/2021
2021/2022
2022/2023
per organization per 1000 students

Figure 7. Dynamics of the number of personal computers used for educational purposes in organizations of
higher professional education of the Kyrgyz Republic, units
While the number of personal computers used for
educational purposes per 1000 students increased by 17
units or 20.7% [7].
Conclusion
The development of the education sector of the
Kyrgyz Republic is an integration process into the
global educational space. Involving foreign partners in
the creation of joint educational programs, participation
in international educational projects, trainings, courses
contributed to joining the Bologna process and adapta-
tion in the structure and content of the main educational
programs of bachelor’s, master’s, and PhD programs.
Digitalization of vocational education is becoming
part of the state strategy for the development of the ed-
ucation sector and the economy as a whole. Digital
technologies contribute to the creation of virtual educa-
tional platforms for distance education, which is be-
coming relevant and in demand. In addition, conduct-
ing online lectures and courses increases accessibility
and provides time flexibility in learning [8].
Accessing the Internet and using the latest infor-
mation and communication technologies allows you to
find partners abroad. In addition, the increase in the
number of educational organizations in the Kyrgyz Re-
public is a prerequisite for the recognition of educa-
tional programs in other countries. This factor allowed
educational organizations of the Kyrgyz Republic to
enter the international educational market and attract
foreign students [6]. This is a trend in the development
of educational organizations, increasing the motivation
of teachers to improve their professional level, includ-
ing language training. English as a language of interna-
tional communication has become a key point for the
development of educational programs for foreigners.
The quality of specialist training has increased and was
supported by positive feedback from graduates and em-
ployers of graduates, which will further serve as adver-
tising and a means of promoting educational services
abroad [5].
Thus, the development of education based on the
digitalization of management processes of educational
organizations, the processes of interaction of all sub-
jects of educational services is a factor in the innovative
development of the economy, increasing its economic
growth, reducing labor migration, increasing the stand-
ard of living of the population, and overcoming poverty
of the population.
References
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23-31.

CHALLENGES IN THE ADVERTISING MARKET FOLLOWING META'S DEPARTURE FROM
RUSSIA
Kostoreva A.
master, University of Georgia School of Law
USA
DOI: 10.5281/zenodo.10957274
ABSTRACT
This article examines the challenges in the advertising market following Meta's departure from Russia. It
highlights the significant shifts in company strategies, the transition to alternative platforms, and their impact on
audience engagement. The adaptations of content and new challenges for marketers are discussed, along with the
socio-economic consequences of these changes on the Russian market.
Keywords: advertising market, Meta departure, Russia, alternative platforms, content adaptation, socio-eco-
nomic impact, marketing strategies.
Introduction
Internet advertising serves as a crucial tool for
reaching a wide audience, increasing brand recognition,
and promoting products or services among consumers.
In the context of growing dependence on digital tech-
nologies and platforms, the departure of a major player
such as Meta represents a significant event capable of
radically altering the landscape of the advertising mar-
ket.
The aim of this research is to analyze the chal-
lenges faced by advertising campaigns in connection
with Meta's departure from Russia, as well as to explore
alternative solutions for internet marketing. This in-
cludes examining how companies have adapted their
advertising strategies to overcome new challenges and
assessing the impact of these changes on the overall
Russian advertising market.
Main part
Meta Platforms, Inc., formerly known as Face-
book Inc., stands as a pivotal entity within the digital
landscape, orchestrating a suite of social networking
sites and technological innovations that have redefined
global communication, media distribution, and adver-
tising strategies. The company’s platforms, including
Facebook, Instagram, WhatsApp, and Messenger, have
collectively amassed billions of active users, cementing
Meta's role in the realm of internet advertising by offer-
ing unparalleled access to diverse and extensive audi-
ences worldwide. Meta's annual advertising revenue
increases annually (fig.1).
Figure 1. Annual advertising revenue of Meta Platforms worldwide, 2018-2023, million dollars [1]
The sustained growth can be attributed to a variety
of factors, including the expanding digital economy,
the efficacy of targeted advertising algorithms, and the
broadening user base that engages with Meta's plat-
forms. As of the end of 2020, that is, before leaving
Russia, Meta's revenue in Russia amounted to 39.9 bil-
lion rubles, while the total volume of the Russian inter-
net advertising market was 323 billion rubles [2].
The role of Meta social networks in the Russian
advertising space before leaving
Meta's platforms, particularly Facebook and Insta-
gram, were instrumental for Russian businesses in
achieving extensive reach, engaging with target audi-
ences, and conducting effective digital marketing cam-
paigns [3]. These platforms offered advanced targeting
capabilities, allowing advertisers to tailor their mes-
sages to specific demographic, geographic, and psycho-
graphic profiles, thereby optimizing campaign perfor-
mance and return on investment (ROI).
Meta's platforms were lauded for their innovative
advertising solutions, including dynamic ads, video
ads, and stories ads, which provided businesses with
creative and interactive ways to showcase their prod-
ucts and services. These features were not only effec-
tive in capturing user attention but also in driving
higher engagement rates and conversions.
According to Brand Analytics, Instagram ranked
first in Russia in terms of active audience size in Octo-
ber 2021 (fig. 2), which had a direct impact on the in-
ternet advertising market [4].

Figure 2. Number of authors per month in 2021, in millions of people [4]
The departure of Meta from Russia has left a no-
ticeable void in the digital advertising space, challeng-
ing businesses to find alternative platforms that offer
comparable reach and sophistication in targeting and ad
formats. This transition necessitates a strategic realign-
ment, as companies are compelled to explore new dig-
ital landscapes and adapt their marketing strategies to
maintain visibility and engagement with their target au-
diences.
The legal foundation for Meta's prohibition in
Russia can be traced back to the country's stringent in-
ternet laws. A pivotal piece of legislation in this context
is the law on «Information, Information Technologies,
and Information Protection» [5].
This legislative framework set the stage for Meta's
platforms to come under scrutiny, culminating in their
designation as «extremist organizations» by Russian
courts. The legal proceedings argued that Meta's failure
to comply with requests to remove content considered
as promoting extremism and violating national laws
was a direct violation of the Russian internet regulation
laws [6]. Consequently, this led to the prohibition of
Meta's operations within the country, marking a signif-
icant shift in the digital and social media landscape in
Russia.
The impact of Meta's departure on advertisers
and brands
Meta's withdrawal from the Russian market has
forced advertisers and brands to critically review their
brand promotion efforts. This withdrawal has left a sig-
nificant void in the ecosystem, as Meta's platforms, par-
ticularly Facebook and Instagram, were previously in-
strumental for Russian businesses in terms of audience
engagement and ad personalization capabilities [7].
The departure of Meta from the Russian market
has necessitated a significant shift in digital advertising
strategies among Russian companies. This transition is
characterized by a move away from global platforms
like Facebook and Instagram to more localized and al-
ternative digital channels. The following table provides
a comparative overview of the advertising landscape
before and after Meta's exit.
Table 1.
Advertising strategies of Russian companies before and after Meta's exit from the market
Aspect Pre-Meta exit Post-Meta exit
Primary advertising
platforms
Instagram, Facebook.
VKontakte (VK), Telegram, Yan-
dex.Direct
Targeting capabilities
Advanced demographic and interest-based
targeting
Diversified targeting including geolo-
cation and behavioral insights
Engagement
strategies
Influencer collaborations, stories ads, car-
ousel ads
Influencer marketing, native VK ads,
Video content
Audience reaches Global and diverse More localize and niche-focused
Measurement and
analytics
Comprehensive insights on user engage-
ment and conversion metrics [8]
Adapted analytics with a focus on local
user behavior patterns
Outcomes High engagement and conversion rates
Maintaining or improving engagement
through localized strategies
After Metal left the Russian market, advertisers
were forced to restructure their digital marketing to-
wards alternative platforms aimed at local audiences. In
this reshaped digital advertising landscape, VKontakte
(VK) and Telegram have emerged as the primary plat-
forms for advertisers seeking to maintain their reach
and engagement with Russian consumers (fig.3).

Figure 3. The number of people over the age of 12 who visited the site or the application at least once a month,
million people [9]
VK, with its extensive user base and robust adver-
tising tools, provides a familiar yet potent environment
for targeted marketing campaigns, community build-
ing, and brand engagement. Similarly, Telegram has
seen a surge in popularity as a versatile messaging app
that offers unique opportunities for direct communica-
tion, content distribution, and channel-based advertis-
ing. These platforms' ascendancy reflects a strategic
pivot among Russian advertisers, emphasizing the im-
portance of adaptability and local focus in the face of
global platform restrictions [10]. Through leveraging
the distinctive features and audiences of VK and Tele-
gram, advertisers continue to navigate the challenges of
digital marketing in a post-Meta era, demonstrating re-
silience and innovation in their approach to reaching
and engaging with their target demographics.
Socio-economic consequences
The departure of Meta from the Russian market
has instigated a series of socio-economic conse-
quences, particularly affected the realm of digital ad-
vertising and altered consumer behavior and brand per-
ception. This exit has prompted a significant reevalua-
tion of the digital advertising landscape in Russia,
leading to a redistribution of advertising budgets.
According to a study by Genius Group and Sostav,
in 2022, advertising budgets from YouTube were most
often reallocated to VK Advertising, programmatic
platforms (automated online ad purchasing), Yan-
dex.Direct video ads, and online cinemas [11]. The
most popular alternative to Google AdWords became
Yandex.Direct. Budgets from Instagram were most of-
ten directed to VK Advertising. Facebook and TikTok
were also frequently replaced by VK's advertising
products. However, some respondents noted a prefer-
ence not to redistribute budgets initially intended for
foreign advertising platforms at all. The highest share
of such responses (over 50%) was noted regarding Tik-
Tok, with less than 5% of respondents reallocating ad-
vertising investments to the alternative service Yappy.
The study involved 102 employees from advertising
agencies and brands, including Nestle, X5, Splat, Hoff,
and Gedeon Richter Pharma.
In response to Meta's departure from the Russian
market, companies have been compelled to adapt the
content of their advertising campaigns to align with
new platforms. This shift necessitates a reevaluation of
content strategies to ensure they resonate with the audi-
ences specific to these alternative platforms, such as
VKontakte (VK), Telegram, and Yandex.Direct. Ad-
vertisers are now tailoring their messages, visuals, and
overall campaign narratives to cater to the unique user
behaviors, preferences, and functionalities offered by
these services. For instance, VK's community-centric
model requires content that fosters engagement and in-
teraction within groups and public pages, while Tele-
gram's focus on channels and bots demands a more di-
rect and personalized communication strategy. Simi-
larly, advertising on Yandex.Direct, which is deeply
integrated with Russia's leading search engine, requires
a keen understanding of search intent and user queries
to craft effective search ads. This adaptation process not
only showcases the versatility and creativity of market-
ers but also underscores the evolving nature of digital
advertising, where content must continually evolve to
meet the demands of diverse platforms and their respec-
tive audiences.
Conclusion
Meta's exit from Russia has catalyzed a period of
significant transformation in the advertising market,
prompting businesses to reevaluate and innovate their
digital marketing approaches. As companies continue
to adapt to this new reality, the evolving landscape pre-
sents an opportunity for growth, learning, and the de-
velopment of a more diversified and robust digital ad-
vertising ecosystem within Russia. This period of tran-
sition underscores the adaptability of advertisers and
the enduring importance of digital marketing in con-
necting brands with their audiences, even amidst
changing technological and geopolitical landscapes.
References
1. Annual advertising revenue of Meta Platforms
worldwide from 2009 to 2023 URL: https://www.sta-
tista.com/statistics/271258/facebooks-advertising-rev-
enue-worldwide/ (date of application: 06.03.2024).
2. INFORMATION ON THE COURT CASE
NO. 05-3221/422/2021//The official portal of the
courts of general jurisdiction of Moscow URL:

https://mos-sud.ru/422/cases/admin/details/77de4aa0-
dfa8-4586-9e44-34a3d1b98456?caseNumber=5-
3221%2F21 (date of application: 06.03.2024).
3. Jassim Ahmad Al-Gasawneh, Malek Alsoud,
Abdullah Alsokkar, Lina H. Warrad, Jumadil Saputra,
and Mohammad Khalaf Daoud. «Internet Advertise-
ments and Brand Equity Amongst User-Generated
Content and Purchase Intention». Migration Letters,
vol. 20, no. S8, Nov. 2023, pp. 467-78,
doi:10.59670/ml.v20iS8.4623.
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official portal of the courts of general jurisdiction of
Moscow URL: https://mos-gorsud.ru/rs/tverskoj/ser-
vices/cases/civil/details/de7ea6a0-a3ab-11ec-8a7e-
51b31fb55b35?participants=meta (date of application:
06.03.2024).
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nyakova, Ya. Lavrinenko, A. Blinov // Economic and
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18–19 октября 2018 года / Editors: Aleksander Malole
tko, Natasa Rupcic, Zoltan Baracskai. – Moscow:
Российский государственный социальный
университет, 2018. – P. 907-917
9. Mediascope: Ratings URL: https://media-
scope.net/data/ (date of application: 06.03.2024).
10. Sigal Segev & Juliana Fernandes (2023) The
Anatomy of Viral Advertising: A Content Analysis of
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11. One in three advertisers increased their budget
for programming in 2022 // Genius Group and Sostav
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genius-group-55841.html (date of application:
06.03.2024).

THE IMPACT OF FINTECH APPLICATION IMPLEMENTATION ON IMPROVING CONSUMER
CREDIT RATINGS
Zakharau A.
Suffolk University, Boston, Massachusets, Master’s degree
DOI: 10.5281/zenodo.10957276
ABSTRACT
The article analyzes the impact of fintech applications (FA) on credit ratings (CR). It examines the functional
capabilities of various fintech tools, such as personal finance management apps, monitoring services, and digital
lending platforms, and their role in ensuring the accessibility of financial services. Using specific applications like
CreditKarma, Mint by Intuit, and SoFi as examples, the significance of FA in shaping the financial literacy of the
population is emphasized. It is highlighted that the development of FA is a complex and multi-stage process that
requires the implementation of a significant list of features and ensuring a high level of information security.
Keywords: Fintech applications, сredit ratings, financial literacy, personal finance management, digital lend-
ing platforms, financial services accessibility.
Introduction
The financial industry is currently undergoing a
significant transformation due to the rapid growth of fi-
nancial technology. This evolution is characterized by
the integration of advanced technology into traditional
financial services, notably through the development
and adoption of fintech applications (FA). These digital
tools are not just changing the way financial transac-
tions are conducted, but also affecting consumers'
credit ratings (CR). According to the forecast of Re-
search and Markets (Dublin, Ireland), the global finan-
cial technology market will reach $225.1 billion by
2027, increasing by an average of 12.9 % [1].
CR serving as a pivotal metric for financial insti-
tutions, determine the creditworthiness of individuals
and play a critical role in their ability to access mort-
gages, and other financial products. Traditionally, these
ratings have been influenced by factors such as repay-
ment history, debt levels, and credit history length.
However, with the advent of FA, there is a growing dis-
course on how these digital solutions are influencing
these traditional metrics and potentially enhancing the
CR of consumers.
The purpose of this study is to analyze the impact
of the introduction of FA on improving consumer CR.
The article discusses the functionality of various
fintech tools, such as personal finance management ap-
plications, credit rating monitoring services and digital
lending platforms.
Main part
Fintech applications (FA), a term that encapsulates
a range of digital tools and platforms in the realm of
financial technology, have emerged as pivotal compo-
nents in the modern financial ecosystem. These appli-
cations are defined by their use of advanced technolog-
ical solutions to deliver financial services, ranging from
payment processing to personal financial management
and investment advising. Their core characteristics are
the fusion of technology with traditional financial ser-
vices to enhance accessibility, efficiency, and user ex-
perience. According to a Statista study, the United
States became the leader in the global fintech market in
2023 (fig. 1).
Figure 1. The number of companies with an estimated value of $1 billion or more in different countries, 2023 [2]
The impact of FA on users' lives is profound and
multifaceted. They have democratized access to finan-
cial services, allowing individuals from diverse socio-
economic backgrounds to engage in financial activities
that were previously out of reach. Fintech tools have
simplified complex financial processes, making them
more understandable and manageable for the average
consumer. The scope of these applications extends be-
yond mere transactional capabilities; they are instru-
mental in shaping financial behavior, promoting finan-
cial literacy, and fostering a more inclusive financial
environment.
Types and functions of FA. Initially, the term
"fintech" applied broadly to the technology employed
at the back-end systems of established financial institu-
tions. However, since the global financial crisis of
2008, fintech has evolved to reshape the way money is

managed, shifting from institutional to consumer-fo-
cused services.
FA continue to evolve, driven by technological ad-
vancements and changing consumer needs. They are
not only making financial services more accessible and
convenient but also democratizing the financial land-
scape, allowing users to have more control over their
financial decisions and data. The ongoing development
of fintech is poised to further transform the financial
sector, promising more innovative solutions and re-
shaping the global economy.
FA represent a broad spectrum of digital solutions
designed to address various aspects of financial man-
agement and operations. These applications are charac-
terized by their unique functionalities, targeting differ-
ent financial needs and preferences of consumers. The
following table 1 categorizes FA into distinct types,
highlighting their key functionalities and how they ca-
ter to specific financial activities. This classification
aids in understanding the diverse nature of fintech so-
lutions and their specific roles in the financial ecosys-
tem.
Table 1.
Types of FA and their characteristics.
Type of FA Functionality Target user Impact on financial management
Digital wallets and
payment apps
Facilitate online and
offline transactions
General consumers.
Accelerate safe transactions globally,
shifting consumer preferences from tra-
ditional to electronic payment methods.
Personal finance
management
tools.
Budgeting, expense
tracking, financial
planning.
Individuals seeking
financial
organization.
Aid in organizing and optimizing per-
sonal finances, fostering financial disci-
pline and informed decision-making.
Investment and
trading platforms.
Access to stock mar-
kets, portfolio manage-
ment.
Novice and
experienced
investors.
Democratize investment opportunities,
educate on financial markets.
Peer-to-peer lend-
ing platforms
Connect borrowers
and lenders, facilitate
loans
Borrowers and
investors.
Provide alternative lending and invest-
ment opportunities.
The table illustrates the multifaceted nature of FA,
each serving distinct functions and catering to varied
consumer needs. Collectively, these applications sig-
nificantly contribute to enhancing financial accessibil-
ity, literacy, and empowerment among users, reflecting
the transformative impact of fintech in the domain of
personal and communal financial management. Ac-
cording to the forecast of the international consulting
company deVere Group, in 2024, the main trends in the
field of fintech will be the growing importance of cryp-
tocurrencies, the spread of digital currencies of central
banks (CBDC), the introduction of AI, the growing de-
mand for mobile payments, cybersecurity and global fi-
nancial accessibility [3]. Increased access to financial
services, especially in developing regions, can contrib-
ute to poverty reduction and the development of eco-
nomic opportunities on a global scale.
CR and their importance. CR a crucial aspect of
the financial sector, are an assessment of the creditwor-
thiness of individuals and entities. These ratings, often
represented as scores, are determined by credit bureaus
based on a range of financial factors. The requirements
for a good CR typically include a history of timely pay-
ments, the length of credit history, the types of credit
used, and the amount of debt relative to credit limits.
According to the Federal Reserve System report,
credit card debt in the United States in 2023 amounted
to $1.13 trillion. The delinquency rate on all types of
consumer debt, except for student loans, also increased
in the last quarter of 2023 [4]. As of the end of Decem-
ber 2023, 3.1 % of the outstanding consumer debt in the
United States was in delinquency.
CR plays a pivotal role in determining an individ-
ual's or entity's ability to borrow money and the terms
of that borrowing, including interest rates. A high CR
indicates a high likelihood of repaying loans, leading to
more favorable loan terms, such as lower interest rates.
Conversely, a low CR can result in higher interest rates
or even denial of credit. CR also extends beyond the
realm of borrowing [5]. They can affect the ability to
rent housing, secure certain types of employment, and
impact insurance premiums. In some regions, CR can
even influence utility service agreements and cell
phone contract terms.
In summary, maintaining a good CR is essential
for financial stability and access to various financial op-
portunities. It reflects an individual's or entity's finan-
cial responsibility and reliability, impacting a wide
range of financial and non-financial aspects of life.
Identifying a CR using a FA. The impact of FA
on CR is a multifaceted phenomenon, reflecting the in-
tersection of technology, finance, and consumer behav-
ior. Fintech tools, through their innovative functionali-
ties, have significantly altered how consumers interact
with financial services, thereby influencing their credit-
worthiness in several ways.
Firstly, FA like personal finance management
tools and budgeting apps have empowered consumers
with better financial oversight [6]. These tools enable
users to track their spending, set budgets, and monitor
account balances in real-time. By fostering financial
discipline and awareness, such applications can help
users avoid late payments and manage debt more effec-
tively, positively impacting their credit scores.

Fintech platforms, especially those involved in
lending and credit scoring, often utilize alternative data
for credit assessments. Traditional credit scoring mod-
els primarily rely on credit history, loan repayment rec-
ords, and credit utilization ratios. However, FA may in-
clude additional factors like utility bill payments, rent
payment history, and even social media behavior in
their credit assessments. This broader data set can pro-
vide a more comprehensive view of a consumer's finan-
cial behavior, potentially benefiting those with limited
traditional credit history. Fintech solutions in the realm
of peer-to-peer lending and microfinancing have
opened up new avenues for credit access. These plat-
forms often serve individuals who are underserved by
traditional banks, offering them loans based on alterna-
tive credit models.
Examples of successful FA:
● Credit Karma (Mountain View, California)
provides users with free access to their credit scores and
reports, along with tools for credit monitoring. This app
helps users understand the factors affecting their credit
score and offers personalized recommendations for im-
proving it. By regularly monitoring their credit status,
users can identify and address issues promptly, thereby
maintaining or improving their CR.
● Mint by Intuit (Oakland, California) is a per-
sonal finance management tool that helps users track
and manage their finances. It aggregates financial in-
formation from various sources, providing users with a
comprehensive view of their financial health. By help-
ing users stay on top of their bills, manage budgets, and
monitor credit usage, Mint can indirectly contribute to
maintaining or improving credit scores by encouraging
responsible financial behavior.
● SoFi (San Francisco, California), initially
known for student loan refinancing, now offers a range
of financial products including personal loans and
credit score monitoring. SoFi's credit score monitoring
tool helps users track their credit score over time,
providing insights into how their financial behavior af-
fects their creditworthiness. By offering educational re-
sources and tools, SoFi empowers users to take in-
formed steps towards improving their credit scores.
FA development is crucial to remain competitive
in the rapidly evolving financial landscape, offering us-
ers convenient and efficient ways to manage their fi-
nances, complete transactions, and access a range of fi-
nancial services anytime, anywhere.The advantages of
FA compared to traditional financial services include:
accessibility of use, reduction of commission costs,
time savings, a wide range of services, personalization
[7].
Required features of FA: adaptive user interface,
high level of information security to ensure the safety
of user data, notification and reminder services for up-
coming payments, online chat for customer support, in-
tegration with the maximum number of banks for fast
transactions, payment gateway for digital payments and
transfers. One of the most popular languages for fintech
development is Python. For example, the popular
Robinhood trading app uses Python and Django.
Conclusion
The rapid development of FA offers users greater
control over their financial decisions. Applications in-
crease the accessibility of financial services and the
overall level of financial literacy, regardless of eco-
nomic status or geographical location. Fintech apps
provide innovative solutions for tracking and predicting
CR, leading to a rethinking of the personal finance
management process. The article emphasizes the im-
portance of fintech in enhancing the financial stability
of the population, which plays a crucial role in ensuring
the sustainable development of the world's economies.
References
1. Global FinTech Marketplace: Technologies,
Applications, and Services 2022 - 2027 // Research and
Markets.
2. With China playing catchup with the U.S.,
these 3 charts show the top countries for fintech in 2023
URL: https://www.cnbc.com/amp/2023/10/26/top-
fintech-companies-2023-us-china-lead-on-most-valua-
ble-firms.html (date of application: 08.02.2024).
3. Taherdoost H. Fintech: Emerging Trends and
the Future of Finance. Financial Technologies and
DeFi. Financial Innovation and Technology. Springer,
Cham, 2023, 1, 29-31. https://doi.org/10.1007/978-3-
031-17998-3_2
4. Household debt and credit report // Federal re-
serve bank of New York URL: https://www.newyork-
fed.org/microeconomics/hhdc (date of application:
15.02.2024).
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приложений: от идеи до рынка // Современные
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тей для улучшения пользовательского опыта в web
и mobile разработках / И.А. Кузнецов // Техниче-
ские науки: проблемы и решения: сб. ст. по матери-
алам LXXXI Международной научно-практиче-
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2024.

MEDICAL SCIENCES
RECURRENT UNDIFFERENTIATED PLEOMORPHIC SARCOMA
Chonov V.,
Department of General and Clinical Pathology, Medical University of Plovdiv, Bulgaria
Ward of General and Clinical Pathology, UMHAT "Kaspela" - Plovdiv, Bulgaria
Bivolarski I.,
Department of General and Clinical Pathology, Medical University of Plovdiv, Bulgaria
Chonova E.,
Ward of General and Clinical Pathology, UMHAT "Kaspela" - Plovdiv, Bulgaria
Ermov D.,
Vangelov N.,
Stanchev D.
Surgical Department, MHAT „Svilengrad“; Town of Svilengrad, Bulgaria
DOI: 10.5281/zenodo.10957284
ABSTRACT
We report the case of a 50-year-old man who was admitted to the surgical department of the Svilengrad
General Hospital in 2019 for surgical treatment of a painless subcutaneous nodule on the dorsal surface of the left
forearm. The removed formation was soft, movable, with a macroscopic appearance of a lipoma. A malignant
mixed mesenchymal tumor with dominant liposarcoma and epithelioid variant of rhabdomyosarcoma components
was diagnosed by biopsy. Two years later, the patient was admitted to KASPELA University Hospital Plovdiv
with the same complaints. During the biopsy, the tumor presented as a malignant undifferentiated blastoma, with
necrotic areas, brown pigment and marked cellular polymorphism. In the performed IHC study, the tumor im-
munophenotype was identified as an undifferentiated pleomorphic sarcoma.
Keywords: unclassified sarcoma, undifferentiated pleomorphic sarcoma.
Introduction
The undifferentiated pleomorphic sarcoma, for-
merly known as malignant fibrous histiocytoma, is a
high-grade aggressive soft-tissue sarcoma. Mesenchy-
mal stem cells are the most likely origin of the tumor,
instead of histiocytes as previously thought. It can af-
fect soft tissues, retroperitoneum and metastasize to
several organs [3].
Undifferentiated soft tissue sarcomas can be di-
vided into four morphologic subgroups: pleomorphic,
spindle cell, round cell and epithelioid undifferentiated
sarcomas [1]. Pleomorphism in tumors denotes the
marked variation in size and shape of tumor nuclei, in-
cluding prominent nuclear hyperchromasia and irregu-
larities of the nuclear membrane. Typically, pleo-
morphism corresponds to high-grade aggressive behav-
ior in a neoplasm, but this is not always the case; many
benign tumors (e.g. pleomorphic lipoma and atypical
fibrous histiocytoma can also exhibit pleomorphism,
and therefore assessment of malignant potential de-
pends on a synthesis of factors including the clinico-
pathologic context, and other morphologic features
such as the mitotic index, and presence of atypical mi-
toses and tumor necrosis [6, 8].
Pleomorphic liposarcoma is a high-grade pleo-
morphic sarcoma containing variable numbers of pleo-
morphic lipoblasts; it lacks any areas of well-differen-
tiated liposarcoma or other lines of differentiation.
These tumors most frequently affect older patients,
with a peak in the 7th decade and a slight male predom-
inance. There is a predilection for extremity deep soft
tissues, especially the lower limb, but these can occur
at a variety of sites, including the trunk and spermatic
cord [2].
The pleomorphic sarcoma is a diagnosis of exclu-
sion, where generous sampling of the specimen is re-
quired to rule out dedifferentiated tumor or specific dif-
ferentiation, other than fibroblasts, myofibroblasts and
histiocyte-like cells.
Material and metods
The histologic specimens were made with fixation
of 10% neutral formalin and embedded in paraffin. The
cut sections were 4 mkm thick and stained with hema-
toxylin and eosin (HЕ). Immunohistochemical tests for
Vimentin, Ki-67, SMA, S-100, HMB-45, Melan A и
PAX-8 were performed.
Results
The patient's first surgery was performed in the
Surgical Department of Svilengrad General Hospital.
The removed subcutaneous formation from the left
forearm measured 4.5 x 5.5 cm and had a macroscopic
appearance of a lipoma. The biopsy diagnosis of the
routine histological examination was a malignant
mixed mesenchymal tumor, with dominant liposar-
coma and epithelioid variant of rhabdomyosarcoma
components (Fig.1). The degree of surgical excision
cannot be estimated (B№241-242/2019)

Malignant mixed mesenchymal tumor - magn.x40, (Fig.1)
Two years later, the patient was admitted with a relapse to "Kaspela" University hospital Plovdiv. The tumor
formation had dimensions of 3.5 x 4.5 x 3 cm, yellow-whitish cut surface and smooth periphery. Histologically,
the tumor appeared as a malignant undifferentiated blastoma, with extensive necrotic areas and marked cellular
polymorphism (Fig. 2,3).
Malignant undifferentiated blastoma with mucoid areas - magn.x40, (Fig. 2)

Malignant undifferentiated blastoma with fibrillar structures and areas of hyalinization - magn.x40, (Fig. 3)
Due to the presence of brown pigment in some tumor cells and evidence of surgically removed carcinoma of
the thyroid gland (10 years ago), IHC examination was performed. The immunohistochemical tests showed posi-
tive staining for Vimentin (Fig. 4), high proliferative index: Ki-67 - 90% (Fig. 5) and negative expression of SMA,
S-100, HMB-45, Melan A and PAX-8.
Malignant undifferentiated blastoma - positive staining for Vimentin - magn.x40, (Fig.4)

Malignant undifferentiated blastoma - high proliferative index (Ki-67 – 90 %) - magn.x40, (Fig.5)
Discussion
The undifferentiated pleomorphic sarcoma, for-
merly known as malignant fibrous histiocytoma, is a
high-grade soft-tissue sarcoma. These tumoursnare
composed of heterogeneous populations of cells with
mesenchymal features that can originate from simple
genomic alterations or complex genomics [9]. Under
light microscopy, undifferentiated pleomorphic sar-
coma exhibits atypical, pleomorphic spindle cells with
abundant mitotic figures. Th depth of penetration can
extend through the deep dermis, hypodermis, fascia,
and striated muscle. The tumor may display a storiform,
fascicular, or sheet-like configuration within a fibrous
stroma [7]. The definitive diagnosis of undifferentiated
pleomorphic sarcoma is confirmed by excluding other
malignancies with a panel of immunohistochemical
markers [5]. These should include keratins, S100 pro-
tein and/or SOX10; smooth muscle actin (SMA); and
desmin, expressed in metastatic sarcomatoid carci-
noma, melanoma, and pleomorphic myogenic sarco-
mas, respectively [4].
Conclusion
Based on the morphological and immunohisto-
chemical characteristics of the tumor, we concluded
that this is a case of unclassified sarcoma. The undiffer-
entiated pleomorphic sarcoma is a diagnosis of exclu-
sion, where a generous sampling of the specimen is re-
quired to rule out dedifferentiated tumor or specific dif-
ferentiation, other than fibroblasts, myofibroblasts and
histiocyte-like cells.
References
1. Choi JH, Ro JY., The 2020 WHO
Classification of Tumors of Soft Tissue: Selected
Changes and New Entities. Adv Anat Pathol. 2021
Jan;28(1):44-58.
2. Elswick SM, Curiel DA, Wu P. et al.,
Complications after thigh sarcoma resection. J Surg
Oncol. 2020 May;121(6):945-951.
3. Goldblum JR., An approach to pleomorphic
sarcomas: can we subclassify, and does it matter? Mod
Pathol. 2014 Jan;27 Suppl 1:S39-46.
4. Hornick JL., Subclassification of pleomorphic
sarcomas: How and why should we care? Ann Diagn
Pathol. 2018 Dec;37:118-124.
5. Leader M, Collins M, Patel J, Henry K.,
Vimentin: an evaluation of its role as a tumour marker.
Histopathology. 1987 Jan;11(1):63-72.
6. Mehren M, Kane JM, Bui MM, et al., NCCN
Guidelines Insights: Soft Tissue Sarcoma, Version
1.2021. J Natl Compr Canc Netw. 2020 Dec
02;18(12):1604-1612.
7. Nascimento AF, Raut CP. Diagnosis and
management of pleomorphic sarcomas (so-called
"MFH") in adults. J Surg Oncol. 2008 Mar
15;97(4):330-9.
8. Thway K., Fisher C., Undifferentiated and
dedifferentiated soft tissue neoplasms:
Immunohistochemical surrogates for differential
diagnosis, Seminars in Diagnostic Pathology, Volume
38, Issue 6, November 2021, Pages 170-186.
9. Widemann BC, Italiano A., Biology and
Management of Undifferentiated Pleomorphic
Sarcoma, Myxofibrosarcoma, and Malignant
Peripheral Nerve Sheath Tumors: State of the Art and
Perspectives. J Clin Oncol. 2018 Jan 10;36(2):160-167.

ВОПРОС О ВЛИЯНИИ ХИМИОТЕРАПИИ ВО ВРЕМЯ БЕРЕМЕННОСТИ НА РАЗВИТИЕ
ВРОЖДЕННЫХ ЗАБОЛЕВАНИЙ У РЕБЕНКА
Рахметов Ж.Ж.
Врач общей практики; Первая городская поликлиника
г. Рудный, Республика Казахстан
THE QUESTION ABOUT THE INFLUENCE OF CHEMOTHERAPY DURING PREGNANCY ON
THE DEVELOPMENT OF CONGENITAL DISEASES IN A CHILD
Rakhmetov Zh.
General doctor; First city clinic in Rudny, The Republic of Kazakhstan
DOI: 10.5281/zenodo.10957293
АННОТАЦИЯ
Среди наиболее сложных и трудно прогнозируемых случаев применения химиотерапии в процессе
лечения онкологических заболеваний являются случаи, когда пациентка беременна. Период беременности
сам по себе сложен для организма женщины, происходят серьёзные изменения в ее гормональном, физио-
логическом и психологическом состоянии. Наличие ЗНО только осложняет эти факторы, т.к. организму, и
без того ослабленному, приходится бороться с поражением, в тоже время давно уже отмечен целый спектр
негативных эффектов, которые может принести активное лечение ЗНО с применением химиотерапевтиче-
ских ЛС. Поэтому очень важно понимать все сложности индивидуального подхода в каждом из подобных
случаев в онкологической практике. Этому и посвящена данная статья.
ABSTRACT
Among the most difficult and difficult to predict cases of chemotherapy use in the treatment of cancer are
cases when the patient is pregnant. The pregnancy period itself is difficult for a woman’s body; serious changes
occur in her hormonal, physiological and psychological state. The presence of cancer only complicates these
factors, because the body, already weakened, has to fight the damage, at the same time, a whole range of negative
effects that can be brought by active treatment of cancer with the use of chemotherapeutic drugs have long been
noted.
Therefore, it is very important to understand all the complexities of an individual approach in each of these
cases in oncological practice. This is what this article is about.
Ключевые слова: химиотерапия, врожденные заболевания, беременность, перинатальная медицина,
акушерские риски.
Keywords: chemotherapy, congenital diseases, pregnancy, perinatal medicine, obstetric risks.
Среди наиболее актуальных и сложных про-
блем современной онкологической практики во
всем мире является лечение онкопациенток в пе-
риод беременности. Несмотря на то, что методика
и технология лечения ЗНО постоянно развиваются
и совершенствуются, химиотерапия остается одной
из наиболее часто применяемых методик, эффек-
тивность которой доказана временем и продолжи-
тельной успешной практикой. При этом стоит от-
метить, что большинство лекарственных средств,
применяемых при химиотерапии, в том числе и в
онкологии, кроме положительных эффектов,
имеют еще и ряд побочных эффектов, связанных в
первую очередь с принадлежностью самих пациен-
тов к различного рода группам риска, среди кото-
рых особенно отмечаются такие факторы как воз-
раст, лишний вес, наличии вредных привычек и –
не в последнюю очередь – беременность [1].
Среди наиболее важных работ по данной теме
можно отметить работы Александрова (2010),
Бутко (2012), Варламова (2015) [2-4]. В них даны
исследования общего характера. Минусом данных
работ может служить только их теоретизированный
характер и отсутствие прямых ссылок на резуль-
таты работы. В тоже время как работы Глаголиной
(2019), Егорова (2014) и Йоффе (2017) [5-7] затра-
гивают темы исключительно отельных форм онко-
логии вне контекста общих тенденций. Ряд других
работ можно расматривать только как анализ кон-
кретных клинических случаев или компиляцию
уже написанныхз работ.
При этом, к сожалению, можно отметить, что
несмотря на указанную выше актуальность про-
блемы, сложно составить четкую картину прове-
денных систематических исследований – чаще
всего они достаточно разрозненны, имеют совер-
шенно различные периоды наблюдения и это очень
затрудняет добросовестный и четкий литературный
анализ трудов, повещённых данной проблеме [8].
Это, в свою очередь затрудняет не только тео-
ретическое изучение данной проблемы, но и выбор
наиболее оптимального лечения пациенток на
практике, что, зачастую, приводит к серьёзным по-
бочным эффектам химиотерапевтического лечения
беременных пациенток.
При этом стоит отметить, что данный период
является очень сложным как в отношении эмоцио-
нального состояния пациентки, так и с точки зрения
физических особенностей ее организма. В этот пе-
риод объем плазмы в крови увеличивается более
чем на 40%, на столько же увеличивается объем

сердечного выброса, почечная и печеночная перфу-
зия также резко увеличена, клубочная фильтрация
увеличивается более чем в 1,5 раз [9].
Это приводит к тому, что концентрация цито-
статиков в плазме крови пациентки резко снижа-
ется
Исследования, посвящённые использованию
при ХТ таких опробованных и эффективных ЛС как
доксорубицин и доцитаксел показывают, что, в
сравнении с небеременными пациентками, у бере-
менных пациенток содержание цитостатических
элементов в плазме было значительно ниже при
одинаковой дозировке препаратов и методике при-
ема. Это ставит вопрос о том, поможет ли в данном
случае при химиотерапии повышение дозы и кор-
реляция методики приема ЛС на положительные
результаты ХТ, при том как гепатотоксический по-
бочный эффект данных препаратов уже давно изу-
чен и является большой проблемой современной
практической онкологии [10].
Проблема осложняется тем, что кроме ХТ есть
еще несколько важнейших внешних факторов, вли-
яющих на здоровье женщины и плода, при водящих
к родовым травмам и летальному исходу. Ведь ци-
тостатики терратогенны, поэтому при генетической
предрасположенности одного из родителей к опре-
деленным заболеваниям, наличие у родителей си-
филиса, таксоплазмоза, сахарного диабета, патоло-
гии шейки матки и других заболеваний как вирус-
ного, так и прочих типов, при употреблении
цитостатических ЛС последствия данных факторов
риска значительно увеличиваются, что приводит,
зачастую к осложнениям, несовместимым с нор-
мальной жизнью и даже смерти матери или плода
[11].
При этом, несмотря на относительно неболь-
шое количество исследований, можно отметить
факторы риска, при наличии которых возможность
проявления терратогенных последствий ХТ ярко
выражена по сравнению с другими случаями:
Срок беременности. Так с первой по пятую не-
делю беременности из-за крайне низкой дифферен-
циации клеток и сниженной активности органоге-
неза, влияния ХТ на организм женщины и плод диа-
метрально различно – в ряде случаев оно вообще
никак не проявляется, а в ряде—приводит к преры-
ванию беременности. При этом недели с 6 по 12 яв-
ляются крайне опасными для здоровья пациентки и
плода, т.к. в этот период, из-за активного органоге-
неза, восприимчивость к ХТ становится максималь-
ной. Как отмечают исследования, 4,3% отмеченных
случаев с мертворождением, связанными с хромо-
сомными нарушениями связано с ХТ-лечением па-
циентки именно в течении 1 триместра беременно-
сти. ХТ-лечение на последующих стадиях беремен-
ности, согласно большинству исследований,
относительно безопасно. Частота мальфации в дан-
ных исследованиях, не превышала 1,3%, что в це-
лом, равнозначно банальной погрешности от
нормы.
1. Особенности ХТ-лечения (дозировка ЛС,
продолжительность срока лечения, схема проведе-
ния химиотерапии);
2. Индивидуальные особенности организма
(особенности метаболизма и перераспределения
элементов, индивидуальная непереносимость, лич-
ный и семейный анамнез) [12].
Достаточно сложным частным случаем явля-
ется исследования влияния ХТ на организм жен-
щин с двойнями и здоровье плодов и в дальнейшем
уже родившихся детей. Так, например, давно уже
отмечено, что при идентичных показаниях, методи-
ках, дозировках и длительности приема одних и тех
же препаратов, один ребенок получал целый спектр
врожденных пороков, связанных с ХТ, вплоть до
развития ЗНО на данном фоне, а другой был абсо-
лютно здоров и не имел на протяжении жизни ни-
каких отклонений ни в физиологическом, ни в пси-
хологическом аспектах.
Относительно недавно было проведено иссле-
дование в США, в котором был проанализирован
опыт химиотерапевтического лечения гемобласто-
зов с помощью химиотерапии. Из 58 объектов ис-
следования, у двух произошли выкидыши на 20-не-
деле, при этом было зафиксировано два мертворож-
дения на 5 и 6 месяце. При этом из оставшихся 54
случаев не было зафиксировано ни одного врож-
денного порока. Также в четырёх случая родились
недоношенные младенцы (с 29 по 32 недели), у
оставшихся вес и другие показатели полностью со-
ответствовали норме [13].
После этого исследователи проверили жизнь
каждого из родившихся детей, чьи матери участво-
вали в эксперименте с 8 летнего возраста до 32 лет.
Было отмечено, что психологические, показатели,
также, как и физиологическое состояние полно-
стью соответствовало нормам. В интеллектуальном
отношении они ничем не уступали сверстникам.
Так, 24 из 54 них получили ученую степень, ни в
отношении никого из них не было замечено хромо-
сомных нарушений, порок сердца, ЗНО. 12 из них
родили детей, при этом у последних не было заме-
чено проблем со здоровьем [13].
Выводы и предложения. В заключении
можно сказать, что столь различные данные не мо-
гут в полной мере дать ответ – какие именно фактор
в большей мере влияют на негативные последствия
ХТ в период беременности и какие шаги следует
предпринять для минимизации рисков для здоровья
будущего ребенка в дальнейшем. Своевременное
обнаружение ЗНО еще на ранней стадии может поз-
волить использовать более щадящий режим при ис-
пользовании химиотерапевтических ЛС, но
насколько то или иное лекарство и план ХТ повли-
яет на плод необходимо рассчитывать только, ис-
пользуя все возможные индивидуальные особенно-
сти конкретного случая.
Литература
1. Доброхотова Юлия Эдуардовна, Боровкова
Екатерина Игоревна Акушерские риски химиотера-
пии во время беременности // Гинекология. 2018.
№6
2. Александров А.А. Химиотерапия при бере-
менности: руководство для врачей. Москва:
Медицина, 2010.

3. Бутко А.В., Коваленко О.В., Балейко М.Н.
Химиотерапия при беременности: практическое ру-
ководство. Киев: Здоровье, 2012.
4. Варламов В.В. Химиотерапия злокаче-
ственных опухолей у беременных женщин.
Вопросы онкологии, 2015, т. 61, №2, с. 189-195.
5. . Глаголина М.В. Химиотерапия опухолей
у беременных женщин. Медицинская визуализация
и репродукция, 2019, №2, с. 56-60.
6. Егоров А.В., Суздальцева Е.А., Кондрать-
ева Е.Н. Химиотерапия злокачественных опухолей
у беременных женщин. Клиническая
онкогематология, 2014, т. 7, №1, с. 33-38.
7. Иоффе Ю.С., Никитина Э.Г., Яценко В.Н.
Химиотерапия опухолей головного и шейного от-
делов у беременных. Акушерство и гинекология,
2017, №2, с. 53-59
8. Паукер Владимир Александрович, Шмаков
Роман Георгиевич Основные принципы диагно-
стики и лечения онкологических заболеваний во
время беременности // Акушерство и гинекология:
Новости. Мнения. Обучения. 2014. №2
9. Паньшин Георгий Александрович, Сло-
бина Елена Леонидовна Лечение злокачественных
новообразований на фоне беременности. Часть 1
(общие вопросы) // Вестник РНЦРР. 2015. №3.
10. Vandenbroucke T., Van Calsteren K., Amant
F. Pediatric outcome after Maternal Cancer Diagnosed
during Pregnancy. N Engl J Med. 2016; 374 (7)
11. Abdel-Hady E.-S., Hemida R. A.-H., Gamal
A. et al. Cancer during pregnancy: perinatal outcome
after in utero exposure to chemotherapy // Arch. Gyne-
col. Obstet. – 2012. – Vol. 286, N 2.
12. Ruddy K.J., Gelber S.I., Tamimi R.M. et al.
Prospective study of fertility concerns and preservation
strategies in young women with breast cancer. J Clin
Oncol. 2014; 32
13. Aviles A., Neri N., Nambo M. J. Hematologi-
cal malignancies and pregnancy: Treat or no treat dur-
ing first trimester // Int. J. Cancer. – 2012. – Vol. 131,
N 11.

ОЦЕНКА РАБОТЫ ПУНКТА ТЕСТИРОВАНИЕ И ВАКЦИНАЦИИ ПРОТИВ
ПАРЕНТАРАЛЬНОГО ВИРУСНОГО ГЕПАТИТА, В ГСВ №4 ЦСМ ГОРОДА ЖАЛАЛ-АБАД
КЫРГЫЗСКОЙ РЕСПУБЛИКИ, ПО ИТОГАМ 2023 ГОДА
Темирова В.Н.
врач акушер гинеколог, Кыргызский научный центр репродукции человека. Кыргызская Республика.
г. Бишкек
SPIN-код: 5545-4627, ORCID:0000-0001-7679-3738
Темиров Н.М.
к.м.н. доцент, зав. кафедры организации здравоохранения,
Жалал-Абадский государственный Университет, Медицинский факультет
г. Жалал-Абад, Кыргызская Республика
SPIN-код:1494-6139, Author ID: 935552 ORCID: 0000-0001-7944-0786
Каратаева У.С.
заведующая межфакультетской кафедры «Общественного здравоохранения, с курсом инфекцион-
ного контроля» ЮФ КГМИПиПК им С.Б. Даниярова
Джусупова А.Н.
студентка медицинского факультета
Жалал-Абадский государственный Университет,
Нурмухамматова Х.И.
студентка медицинского факультета,
Жалал-Абадский государственный Университет,
EVALUATION OF THE WORK OF THE TESTING AND VACCINATION POINT AGAINST
PARENTAL VIRAL HEPATITIS, IN FGP No. 4 FMC OF JALAL-ABAD CITY, KYRGYZ REPUBLIC,
AT THE RESULTS OF 2023
Temirova V.,
obstetrician-gynecologist,
Kyrgyz Scientific Center for Human Reproduction. Republic of Kyrgyzstan. Bishkek,
SPIN code: 5545-4627, ORCID:0000-0001-7679-3738
Temirov N.,
Ph.D. Associate Professor, Head Department of Health Organization, Jalal-Abad State University, Faculty
of Medicine. Jalal-Abad, Kyrgyz Republic
SPIN code: 1494-6139, Author ID: 935552 ORCID: 0000-0001-7944-0786
Karataeva U.,
head of the interfaculty department of “Public Health, with a course of infection control” at the Law School
of the KGMIPiPK named after S.B. Daniyarov
Dzhusupova A.,
student of the Faculty of Medicine. Jalal-Abad State University, Jalal-Abad, Kyrgyz Republic
Nurmukhammatova Kh.
student of the Faculty of Medicine, Jalal-Abad State University, Jalal-Abad, Kyrgyz Republic
DOI: 10.5281/zenodo.10957301
АННОТАЦИЯ
В статье отражены результаты организации работы пунктов тестирование и вакцинации против ви-
русного гепатита В, среди взрослого населения группы семейного врача (ГСВ) №4, центре семейной ме-
дицины (ЦСМ) городе Жалал-Абад. За 2023 год, экспресс тестирования из число подлежащих прошли
n=290 (1,9%) человек, из них с отрицательными результатами n=288(99,3%), выявлено- n=2(0,7%) человек,
с положительными результатами на вирусного гепатита В. На первую вакцинации подлежало 288 человек
с отрицательными результатами экспресс теста и 21 человек по результатами ИФА. Всего вакцинированы
с первой вакцинацией 309 человек. При анализе ежедневной среднюю нагрузку обращаемости население
пункт тестирование и вакцинации против парентерального вирусного гепатита, в течение года составило
очень низкий, за один день в среднем - 1,3 человек. Высокая частота обращаемости за 1-2-3-й вакцинацией
на 1000 население против вирусного гепатита В, приходиться к возрастной группе 50-59 лет, 30-39 лет и
40-49лет. Большой удельный вес вакцинированных с 1-2 -3 дозой вирусного гепатита В составляют не
работающие население (код 120) затем на втором месте государственные и муниципальные служащие
(код- 124) и на третьем месте медицинские работники (код -118) и преподаватели ДДУ,СШ,СУЗ, ВУЗ и
др. (код -121). За вакцинацией против парентерального вирусного гепатита больше обращается женщины
- 65,7%, чем мужчины- 34,6%.

ABSTRACT
The article reflects the results of organizing the work of testing and vaccination points against viral hepatitis
B, among the adult population of family doctor group (FGP) No. 4, family medicine center (FMC) in the city of
Jalal-Abad. In 2023, n=290 (1.9%) people underwent express testing, of which n=288 (99.3%) had negative re-
sults; n=2 (0.7%) people were identified with positive results. results for viral hepatitis B. 288 people with negative
results of the express test and 21 people with negative results of the ELISA test were subject to the first vaccination.
A total of 309 people were vaccinated with the first vaccination. When analyzing the daily average load of the
population at the point of testing and vaccination against parenteral viral hepatitis, during the year it was very low,
on average 1.3 people per day. The high frequency of applications for 1-2-3 vaccinations per 1000 population
against viral hepatitis B is in the age groups of 50-59 years, 30-39 years and 40-49 years. A large proportion of
those vaccinated with 1-2-3 doses of viral hepatitis B are the non-working population (code 120), then in second
place are state and municipal employees (code - 124) and in third place are medical workers (code -118) and
preschool teachers, Secondary school, college, university, etc. (code -121). . More women apply for vaccination
against parenteral viral hepatitis - 65.7% than men - 34.6%.
Ключевые слова: вакцинация, ГСВ, вирусный гепатит В, экспресс тест, доза, коды, источник зара-
жение.
Keywords: vaccination, FGP, viral hepatitis B, rapid test, dose, codes, source of infection.
Введение: Вирусные гепатиты являются гло-
бальной проблемой современного здравоохране-
ния. Показатели заболеваемости острыми вирус-
ными гепатитами в республике за последние 40 лет
остаются на высоком уровне, составляя от 163,3 до
1084,5 на 100000 населения. Для дальнейшего со-
вершенствования системы профилактики за вирус-
ными гепатитами в области и городе, а также руко-
водствуясь «Об утверждении алгоритма проведе-
ния экспресс тестирования и вакцинации против
вирусного гепатита В среди взрослого населения»
приказом МЗ КР от 12.01.23года №7 в городском
ЦСМ, каждом ГСВ организованы пункты тестиро-
ваны и прививочные пункты для вакцинация про-
тив вирусного гепатита В взрослого населения. В
каждой ГСВ привлечённых к проведению вакцина-
ции против вирусного гепатита В, назначены ответ-
ственные лица по проведению экспресс тестирова-
нии и вакцинации, а также врач, который ведет
осмотр перед вакцинацией и наблюдение за лицами
положительными результатами на ВГВ. До начало
тестирование и вакцинации все ответственные мед-
работники подготовлены путём проведение семи-
наров, тренингов и практического обучения. Осу-
ществлены информирование населения о проведе-
нии тестирования на вирусные гепатиты экспресс
тестом и вакцинации против вирусного гепатита В
проводится через все доступные СМИ. [4].
Цель работы: Оценка организации профилак-
тической вакцинации у население против паренте-
рального вирусного гепатита на территории
ГСВ№4, ЦСМ г. Джалал-Абаде.
Материалы и методы исследования
Материалом для проведения анализа служили
медико-информационный отдел ЦСМ, «Форма
журнала регистрации исследований на ВГВ» каби-
нета для проведения экспресс теста ГСВ, «Журнал
регистрации о проведения вакцинации от ВГВ»
привычного кабинета ГСВ, «Форма журнала реги-
страции лиц с положительным результатом на
ВГВ», также медицинские карты населения с поло-
жительными результатами экспресс теста. В ходе
исследования применяли методы опроса для сбора
эпидемиологического анамнеза лиц с положитель-
ными результатами на парентерального вирусного
гепатита и информированности населения о прове-
дение экспресс тестировании и вакцинации против
парентерального вирусного гепатита среди взрос-
лого населения. Аналитические исследования, ста-
тистические обработки, и методы математического
анализа[4].
Обработка полученных данных при помощи
персонального компьютера с использованием таб-
личного редактора Excelў 2002 с пакетом анализа
для Windows XP.
Результаты и их обсуждения
В ГСВ №4 на территории проживают 22820
населения, из них в возрасте от 18 лет и старшее со-
ставляют всего n=15100(66.1%) человек, которые
подлежат к профилактической вакцинации против
парентерального вирусного гепатита.
Организации вакцинации у населении начато с
18 января месяца 2023г. За 2023год, экспресс тести-
рования из число подлежащих прошли n=290
(1,9%) человек, из них с отрицательными результа-
тами n=288(99,3%), выявлено- n=2(0,7%) человек, с
положительными результатами на вирусного гепа-
тита В то есть маркеры вирусного гепатита В ДНК
вируса, вирусные антигены HBsAg и HBeAg, а
также антитела к ним анти-HBs, анти-HBe, и к ядер-
ному белку. приведены в таблице 1.
Таблица 1
Население прошедшие экспресс тест на ВГВ по ГСВ №4,
ЦСМ города и Жалал-Абадской области за 2023г.
Наимено-
вание
Всего
населе-
ние
Подлежали 18
и старше лет
Прошли экспресс
тест на ВГВ
Из них отрица-
тельный
Из них поло-
жительный
Абс
чис
%
абс.
чис
%
Абс.
чис.
%
Группа семейных
врачей №4
22820 15100 290 1.9 288 99,3 2 0,7

В пункт вакцинации ГСВ, в течение года обра-
тились 21 человек обследованных в лабораториях
центр СПИДа и частных лабораториях организации
здравоохранения города, с отрицательными резуль-
татами ИФА, Таким образом на первую вакцинации
подлежало 288 человек с отрицательными резуль-
татами экспресс теста и 21 человек по результатами
ИФА. Всего вакцинированы с первой вакцинацией
309 человек. При анализе ежедневной среднюю
нагрузку обращаемости население пункт тестиро-
вание и вакцинации против парентерального вирус-
ного гепатита, в течение года составило очень низ-
кий, за один день в среднем - 1,3 человек. В начале
организации вакцинации в январе месяце составило
за день - 5,1 человек, феврале 3,7 и март месяце 2,2
человек. Последующие месяцы ежедневная
нагрузка обращаемости за вакцинацией рабочие
дни в пункт тестирование и вакцинации составила
менее одного человека за день, как видно из таб-
лицы 2, что свидетельствует о низком осведомлён-
ности и обращаемости взрослого население за вак-
цинации на закрепленном территории ГСВ.
Таблица 2
Средняя ежедневная нагрузка пункта для проведения тестирования и вакцинации против парентераль-
ного вирусного гепатита в ГСВ №4 и ЦСМ города Жалал-Абад за 2023г.
Вакцинация
Месяцы
Средний
I II III IV V VI VII VIII IX X XI XII
1-2-3 5,1 3,7 2,2 0,8 1,1 0,7 0,7 2,2 0,1 0,1 0.1 1,3
В течение года, высокая частота вакциниро-
ванных при получении 1-2-3-й дозу приходиться к
возрастной группе 50-59 лет (по 26,0 и 23,5 на
1000население), и на втором месте 30-39 лет (по
25,8 и 22,7 на 1000население). На третьем месте в
возрасте 20-29лет -по 17,9 и 15,0 на 1000население.
Самый низкий охват — это возрастная категория
18-19лет (по 5,0 и 3,3 на 1000население) таблица 3.
Вторую вакцинацию получали все 100%, после пер-
вой вакцинации через 30 дней. Третья вакцинация
проводится через 5 месяцев после второй согласно
приказа Министерство Здравоохранения Кыргыз-
ской Республики №524. Но -11.1% человек не полу-
чили третью вакцину, так как еще не подошел срок
ревакцинации. таблица 3.
Таблица 3
Население получивших 1-2-3 дозы вакцинации против парентерального вирусного гепатита по возраст-
ным категориям в ГСВ №4 ЦСМ города Жалал-Абадской области за 2023г. (на1000 население)
Схема/сроки
вакцинации
возраст
всего
18-19 20-29 30-39 40-49 50-59 60-стар
1.
Абс.
чис
3 56 83 69 60 38 309
Инт
пок
5.0 17.9 25.8 23.4 26.0 13.4 20.4
2
Абс.
чис
3 56 83 69 60 38 309
Инт.
пок
5.0 17.9 25.8 23.4 26.0 13.4 20.4
3
Абс
чис
2 47 73 60 59 34 275
Инь
пок
3.3 15.0 22.7 20.3 23.5 11.9 18.2
Для получение вакцинации против паренте-
рального вирусного гепатита больше обращается
женщины - 65,7%, в том числе, первая доза 65,4%,
вторая доза 66,2 % и третья 65,6%. Мужчины, со-
ставили - 34,6%, в том числе, первой дозы 34,6%,
второй дозы 33,8%, и третья доза 34,4%. таблица 4.
Таблица 4
Удельный вес по полу вакцинированных 1-2-3-й дозой парентерального гепатита в ГСВ №4 ЦСМ города
Жалал-Абад 2023г.
№ Пол
1
вакцинация
2
3
Средняя
1 Мужчина 34,6 33,8 34,4 34,6
2 женщина 65,4 66,2 65,6 65,7
Среди обратившихся за 1-2 -3 вакцинацией
большой удельный вес составляют не работающие
население (код-120) – по 41.1% и 40,7%, затем на
втором месте государственные и муниципальные
служащие (код- 124) -по 17,8% и 19,2% и на третьем
месте медицинские работники (код -118) – по 17,1%
и 19% и преподаватели ДДУ,СШ,СУЗ, ВУЗ и др.
(код -121) -по 17,5 % и 16,8 %. таблица 5.
Самая низкая удельный вес обращаемости
среди взрослого население за 1-2-3 вакцинацией со-
ставило половые партнеры беременных (код-116) -
по 0,6% и 0,7% и студенты (код-122) – 0,9%, затем
прочие контингенты таблица 5.

Sciences of Europe journal No 138 (2024)

Sciences of Europe journal No 138 (2024)

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