bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical Procedures with Questionable Indications Used in Russia
Authors: Jargin Sergei
Published: January 2024

This review summarizes available data on invasive procedures applied with questionable indications in Russia in the recent past: mastectomy with the removal of muscles, gastrectomy for peptic ulcers, spleno-renal anastomosis for diabetes mellitus, thoracic surgery for bronchial asthma, overuse of surgery in tuberculosis, excessive and compulsory treatments of alcohol-dependent patients, etc. Among factors contributing to the use of invasive procedures with unproven efficiency have been the partial isolation from international scientific community, insufficient consideration of the principles of professional autonomy, informed consent and scientific polemics, training of medical personnel. It is known that invasive procedures can exert a placebo effect, which might have contributed to reported efficiency of some methods discussed here. However, by definition, placebo must be free of risks.
Non-thermal Plasma Reduces HSV-1 Infection of and Replication in HaCaT Keratinocytes In Vitro
Authors: Sutter Julia , Brettschneider Jascha , Wigdahl Brian , Bruggeman Peter J. , Krebs Fred , Miller Vandana
Published: January 2024

Herpes simplex virus type 1 (HSV-1) is a lifelong pathogen characterized by asymptomatic latent infection in the trigeminal ganglia (TG) with periodic outbreaks of cold sores caused by virus reactivation in the TG and subsequent replication in the oral mucosa. While antiviral therapies can provide relief from cold sores, they are unable to eliminate HSV-1. We provide experimental results that highlight non-thermal plasma (NTP) as a new alternative therapy for HSV-1 infection that would resolve cold sores faster and reduce the establishment of latent infection in the TG. Additionally, this study is the first to explore the use of NTP as a therapy that can both treat and prevent human viral infections. We investigated the antiviral effect of NTP using an in vitro model for HSV-1 cold sores, involving the application of NTP from two separate devices to cell-free HSV-1, HSV-1-infected cells, and uninfected cells. We found NTP reduced the infectivity of cell-free HSV-1, reduced viral replication in HSV-1-infected cells, and diminished the susceptibility of uninfected cells to HSV-1 infection. This triad of antiviral mechanisms of action suggest the potential of NTP as a therapeutic agent effective against HSV-1 infection.
Influence of Laser Treatment on the Thermoelectric Properties of Bismuth Antimony Telluride Material
Authors: Samourgkanidis Georgios , Kyratsi Theodora
Published: January 2024

In this study, the effect of laser processing (LP) on the thermoelectric (TE) properties of bismuth antimony telluride (BST) alloy pellets is investigated. The stoichiometric alloy used is Bi0.4Sb1.6Te3.0, which was prepared by mechanical alloying techniques (MA) and hot pressed (HP) into pellets under optimal pressing and temperature conditions. An innovative approach to HP was also developed to enhance the yield of BST samples per HP process while maintaining the TE profiles of the samples within a variance of less than 1%. The LP process was executed by employing a metal 3D printer, with a thorough analysis of beam parameters. Notably, the laser power (P) was held constant at 25 W, along with a fixed hatching distance (HD) of 50 μm, while the parameter adjusted was the laser's scanning speed (SS), which spanned from [600 - 1800] mm/s in increments of 200 mm/s. Examination via scanning electron microscopy (SEM) revealed two material states: melted and sintered. The melted state formed the surface crust of "canyon" patterns that were held on the surface of the samples, and which both size and quantity were altered with changes in SS. For thermoelectric characterization, two distinct shapes of LP samples were produced: rectangular (for electrical properties) and disk (for thermal properties). The results demonstrated that the electrical properties are profoundly influenced by SS, with the electrical conductivity peak at SS value of 1600 mm/s, while the Seebeck coefficient reaches a minimum at the same value. Consequently, within the temperature range of interest, a notable 12% increase in electrical conductivity and a 9% decrease in the Seebeck coefficient were observed compared to the non-LP material state. Overall, the ZT value experience an 6.9% decline within the same temperature interval.
Cellular Senescence, Mitochondrial Dysfunction, and Their Link to Cardiovascular Disease
Authors: Camacho-Encina Maria , Booth Laura K , Redgrave Rachael , Folaranmi Omowumi , Richardson Gavin David
Published: January 2024

Cardiovascular disease (CVD), a group of disorders affecting the heart or blood vessels, are the primary cause of death worldwide, with an immense impact on patient quality of life and disa-bility. According to the World Health Organization, CVD takes an estimated 17.9 million lives each year, where more than four out of five CVD deaths are due to heart attacks and strokes. In the decades to come, increased prevalence of age-related CVD, such as atherosclerosis, coronary artery stenosis, myocardial infarction (MI), valvular heart disease, and heart failure (HF) will contribute to even greater health and economic burden as the global average life expectancy increases and consequently the world’s population continues to age. Considering this, it is important to focus our research efforts on understanding the fundamental mechanisms underlying CVD. In this review, we focus on cellular senescence and mitochondrial dysfunction, which have long been established to contribute to CVD. We also assess the recent advances in targeting mitochondrial dysfunction and senescence with a focus on therapies that influence both and therefore perhaps represent strategies with the most clinical potential, range, and utility.
Sensory Nutrition and Polyphenols; Regulation of Homeostasis through Chemosensory Receptor Interaction with Bitter or Astringent Taste
Authors: Osakabe Naomi , Shimizu Takafumi , Fujii Yasuyuki , Fushimi Taiki , Calabrese Vittorio
Published: January 2024

Recent studies suggest that the interaction of dietary constituents with taste and olfactory receptors and nociceptor expressed in the oral cavity, nasal cavity and gastrointestinal tract may regulate homeostasis through activation of the neuroendocrine system. Polyphenols, of which 8,000 have been identified to date, represent the greatest diversity of secondary metabolites in plants, most of which are bitter and some of them astringent. Epidemiological studies have shown that polyphenol intake contributes to maintaining and improving cardiovascular, cognitive and sensory health. However, because polyphenols have very low bioavailability, the mechanisms of their beneficial effects are unknown. In this review, we focus on the taste of polyphenols from the perspective of sensory nutrition, summarize the results of previous studies on their relationship with bioregulation, and discuss their future potential.
Revisiting the Effect of Dividend Policy on Firm Performance and Value: Empirical Evidence from Korean Market
Authors: Njoku Okechukwu Enyeribe , Lee Younghwan
Published: January 2024

This study investigates the effect of dividend policy on firm performance and value in the Korean market, taking into account the unique context of Chaebol ownership structures. Analyzing 5,478 observations from the Korean Composite Stock Price Index, the research employs multiple regression models to explore the effects of various dividend policy measures under alignment and entrenchment theories. The key findings reveal significant impacts of cash dividend payment on firm value, while dividend yield and dividend policy exhibit varying associations. In the Chaebol and non-Chaebol context, mixed results suggest complex interactions between dividend policy and business outcomes. Policy recommendations emphasize transparent communication about dividend policy to mitigate information asymmetry and enhance corporate governance in the Korean market.
Water Supply Network Renewal Strategic Planning Utilizing the VIKOR Method
Authors: Orasanin Goran , Simic Stojan , Kosarac Aleksandar , Vaskovic Srdjan , Milic And Davor
Published: January 2024

Water networks are critical infrastructure components, ensuring the continuous supply of high-quality drinking water to consumers. To secure such water supply, regular maintenance, including the replacement of deteriorating pipelines, is essential. In this study, a methodology has been developed for determining optimal pipeline replacement solutions in water supply systems at water utilities with limited data availability. Hydraulic analysis has been conducted on the segment of 25 km of the water supply network using the free software EPANET. Applying water network optimization, eight pipeline replacement projects according to 13 pre-defined criteria have been identified and evaluated. The paper outlines the methods for evaluating the criteria, including defining specific quantitative limits. The Analytical Hierarchical Process (AHP) method was used in the paper to determine the weights of the criteria. The reason for applying this method refers to problems that involve a set of criteria with a mixed structure, including both quantitative and qualitative aspects. Also, the paper describes the steps of the multi-criteria optimization method VIKOR, used to select the optimal project. This paper, considered as case studie, describes a method, i.e. application of a new principles and an innovative way to solve a problem for developing countries.
Users’ Preference Towards Highway Landscape Characters: A Systematic Literature Review
Authors: Gao Hangyu , Abu Bakar Shamsul , Maulan Suhardi , Mohd Yusof Mohd Johari , Mundher Riyadh , Chen Benxue
Published: January 2024

Regarding landscape preferences for highways, there is a dynamic interaction between users and the variety of natural and cultural landscape elements along the roadside, reflecting a balance between the highway and the natural environment. However, the rapid pace of urbanization has accelerated the development of highways, leading to the neglect or destruction of valuable landscapes. This highlights the need for visual preference assessments to protect aesthetic and environmental values. Currently, there is a lack of comprehensive criteria for assessing the visual preference of highway landscapes. Therefore, this study aims to review existing literature and establish complete assessment criteria. This study conducted a systematic literature review by searching for keywords in three databases: Web of Science, Scopus, and Google Scholar. The review included 22 papers published between 2013 and 2023 that met the criteria. An additional four relevant papers were included through a “snowballing” approach to supplement the research and results. The results of the study focused on the relationships between highway landscapes and users, user preferences, preference methods, and related variables. These inter-established relationships were used to complete an assessment framework, which establishes a basic reference standard for professionals.
Anti-inflammatory Effect of Atorvastatin and Rosuvastatin on Monosodium Urate-Induced Inflammation through IL-37/Smad3 Complex Activation
Authors: Kim Seong-Kyu , Choe Jung-Yoon , Kim Ji-Won , Park Ki-Yeun , Kim Boyoung
Published: January 2024

Objective: The pleiotropic effect of hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) is responsible for potent defense against inflammatory response. This study evaluated the inhibitory effects of HMG-CoA reductase inhibitors on monosodium urate (MSU)-induced inflammatory response through the regulation of interleukin-37 (IL-37) expression.
Methods: Serum was collected from patients with gout (n = 40) and from healthy controls (n = 30). The mRNA and protein expression of target molecules IL-1b, IL-37, caspase-1, and Smad3 was measured in THP-1 cells stimulated with MSU, atorvastatin, or rosuvastatin using real-time quantitative polymerase chain reaction and Western blot assay. Transfection with IL-1b or Smad3 siRNA in THP-1 cells was used to verify the pharmaceutical effect of statins in uric acid-induced inflammation.
Results: Serum IL-37 level in gout patients was significantly higher than in controls (p < 0.001) and was associated with serum uric acid level (r = 0.382, p = 0.008). THP-1 cells stimulated with MSU markedly induced IL-37 mRNA expression and transition of IL-37 from cytoplasm to nucleus. Recombinant IL-37 treatment dose-dependently inhibited activation of caspase-1 and IL-1b in MSU-induced inflammation. Atorvastatin and rosuvastatin attenuated caspase-1 activation and mature IL-1b expression but augmented translocation of IL-37 from cytoplasm to nucleus. Atorvastatin and rosuvastatin induced phosphorylation of Smad3 in THP-1 cells treated with MSU crystals. Statins potently attenuated translocation of IL-37 from cytoplasm to nucleus in THP-1 cells transfected with Smad3 siRNA compared to cells with negative control siRNA.
Conclusion: This study revealed that statins inhibit MSU-induced inflammatory response through augmentation of phosphorylated Smad3-mediated IL-37 expression in THP-1 cells.
The Influence of Additional Treatments, Injected Activity and Mean Dose to the Tumor on the Overall Survival of Patients Undergoing Transarterial Radioembolization (TARE)
Authors: Quartuccio Natale , Ialuna Salvatore , Scalisi Daniele , D'Amato Fabio , Barcellona Maria Rosa , Bavetta Maria Grazia , Fusco Giorgio , Bronte Enrico , Musso Emma , Bronte Fabrizio , Picciotto Viviana , Carroccio Antonio , Verderame Francesco , Malizia Giuseppe , Cistaro Angelina , La Gattuta Fabio , Moreci Antonino Maria
Published: January 2024

We present our preliminary experience with transarterial radioembolization (TARE) with Yt-trium-90, and investigate the influence of additional treatments, injected activity, mean dose to the tumor on overall survival (OS). Our database was interrogated to retrieve patients who had undergone TARE with Yttrium-90 (90Y) glass or resin microspheres. The following information were searched: 1) type of pathology; 2) sex; 3) age; 4) administered activity; 5) mean dose to the tumor; 6) additional treatments; 7) OS. The OS of the different groups of patients were compared (p<0.05). A bivariate correlation (p<0.05) was used to investigate the association between injected activity and OS, and between mean dose to the tumor on OS. Thirty-nine patients were retrieved (Sex: 27 M, 12 F; mean age: 61.26 ± 14.95 years): 23 with hepatocellular carcinoma (HCC) and 16 with colorectal cancer (CRC) liver metastasis. Globally, patients with HCC demonstrated a sig-nificantly longer OS than those with CRC liver metastasis (22.66±19.11 vs. 10.41±8.75 months; p=0.022). Among patients with CRC liver metastasis, those receiving TARE and additional treatment demonstrated a longer OS than patients receiving only TARE (23.50±19.76 months vs. 8.54±5.31; p=0.018), there was a direct correlation between injected activity and OS (R=0.55, p=0.034) and between mean activity reaching the tumor and OS (R=0.812; p=0.008). Patients with HCC receiving TARE achieved a longer OS than those with CRC liver metastasis. Additional treatments, increasing injected activity and higher mean dose to the tumor seem beneficial for outcome, especially in patients with CRC liver metastases.
Exact Closed-Form M/D/c Queueing Delay Formula
Authors: Wong David Tung Chong
Published: January 2024

It has been more than a century since Erlang published his paper in 1909. The classical queueing system for the M/D/c queue has been investigated by many authors. The key is to find the roots of an equation using explicit or numerical methods. We present an alternate form of explicit solution(s) of this/these root(s) using the Lambert-W function in this paper. In addition, the unsaturated probabilities of the number of customers in the system is derived explicitly in terms of this/these root(s). Finally, the mean number of customers in the system and the mean queueing delay are obtained from these probabilities. The exact queueing delay formula for the M/D/c queue is expressed in closed-form in terms of the root(s). Numerical results show that they are in excellent agreement with the numerical results published by Seelen, Tijms and Van Hoorn.
Treatment Strategies for Anti-vegf Resistance in Neovascular Age-Related Macular Degeneration by Targeting Arteriolar Choroidal Neovascularization
Authors: Fu Yingbin , Zhang Zhao , Webster Keith , Paulus Yannis
Published: January 2024

Despite extensive use of intravitreal anti-vascular endothelial growth factor (anti-VEGF) biologics for over a decade, neovascular age-related macular degeneration (nAMD) or choroidal neovascularization (CNV) continues to be a major cause of irreversible vision loss in developed countries. Many nAMD patients demonstrate persistent disease activity or experience declined responses over time despite anti-VEGF treatment. The underlying mechanisms of anti-VEGF resistance are poorly understood, and no effective treatment strategies are available to date. Here we review evidence from animal models and clinical studies that supports the roles of neovascular remodeling and arteriolar CNV formation in anti-VEGF resistance. Cholesterol dysregulation, inflammation, and ensuing macrophage activation are critically involved in arteriolar CNV formation and anti-VEGF resistance. Combination therapy by neutralizing VEGF and enhancing cholesterol removal from macrophages is a promising strategy to combat anti-VEGF resistance in CNV.
The Influence of Some Neuropsychological Diseases on the Environmental Education Ability of Residents – Review
Authors: Rozenský Ladislav , Lípa Jan , Hansen Justin Michael , Vrba Zdeněk , Dolista Josef
Published: January 2024

Humanity is currently facing several global problems, such as global warming, air pollution, water pollution, deforestation, desertification and land degradation, which are connected to the consequences of negative human activity. One of the possible and effective institutional tools for environmental protection is the environmental education of the general population. It is a relatively well-known and used environmental protection policy tool that governments of all developed countries have in their instrument mix. This qualitative analysis assigned itself the task of investigating whether the ability of environmental education can be affected by certain neuropsychological diseases in addition to thinking about the psychology of environmental education at large. In order to fulfill this main task, the authors asked themselves the following research questions: 1st - Is pedagogical psychology identical and also applicable in the case of environmental education? And 2nd - What effect do some neuropsychological disorders have on the ability of environmental education? Based on the study, analysis, selection and comparison of current professional scientific works obtained from the research activities of current researches on this topic, it is possible to accept the premise that the psychology of environmental education is basically the same as the general psychology of education and that neuropsychological diseases do indeed affect the ability of environmental education similarly to scholarly education.
How Satellite Altimetry Data Can Help Us Understand Sea Level Fluctuations and Classify Water Drainage Areas in the Caspian Sea
Authors: A. Ardalan Alireza , Hashemifaraz Asiyeh
Published: January 2024

This study introduces a technique to uncover concealed patterns in satellite altimetry data, reflecting sea level variations in inland water bodies. We applied the methodology to the Caspian Sea, using altimetry data from four satellite missions over 27 years (1993-2020): TOPEX/Poseidon, Jason1, Jason2, and Jason3. The approach involves two steps: estimating sea level trends and identifying breakpoints that indicate trend shifts; and leveraging time lags between breakpoints at various locations to classify water drainage areas according to their degree of influence on each period. By revealing concealed patterns in the altimetry data, this technique can provide insights to understand the impacts of global warming and local climate changes on sea level fluctuations in the Caspian Sea. We hope that our study can facilitate subsequent interdisciplinary research on the intricate interplay between climate change and hydrological processes in inland water bodies.
Biomechanical Effects on Periodontal Ligaments during Expansion of the Maxillary Arch Using Thermoformed Aligners Modeled by Computational Methods
Authors: Rodriguez Urete Edward Stiven , Rojas Pinilla Gustavo Adolfo , Garcia Melo Jose Isidro
Published: January 2024

Purpose: this paper evaluates the effect of thermo-formed aligners with complementary biomechanical attachments (CBA) on periodontal ligaments (PDL) during the expansion process of the maxillary arch using simulations based on the finite element method (FEM).
Methods: four types of teeth (canine 3, premolar 4, premolar 5 and molar 6) were modeled using 3D CAD. In addition, aligners, CBAs and PDL were also 3D modeled. With this information, a FEM model was generated, and a clinical rehabilitation scenario was simulated. For the validation of the results, a comparison with medical records was performed.
Results: for canine 3, the displacement was 0.134 mm with a maximum stress of 4.822 x10-3MPa in the amelocemental junction. For premolar 4, the displacement was 0.132 mm at a maximum stress of 3.273x10-3MPa in the amelocemental junction. Premolar 5 had a displacement of 0.129 mm and a stress of 1.358 x10-3MPa at 1 mm from the amelocemental junction. Molar 6 had a displacement of 0.124 mm and a maximum stress of 2.440 x10-3MPa.
Conclusions: The simulations showed that the use of CBA reduces tooth tipping. The model with Vestibular CBA presented the best results in terms of the dental movement of expansion of the maxillary arch with the use of thermoformed aligners.
Significance: Considering the difficulty of performing in vivo tests that evaluate the configuration effectiveness of the different CBA alternatives in thermoformed aligners, FEM techniques were used to reduce time and costs, and get accurate results with minimal errors.
Transcription Factor Regulation of Gene Expression Network by ZNF385D and HAND2 in Carotid Atherosclerosis
Authors: Tan Ming , Andersen Lars Juel , Bruun Niels Eske , Lindholm Matias Greve , Tan Qihua , Snoer Martin
Published: January 2024

Carotid intima-media thickness (CIMT) is a surrogate indicator for atherosclerosis and has been shown to predict cardiovascular risk in multiple large studies. Identifying and characterizing molecular markers for carotid atheroma plaque formation can be critical for early intervention and prevention of atherosclerosis. This study performed transcription factor (TF) network analysis of transcriptomic data focusing on two TF genes, ZNF385D, HAND2, whose polymorphisms reportedly associate with carotid atherosclerosis. Gene expression data were measured from pieces of carotid endarterectomy of hypertensive patients each paired with one sample of distant macroscopically intact tissue. TF networks were reconstructed for ZNF385D and HAND2 and their association with carotid atheroma progression examined using gene-set enrichment analysis with high statistical significance (p<6.95e-7) suggesting involvement of expression quantitative loci (eQTL). Examination of the regulation and correlation patterns suggests high clinical and interventional impacts of the two TF genes on impairing carotid atheroma plaque formation and preventing carotid atherosclerosis.
Refusal of prescribed drug therapy (absolute non-adherence) after acute myocardial infarction/unstable angina: data from prospective observation in the LIS-3 registry
Authors: Martsevich S. Yu. , Zolotareva N. P. , Zagrebelnyy A. V. , Kutishenko N. P. , Lukina Yu. V. , Ginzburg M. L. , Drapkina O. M.
Published: January 2024

Aim. Within the LIS-3 register of acute coronary syndrome (ACS), to evaluate the phenomenon of complete refusal of treatment (absolute non-adherence) after discharge from the hospital of patients diagnosed with acute myocardial infarction (AMI)/unstable angina (UA): to study the characteristics of absolutely nonadherent patients, disease outcomes after 2.5 years after first contact.

Material and methods. The study was conducted within the framework of the LIS-3 register. This part of the study included patients who survived ACS and were discharged from the hospital in the first 9 months of 2014 (104 people) and patients who survived ACS and were discharged from the hospital in the first 9 months of 2018 (223 people). Of the 327 patients who survived after AMI/UA, 226 patients remained alive by the time of the first survey (on average 3 years after discharge). The created questionnaire was used, which includes questions about possible long-term outcomes, adherence to visits to medical and preventive institutions (health facilities) and adherence to drug therapy. 221 people answered questions about treatment, 11 (5%) of them did not take any drug therapy (absolutely non-adherent). On average, 29 months (2.5 years) after the initial survey, a repeat survey of completely non-adherent patients or their relatives was carried out, information was collected on the vital status of these patients, repeated cardiovascular events and on the use of recommended drug therapy, about visiting a health facility.

Results. When comparing the clinical and demographic characteristics of patients who were adherent and completely non-adherent to the prescribed therapy, no significant differences were noted. By the time of the repeat survey, 4 patients from among those who were completely non-adherent had died, 2 had suffered ACS. Of the 6 patients who survived, at the time of re-contact, 2 had not started taking medications, explaining that they were feeling well, 2 had resumed taking medications in full, 2 — partially, contact with 1 patient was lost.

Conclusion. A certain proportion of patients who have suffered AMI/UA completely refuse the prescribed treatment, mainly because they feel well. The likelihood of death and recurrent cardiovascular events in such patients is extremely high.
Obituary — Academician Leonid S. Barbarash (22.06.1941 — 14.11.2023)
Authors: Editorial Article
Published: January 2024

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On the organization of internal quality control and safety of medical activities in a multidisciplinary hospital: practical experience and problems
Authors:   Federal State Healthcare Institution «Medical and Sanitary Unit of the Ministry of Internal Affairs of the Russian Federation in Moscow», Mendel S. A. , Kuzmina T. S. ,   Federal State Healthcare Institution «Medical and Sanitary Unit of the Ministry of Internal Affairs of the Russian Federation in Moscow», Kalinina E. A. ,   Orenburg State Medical University of the Ministry of Health of the Russian Federation
Published: January 2024

The article presents the features of the implementation of the Regulations on internal quality control and safety of medical activities in the Clinical Hospital of the Federal Medical Institution «Medical and Sanitary Unit of the Ministry of Internal Affairs of the Russian Federation in Moscow». To implement this line of activity, a person responsible for this type of control was appointed, medical workers improved their qualifications on the issues of examination of the quality of medical care and quality control and safety of medical activities. The peculiarity of the implementation and implementation of internal control was associated with a large number of structural units and a bed fund. A regulation on interaction with the medical commission of a medical organization has been created. The general functions of the internal control system, the medical commission and the examination of the quality of medical care are defined.
Prediction of the risk of an unfavorable outcome in COVID‑19 using the classification tree method, taking into account the age and number of comorbid pathology according to the infectious hospital.
Authors:   Astrakhan State Medical University, Kalashnikov E. S. , Shapovalova M. A. ,   Astrakhan State Medical University, Polunina E. A. ,   Astrakhan State Medical University
Published: January 2024

Objective: to determine the probability of the risk of an unfavorable outcome using the classification tree method in patients with COVID‑19 who were treated in an infectious hospital based on the analysis of the contribution of such predictors as age and the amount of comorbid pathology. Materials and methods. The data of outpatient records of 5304 patients who were treated in an infectious diseases hospital with a diagnosis of COVID‑19 from January 1, 2021 to January 1, 2022 were analyzed. The age of the examined patients was 62 [56–66] years. Among 5,304 patients, there were 2,891 males (54,5%) and 2,413 females (45,5%). The patients were divided into age groups according to the WHO classification. The frequency of comorbid pathology was analyzed taking into account the nosological unit of the disease registered in at least 1% of the patients included in the study. Results. In the studied sample, the elderly prevailed in a larger percentage – 46.8%. The presence of one or more comorbid pathology was revealed in the prevailing number of hospitalized – in 5,244 people (98,9%). The most common comorbid pathology in the examined patients was arterial hypertension in 2038 people (38,4%), coronary heart disease in 1997 people (37,7%) and type 2 diabetes mellitus in 1629 people (30,7%). A classification tree was constructed to predict the risk of the probability of an unfavorable outcome in patients with COVID‑19.The minimum number of observations in the parent node in the classification tree was 400 people, in the child node – 200 people. In the resulting classification tree, 8 terminal nodes were observed. Conclusion. The probability of the risk of an unfavorable outcome in the analyzed sample of patients increases with an increase in the number of comorbid pathology and the age of patients. According to the forecast using the classification tree method, the greatest probability of risk (3,2 times) of an unfavorable outcome in relation to the general sample was among elderly persons+centenarians with more than three comorbid pathology. The developed classification tree showed a high probability of correct predictions (80%). The sensitivity of the resulting model was 77,9%, the specificity was 64,2%.
Factors affecting the shortage of nursing staff in medical institutions.
Authors:   Orenburg State Medical University., Krylova N.Yu. , Katsova G. B. ,   Orenburg State Medical University.
Published: January 2024

The article presents the literature data on the shortage of nursing staff in medical institutions. The characteristic of the base on which the research was conducted is given. The analysis of completing of the nursing staff of the SAHI «Center for the Protection of Motherhood and Childhood» was carried out. It was found that during the three years of the Center’s existence, there was a shortage of secondary medical personnel from 50.0% to 65.0%. The study identified factors affecting the formation of a personnel shortage. The main ones were: dissatisfaction with the management style of the Center (57.2%), a high risk of overstrain and stress when performing functional duties, dissatisfaction with wages that do not correspond to professional loads. The insufficient involvement of young personnel under the age of 30 and the lack of motivation to obtain qualification categories when working in this medical institution had a negative impact on the replenishment and preservation of personnel potential. Based on the results of this study, ways to solve the problem of shortage of nursing staff in the Center have been developed.
Indicators and directions for optimizing primary health care in the Southern Federal District.
Authors:   Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University» of the Ministry of Health of the Russian Federation, Department of Healthcare Organization and Public Health with the course of ICT in healthcare and medicine No. 2, Zoricheva A. L.
Published: January 2024

The study of indicators and directions for optimizing primary health care in the regions of the Russian Federation allows us to assess the effectiveness of the functioning of the first and basic level of contact of patients with the health care system. The purpose of the work is to study indicators and directions for optimizing primary health care in the Southern Federal District. Materials and methods: A theoretical analysis of literature, statistical information and documents related to indicators and optimization of primary health care in the Southern Federal District was performed. For a comparative assessment of the dynamics of indicators, the growth (%) was calculated. Results. The supply of local therapists in the Southern Federal District is lower than the national average. It was revealed that the Republic of Kalmykia, Astrakhan region and Rostov region have a negative increase in the provision of local therapists for 2016 and 2021: –6.1; –20.9 and –22.2% respectively. In terms of the number of local pediatricians, a negative increase (9.0%) is observed only for the Rostov region. An analysis of directions for optimizing primary health care showed that in the regions of the Southern Federal District programs are being implemented to improve the infrastructural organization and equipment of primary health care, as well as to eliminate the personnel shortage of medical personnel. However, the reports indicate only indicators of the number of doctors per 10 thousand population without highlighting primary health care workers. Conclusion. The key problem of the Southern Federal District is the shortage of doctors in the field of primary health care. The dynamics of the health care situation in the Southern Federal District have not been sufficiently studied. It is necessary to continue: improving the material and technical equipment of the industry, including in hard-to-reach areas, carrying out preparatory work with students in medical institutions, improving working conditions and offering attractive labor financing for workers and organizing social assistance.
Project management in medicine on the experience of the program "Face Clinic" implementation.
Authors:   Sklifosovsky Research Institute For Emergency Medicine, Petrikov S.S. , Tsaranov K.N. ,   Moscow Metropolitan Governance Yury Luzhkov University, Zavaliy L.B. ,   Sklifosovsky Research Institute For Emergency Medicine, Polkovnikov A.V. ,   Project Practice Ltd, Tyrov I.A. ,   Moscow Healthcare Department, Solovieva А.А. ,   Sklifosovsky Research Institute For Emergency Medicine, Tyuryumina А.А. ,   Sklifosovsky Research Institute For Emergency Medicine, Ramazanov G.R. ,   Sklifosovsky Research Institute For Emergency Medicine, Sinkin M.V. ,   Sklifosovsky Research Institute For Emergency Medicine, Evdokimova O.L. ,   Sklifosovsky Research Institute For Emergency Medicine, Klychnikova E.V. ,   Sklifosovsky Research Institute For Emergency Medicine, Grin A.A. ,   Sklifosovsky Research Institute For Emergency Medicine
Published: January 2024

A new management method in the public health care system is project management. A i m . Improving the quality of medical care in a public health care institution for patients with neurological disorders of the face through organizational measures using project management. M a t e r i a l s a n d m e t h o d s . The state medical organization has implemented an original program of assistance to patients with neurological disorders in the face in several stages. Used project management. There was no restructuring of medical departments or hiring of new employees. R e s u l t s . At the Sklifosovsky Research Institute, in total for the period 2021–2022, 865 offline (over the year, the growth rate of consultations increased by 2.5) and 48 online consultations with neurologists were conducted, there were 139 MRIs, 180 electrodiagnostic procedures, surgical treatment was performed on 101 patients, and 161 botulinum therapy procedures were performed. Scientific research included the development of protocols for magnetic resonance imaging and electrodiagnostics, an algorithm for making decisions about surgical care was described, and new methods of physical rehabilitation were proposed. 28 scientific articles were published, the results were reported at scientific and practical conferences and congresses. A team of specialists has developed a postgraduate educational program. Provided patient education. The Face Clinic project is recognized as socially important. C o n c l u s i o n s . For a specific group of patients, in order to quickly achieve results, it is better to organize work through project management. It is necessary to teach doctors management tools.
Asessment of healthcare workers’ perceptions on the effectiveness of medical care in the profile of psychiatry in the Moscow region.
Authors:   Moscow Research and Practical Centre for Addictions, Borovkov E.I. , Mosyakin A.V. ,   Moscow Research and Practical Centre for Addictions, Zolotareva L.S. ,   Pirogov Russian National Research Medical University, Lutsko V.V. ,   Federal Research Institute for Health Organization and Informatics of Ministry of Heath of the Russian Federation
Published: January 2024

Relevance. The reorganization and modernization of the psychiatric service in Moscow (from 2010) and in Moscow region (from 2021) was carried out. The reforms were carried out in accordance with WHO regulations and consisted in reducing the medical care provided in a hospital setting and expanding the outpatient link. Aim. Asessing the perceptions of employees on the effectiveness of providing assistance in the profile of “psychiatry” in the Moscow region after its restructuring. Methods. An anonymous survey of employees of the psychiatric service in the Moscow region was conducted regarding the transformations carried out (N=236). Results and discussions. The reforms have been positively assessed by the healthcare workers interviewed. According to them, the provision and equipment of clinics with modern examination methods and equipment has improved. The reorganization has led to a better quality of medical care and accessibility at the local level, the number of beds in day hospitals has increased and the conditions of patients’ stay in medical organizations improved. Existing protocols for the provision of mental health services to the public need to be regularly updated, as most respondents indicated. Also, as mentioned by interviewees, both the psychiatric care service as a whole and psychiatric care in a hospital separately needed an increase in funding. In the course of the study, respondents noted that further modernization of the psychiatric service should primarily be carried out in the following areas: unification into a single complex of a psychoneurological dispensary and a psychiatric hospital, expansion of the volume of outpatient care, development and improvement of coordination between general somatic care and help in the “psychiatry” profile, development of medical care based on general somatic hospitals. Conclusion. The majority of respondents positively assessed the reforms carried out in the Moscow region in the field of assistance in the profile of “psychiatry”. Further modernization of the psychiatric service should include the development and improvement of coordination between general somatic care and assistance in the “psychiatry” profile, the expansion of the volume of outpatient care, the best use of resources based on the needs of the population.
Opinion of the parent community on the availability of pediatric otorhinolaryngological care.
Authors:   N. A. Semashko National Research Institute of Public Health, Oleinik A. V. , Mingazova E. N. ,   N. A. Semashko National Research Institute of Public Health,   Kazan State Medical University
Published: January 2024

The prevalence of ENT diseases in the pediatric population remains an urgent problem in practical pediatrics, otorhinolaryngology and healthcare, which is associated with their high level of occurrence in all age groups of children and the frequent development of various complications. One of the prerequisites for solving this problem is to ensure the availability of otorhinolaryngological care for children in primary health care. The purpose of the study was to study the opinion of the parent community on the availability of otorhinolaryngological care for children aged 0 to 14 years. Materials and methods. The study was conducted on the basis of state children’s clinics and private children’s ENT offices in the city of Ramenskoye, Moscow region in 2023; A survey of parents of children aged 0–14 years was conducted (1200 respondents). Statistical processing of the material involved processing and creating a database in electronic tables. The results and conclusions of the analysis of a survey of the parent community showed that the general priority areas for increasing the availability of care for children for public and private health care systems are improving the organization of care, overcoming the obstacles of geographic remoteness of health care facilities, improving the level of medical information for patients, developing telemedicine technologies and the availability of allied health care specialists.
IPSG. 2 MIS support. Improving the efficiency of communications.
Authors:   Federal Ailamazyan А. К. Program Systems Institute of Russian Academy of Sciences, Elistratova O.S. , Belyshev D. V. ,   Federal Ailamazyan А. К. Program Systems Institute of Russian Academy of Sciences
Published: January 2024

Ensuring high quality of medical care and patient safety is one of the most important tasks of modern medicine. Medical information systems (MIS) can make a significant contribution to achieving this result. MIS are important for the creation of clinical safety system due to their capabilities of access to information, unification of medical technological processes, organization of communication between participants of the therapeutic and diagnostic process, including the transmission of signals and warnings about the occurrence of critical events. When critical events are detected, MIS with different degree of automation is able to send a notification about them to the addressee – the attending physician or other responsible person, which allows to quickly take measures and prevent possible complications, contributing to improving the level of clinical safety and improving the quality of medical care. The article discusses the implementation of one of the ways to improve the efficiency of communications, namely, the transmission of messages when critical results of tests or other critical conditions of the patient are detected using the tools included in the MIS.
Personal account and empowerment of patients in digital healthcare ecosystems.
Authors:   Federal Ailamazyan А. К. Program Systems Institute of Russian Academy of Sciences, Mikheev A. E.
Published: January 2024

With the proliferation of web technologies and social networks, an approach to providing health care based on the active participation of patients in medical processes is gaining more and more support. This implies that the patient is actively involved in managing their health and has the authority and tools to do so. A personal account is considered as the main tool for empowering patients, providing patients with a personal information system with full access to electronic medical records stored in medical organizations. Due to the variety of sources of data on a citizen’s health, a personal account acquires the most complete functional implementation when functioning as part of digital health care ecosystems. The possibilities of personally controlled electronic medical records as part of integrated personal accounts are analyzed. The hypothesis is considered that a patient’s personal account in the medical care ecosystem can significantly change the clinical processes and methods of self-help of patients if it provides the opportunity for systematic communication between patients and doctors, automatic replenishment of data from various information systems, transformation of clinical indicators and observation results into meaningful and useful information. It is concluded that in this context, a patient’s personal account can become a breakthrough medical technology, and the exchange and dissemination of experience in health-saving and treatment will become the main trend in the near future and will help the development of medical information technologies in Russia as a whole.
Opportunities, problems and prospects of information technologies in the field of clinical safety.
Authors:   Federal Ailamazyan А. К. Program Systems Institute of Russian Academy of Sciences, Mikheev A. E.
Published: January 2024

The article describes the possibilities of using information technology (IT) to ensure patient safety. The role of IT is examined in three aspects of patient safety: creating a safe health care environment, safely delivering health care, and assessing patient safety. Purpose of the study is to explore the current state of information technology and environmental factors in the field of clinical safety. Materials and methods. Analyze the current capabilities of using information technology to ensure patient safety in three aspects: creating a safe environment for the provision of medical care, safe delivery of medical care and assessing patient safety. Based on the results of the analysis, determine the problems and prospects of information technologies in the field of clinical safety. Results. One of the components of a safe medical care environment is a patient’s personal account. Research examining the impact of patient privacy on health care safety is an important and promising area for future research. It is stated that today without IT it is impossible to create safe conditions for the provision of medical care. Based on the results of the analysis of the problem of the relevance of medical knowledge, the need for a transition to medical ecosystems is stated for a comprehensive solution to patient safety problems, including in relation to the use of DSS in medicine. Approaches to solving IT problems in the field of clinical safety are proposed, which are to optimally integrate compliance functions of multiple requirements and clinical data coming from different sources into complex medical technological processes, ensuring maximum patient safety with minimal complication of these processes. The assessment of compliance (certification) with safety standards is described as one of the ways to confirm the compliance of the results of activities with the requirements of not only quality, but also safety for the patient. Findings. There is a need to intensify research on the impact of health IT on patient safety, with particular attention to improving methods for identifying side effects and assessing patient safety, clinical decision support systems, adequate representation of biomedical knowledge, patient personal accounts, ecosystem solutions and support for continuity of care using IT, and also to the use of informatization criteria in the development and improvement of standards for the quality and safety of medical care.