[The mortality of children population].

The article presents comprehensive medical statistical analysis of indicators and causes of mortality of children population of the Russian Federation in 2017-2021. It is emphasized that in Russia, in conditions of extremely unfavorable demographic situation, the hyper actual task is to preserve life of every child. It is demonstrated that crucial role in mortality of children population is played by not only infant mortality and mortality of children aged 1-4 years, but also by mortality of children of older ages. The children population mortality still keeps gender and residence differences. The problem of reliable registration of infant mortality is to be revisited since part of newborns born alive are classified after birth as stillborn. Beginning from 2018, the first place was taken by the class "Injuries, poisonings and some other consequences of external causes" driving back the class "Individual conditions occurring in perinatal period". Thus, measures of preventing negative impact of social factors on children health continue to be an important component of modern system of health care of children population. The directions of measures reducing children mortality in Russia are proposed.

[Modern possibilities for transcatheter pulmonary valve replacement]. / Sovremennye vozmozhnosti transkateternogo protezirovaniya klapana legochnoi arterii.

The literature review is devoted to transcatheter pulmonary valve replacement. The authors summarize the indications, clinical data and current capabilities of transcatheter pulmonary valve replacement. The authors also overviewed modern valves for transcatheter pulmonary artery replacement. Effectiveness of transcatheter pulmonary valve implantation has been substantiated. Various studies comparing the outcomes of different valve systems for endovascular implantation were analyzed. The authors concluded the prospects for transcatheter pulmonary valve implantation.

[The dynamics of demographic situation and state of reproductive health of population of circumpolar region of the Russian Federation].

The priority of state policy of the Russian Federation is to make conditions for sustainable social economic development of national regions, including the territories of the Arctic Zone. The successful solution of these tasks is possible only if there is sufficient amount of labor resources and at achieving positive dynamics of main demographic processes. The purpose of the study is to establish characteristics of both dynamics of main demographic processes and reproductive health of Northerners as exemplified by the Republic of Komi. MATERIALS AND METHODS: The retrospective ecological epidemiological study was carried out using reports of the Federal statistical observation. To evaluate demographic processes the values of main demographic parameters were calculated. To analyze dynamics of demographic processes time series of demographic coefficients were constructed and values of growth rate indicators were calculated. RESULTS: The number of male and female population of the Komi Republic in 1990-2023 decreased by 46.5% and 37.1%. The specific weight of people older than able-bodied age increased in males from 4.9% to 14.7% and in females from 15.7% to 31.6%. The number of females of fertile age (16-49 years) in the Komi Republic decreased by 152.602 people (-47.5%) and their general fertility rate decreased by 33.3%. The birth rate in the group of young women aged 15-19 years decreased in 1990-2021 by 80.1%; and of women aged 20-24 years decreased by 60.4%. The frequency of abortions tends to decrease, but significantly exceeds the national average values. CONCLUSION: The replacement-level fertility is not achieved in the Komi Republic. Taking into account the peculiarities of demographic, social economic processes, it is necessary to develop and to implement regional program of reproductive health improvement.

Are the Goals of Therapy Achievable in Patients with Rheumatoid Arthritis Receiving Upadacitinib in Real Clinical Practice?

The aim of the study was to evaluate the effectiveness of UPA in RA patients in real clinical practice after 3 and 6 months of therapy. The study included 63 RA patients with high activity of the disease. Activity was assessed according to the DAS28(ESR), DAS28(CRP), SDAI, CDAI; functional ability to HAQ; quality of life to the EQ-5D; disease activity according to the patient's RAPID-3 index; the level of depression and anxiety to the HADS scale. The effectiveness of therapy was evaluated after 3 (n = 45) and 6 (n = 31) months of UPA therapy. Remission or low activity of the disease by 3 months of therapy was achieved by most patients: remission of 69.8% of patients, low activity of the disease-16.3% of patients. Moderate or high activity persisted in 13.9% of patients. By the 6th month of UPA therapy, the number of remissions reached 90%, low activity 3.3%, moderate activity persisted in 6.7% of patients, high activity of the disease was not in any patient. 20% improvement in function was achieved in 71.8% of patients by the 3rd month of therapy and in 77.8% by the 6th month of treatment; the difference in average HAQ values by the 3rd month of therapy was 0.38 points, by the 6th month-0.58 points. After 3 months of follow-up, 31.1% of patients continued taking GC, by 6 months-24.2%. The dose of GC was reduced from an average of 7.23 to 5.6 mg/s. The percentage of patients requiring NSAIDs decreased from 95.2 to 35.6% and 33.3%, respectively. DMARDs continued to be received by 75.6% of patients by 3 months and 69.7% by 6 months of follow-up. Achieving remission or low activity of the disease in patients with RA receiving UPA in real clinical practice is possible in most patients. A rapid decrease in inflammatory activity is accompanied by a significant improvement in the functional state and quality of life of patients. UPA therapy reduces the need for the use of NSAIDs and reduces the dose of GC in a third of patients.

[Laparoscopic right-side partial nephrectomy with fluorescence imaging in the near infrared spectrum using indocyanine green].

A clinical case of the use of fluorescence imaging in the near infrared spectrum with indocyanine green during laparoscopic right-side partial nephrectomy is presented in the article.

[The determinants of vaccination against the new coronavirus infection (COVID-19) of residents of the circumpolar region of Russia].

The maintenance of health of residents of the Northern Regions of Russia, including those living in the Arctic zone of the cbountry, is a condition of its advance development in XXI century. The percentage of Russian citizen vaccinated against the new coronavirus infection (COVID-19) does not exceed 50% after beginning of implementation of vaccination program. It can be conditioned by lower level of both of credence of citizen to health care system and health literacy.Purpose of the study is to establish determinants of vaccination of population against COVID-19 in circumpolar region of Russia as exemplified by the Arkhangelsk Oblast.The sociological survey was carried out using the interview technique of patients of medical organizations (n=433) and conditionally healthy residents of the Arkhangelsk Oblast (n=139). To evaluate the level of general health literacy the Russian version of questionnaire HLS19 - Q22-RU was applied. The most of conditionally healthy respondents and consumers of medical services looked for information about methods of prevention and treatment (80.4% and 58.2% correspondingly), had an experience of vaccination against COVID-19 (79% and 56.3% correspondingly). The relative chances of conditionally healthy respondents, women, and respondents having no children and no credence to national health care system to independently look for information related to COVID-19 is higher at 2.94, 2.08, 1.55 and 1.48-1.57 times correspondingly. The relative chances of conditionally healthy respondents having no children in family and assessing one's economic status as "higher than average" to be vaccinated against COVID-19 is higher at 4.02, 1.52, 1.53 times correspondingly. Availability of experience of vaccination against COVID-19 is conditioned by higher level of general health literacy.In the Arkhangelsk Oblast and other circumpolar regions of Russia the programs of increasing loyalty of citizen to measures of population prevention, including vaccine prevention, is to be implemented with consideration of established determinants of of vaccinations against COVID-19.

[Statistical modeling of the fact and requests frequency for emergency medical care by primary care different age groups patients.]

The frequency of seeking emergency medical care (EC) can be mediated by the characteristics of the patient's social status, his health literacy (HL) but not only by the clinical signs of the disease, health status. The goal of the cross-sectional survey was to identify factors determining the frequency of applying for EC by the young-aged, middle-aged (18-59 years) and elderly (60-74 years) patients of the primary health organizations in the Arkhangelsk Region and the Komi Republic (North-West Russia). Logistic regression (LR) was used to identify factors mediating the fact of applying for EC; zero-inflated negative binomial regression (ZINB) - to identify factors mediating the frequency of appeals. The majority of elderly respondents in the Arkhangelsk Region (72,5%) and the Komi Republic (74,1%) applied for EC at least once during the calendar year; among the young-aged and middle-aged respondents - 45,3% and 52,1% respectively. In the group of young-aged and middle-aged respondents, a higher frequency of appeals for EC is mediated by the age, low self-esteem of the well-being and health status, a chronic disease(s) affecting daily well-being in anamnesis, a low level of HL; in the group of the elderly respondents - by the fact of absence of a spouse, low self-esteem of the well-being, a chronic disease(s) affecting daily well-being in anamnesis, low levels of HL respectively. The obtained results obtained can be used to identify the «risk group¼ of patients of the primary health organizations who have a higher probability of applying for EC, and to organize additional preventive work with the min primary health organizations.

Quantum cascade lasers monolithically integrated on germanium.

Silicon (Si) photonics can have a major impact on the development of mid-IR photonics by leveraging on the reliable and high-volume fabrication technologies already developed for microelectronic integrated circuits. Germanium (Ge), already used in Si photonics, is a prime candidate to extend the operating wavelength of Group IV-based photonic integrated circuits beyond 8 µm, and potentially up to 15 µm. High performance quantum cascade lasers (QCLs) and interband cascade lasers grown on Si have been demonstrated, whereas no QCLs monolithically integrated on Ge have been reported yet. In this work, we present InAs-based QCLs directly grown on Ge by molecular beam epitaxy. The lasers emitting near 14 µm exhibited threshold current densities as low as 0.8-0.85 kA/cm2 at room temperature.

[The competence in health issues of population of circumpolar region of the Russian Federation].

The health literacy of citizen is determined by a set of demographic and social factors. The deficiency of health literacy of population in the Russian Arctic Zone conditions delay in indicators characterizing population health from their all-Russian values and menaces ability to achieve the targets of the National Strategy of Development of Russian Arctic Zone and Ensuring National Security up to 2035.The purpose of the study is to assess level of health literacy of patients and healthy population residing in circumpolar territories of Russia (Arkhangelsk Oblast).The level of general health literacy in the subgroups of respondents varied in narrow range of 26.9-36.3 points. The most significant difference was established between scores of interactive health literacy (Δ = 4.1 points) and critical health literacy (Δ = 3.4 points), which were higher in group of healthy respondents. The predictors of level of general health literacy are clinical status (value of dependent variables in healthy respondents was on average higher on 0.75-1.73 points), self-assessment of one's positioning in society (every additional point increases average level of general health literacy by 0.47-0.79 points) and age (every additional year of life reduces level of general health literacy by 0.08 - 0.09 points). The results of the study indicate on dependency between clinical status and the level of health literacy, determine social characteristics of risk group with low health literacy as object of additional preventive measures directed at citizen residing in in circumpolar terrotories of The Russian Federation.

[SATISFACTION OF THE RESIDENTS OF THE CIRCUMPOLAR REGION WITH THE STATE HEALTHCARE SYSTEM, DEPENDING ON THE LEVEL OF THEIR HEALTH LITERACY].

Regions of Arctic Zone and Far North of Russia have a weak social infrastructure, including regional segments of the state healthcare system. The study of citizens satisfaction with the healthcare system is one of the leading methods for assessing its effectiveness. Citizens satisfaction may be distorted by their health literacy (HL). Half of the 'healthy' citizens (51.1%) had an excellent or sufficient level of general GVH; 2/3 of the patients of medical organizations (70.4%) had an insufficient or problematic level of general HL. The level of citizens` satisfaction with domestic healthcare is determined by their clinical status - it is higher in the group of patients (60.1%) than in the group of 'healthy' people (31.0%). Patients evaluate it more loyally in comparison with health people. Respondents with an insufficient HL evaluate the health care system less loyally. The high level of HL allows patients to assess the results of the work of the domestic health care system more objectively in comparison with healthy citizens. The aim of this study is to assess the satisfaction of the residents of the circumpolar region of Russia (the Arkhangelsk Oblast) with the regional segment of the State Healthcare System, depending on the level of their HL.

[Bilateral laparoscopic nephrectomy for polycystic kidney disease].

A clinical case of surgical treatment of a patient with autosomal dominant type of polycystic kidney disease, stage 5 of chronic kidney disease and secondary arterial hypertension is presented in the article. The technique of single-stage bilateral laparoscopic nephrectomy, patented by the authors, is described. The practicability and safety of a simultaneous bilateral procedures was demonstrated, as well as the advantage of laparoscopic access for this type of surgical interventions. The successful and prompt procedure allowed the patient to undergone to allotransplantation of a cadaveric kidney as soon as possible.

The medical demographic characteristic of group of citizen injured in road accidents on the Federal Highway.

The role of citizen of elderly age in road accidents on the Federal Highway was principally passive since passengers of vehicles predominated (p<0,0001). The most of victims of elderly age (66,7%) suffered of combined lesions. Considering gender of victim, presence of ethanol in blood at the moment of hospitalization, the role of victim of road accident and degree of severity of lesions in citizen of elderly age was in overall higher than in citizen of able-bodied age up to 2.3-2.9 points according ISS scale. The established medical demographic characteristics of victims of elderly age condition necessity of development of differentiated approaches to their medical care support, planning of measures of population prevention of medical sanitary aftermaths of road traumatism.

[The development of first medical care support to victims of road traffic accidents: The publications review].

The medical and demographic losses because of road traffic accidents continue to be significant in most of economically developed and developing countries. The national strategies of reducing medical and demographic losses include two groups of measures, depending on object of exposure: (1) targeted to decreasing risk of road traffic accidents and (2) targeted to timely and adequate medical care support of victims. Beyond this classification are activities targeted to developing and improving in participants of road traffic skills of first self-care and mutual assistance. The availability of mentioned skills is important for saving lives and preventing permanent disability of victims of road traffic accidents.

[The means of optimization of medical care support of victims of road traffic accidents at the hospital stage: The publications review].

The road traffic traumatism remains among the most actual medical social problems in Russia. The injured because of road traffic accidents suffer of predominant severe multiple and combined injuries (polytrauma) very often resulting in permanent disablement and lethal outcomes. The existing three-level system of traumatologic centers to supply specialized medical care of the injured in road traffic accidents demonstrates efficiency only on condition of observation of routing of patients. The new organizational approaches to specialized medical care to the injured at the hospital stage is needed for further decreasing of lethality and disability in group of victims of road traffic accidents.

Laser-induced fluorescent visualization and photodynamic therapy in surgical treatment of glial brain tumors.

High-grade gliomas have a diffuse and infiltrative nature of the growth of tumor cells, due to which the achievement of radical resection is difficult. Surgical resection completeness of brain tumors is an important factor in prolonging the life of patients. An accurate definition of tumor boundaries and residual fluorescent regions is impossible due to imperfections of the equipment used for fluorescent imaging. 5-aminolevulinic acid (5-ALA) is a precursor of protoporphyrin IX (PpIX) in humans and is clinically used to detect and treat tumors. Currently, fluorescence-guided surgery with PpIX used a surgical microscope with an excitation wavelength in the blue spectrum range. Because of its low ability to penetrate into biological tissue, blue light is ineffective for providing high-quality fluorescent navigation. Also, when performing an operation using radiation in the blue spectrum range, the photosensitizer's surface layer (PS) often bleaches out, which leads to frequent errors. The use of red light emission makes it possible to slow down the PS bleaches out due to the absorption properties of PpIX, but this task is technically more complicated and requires highly sensitive cameras and specialized optical filters. The new two-channel video system for fluorescent navigation has a radiation source in the red range of the spectrum, the penetration depth of which is greater than the blue light, which makes it possible to increase the depth of probing into biological tissues. The study's clinical part involved 5 patients with high grade glioma and 1 patient with low grade glioma: grade III oligodendrogliomas (2), grade IV glioblastomas (3), and grade II diffusion astrocytoma (1).

[Changes in the intestinal microbiota as a risk factor for dyslipidemia, atherosclerosis and the role of probiotics in their prevention].

The review presents an analysis of studies on the role of the intestinal microbiota and microbiome in lipid metabolism and the development of dyslipidemia, atherosclerosis and cardiovascular diseases. The role of the intestine as a metabolic organ with a multifactorial strain evolution, involved in lipid metabolism, cholesterol homeostasis and enterohepatic circulation is shown. The influence of microbial imbalance on the development of dyslipidemia and atherosclerosis is considered. Special attention is paid to preventive therapy with hypolipidemic probiotics. It is shown that the use of probiotics with hypolipidemic properties and consisting of a mixture of such strains asLactobacillus plantarumCECT7527, CET7528 and CECT7529, mixtures ofLactobacillus acidophilusLa-5,Bifidobacterium lactisBB-12,Bifidobacterium animalis lactisBB-12 contribute to reducing the level of LDL-C, CCS, TG, are safe and well tolerated, can be used as an adjuvant non-drug therapy in combination with hypolipidemic drugs for dyslipidemia, multifocal atherosclerosis.

Constraints on the K_{S}

A search for the decay K_{S}^{0}→µ^{+}µ^{-} is performed using proton-proton collision data, corresponding to an integrated luminosity of 5.6 fb^{-1} and collected with the LHCb experiment during 2016, 2017, and 2018 at a center-of-mass energy of 13 TeV. The observed signal yield is consistent with zero, yielding an upper limit of B(K_{S}^{0}→µ^{+}µ^{-})<2.2×10^{-10} at 90% C.L.. The limit reduces to B(K_{S}^{0}→µ^{+}µ^{-})<2.1×10^{-10} at 90% C.L. once combined with the result from data taken in 2011 and 2012.

[The combined use of kinesio- and laser therapy in the regional hemodynamic disorders correction in dilated cardiomyopathy]. / Sochetannoe primenenie kinezo- i lazeroterapii v korrektsii narushenii regionarnoi gemodinamiki pri dilatatsionnoi kardiomiopatii.

The search for new methods of symptomatic therapy of dilated cardiomyopathy (DCM) remains a relevant objective of modern cardiology. This is due to the low and short-term existing methods effectiveness of conservative and surgical treatment, including drug therapy. PURPOSE OF THE STUDY: Efficacy evaluation of the combined use of kinesio- and laser therapy for the correction of regional hemodynamics in patients with DCM against the background of maintenance drug therapy. MATERIAL AND METHODS: 100 patients with DCM were examined. All patients received differential maintenance drug therapy (beta-blockers, ACE inhibitors, with intolerance to the latter - angiotensin II receptor blockers, aldosterone receptor antagonists, diuretics, cardiac glycosides, antiarrhythmic drugs). Patients were divided into 2 groups at least 3 months after the selection of drug therapy. Intravenous laser blood irradiation (ILBI) and the selection of unloading therapeutic exercises were performed for patients of the main group during therapy. Patients in the control group received only drug therapy. The main research method was venous occlusion plethysmography. It was used to assess regional hemodynamics with the determination of recirculating blood flow (Qr) and regional vascular resistance (Rr) at rest, venous tone (Vt), reserve blood flow (QH) and regional vascular resistance (RH) against a functional stress test. RESULTS: Data obtained in the dynamic observation process (after 1, 3, 6, 9 and 12 months) in the main group indicate a significant increase in Qr and QH, a decrease in Rr and RH, Vt. Significant positive dynamics in the control group was not observed. The regional hemodynamics indices after 9 and 12 months of observation significantly worsened. CONCLUSION: Thus, according to venous-occlusal plethysmography, the use of unloading therapeutic exercises in combination with ILBI against the background of rationally selected differentiated drug therapy in patients with DCM significantly improves the regional hemodynamics. The developed symptomatic therapy methods can be applied in the practice of cardiologists, general practitioners, therapeutists, rehabilitation physicians to optimize the treatment of patients with DCM.

Measurement of CP-Averaged Observables in the B

An angular analysis of the B^{0}→K^{*0}(→K^{+}π^{-})µ^{+}µ^{-} decay is presented using a dataset corresponding to an integrated luminosity of 4.7 fb^{-1} of pp collision data collected with the LHCb experiment. The full set of CP-averaged observables are determined in bins of the invariant mass squared of the dimuon system. Contamination from decays with the K^{+}π^{-} system in an S-wave configuration is taken into account. The tension seen between the previous LHCb results and the standard model predictions persists with the new data. The precise value of the significance of this tension depends on the choice of theory nuisance parameters.