Seasonal differences in participation and time spent in physical activity in Russia: The Know Your Heart survey.

This study aimed to assess the levels and investigate socioeconomic, demographic, and health-related predictors of winter and summer physical activity (PA) in Russia using the data from the Know Your Heart population survey conducted in Novosibirsk and Arkhangelsk (2015-2018; n = 5068; aged 35-69 years). Employing a series of probit, Tobit, and the Cragg models, we separated the predictors of the probability of participating in leisure-time PA from the predictors of time spent in PA. Our study showed that financial constraints limited males' participation in winter PA (probability of participation decreased by 12 percentage points) and females' engagement in winter and summer PA (decrease in the number of hours of practicing PA by approximately 1 h a week). Education, self-reported health, smoking, and cues to action had different impacts on both probability and time spent in PA in winter and summer. We also found significant gender differences in participation and time spent in PA across seasons. Older age, poor health, and smoking were greater obstacles to PA for males compared to females both in winter and summer. However, males were more likely to follow physician's advice to lose weight and take up physical exercise. Information campaigns that promote physical activities, including those that are free of charge, are needed to help limit barriers to PA for people with low socioeconomic status and individuals with little or no exercise experience. Also, making sports more accessible to citizens by providing free and low-cost sports facilities can increase their participation and time spent in PA, improving individual health and productivity.

Initial Respiratory System Involvement in Juvenile Idiopathic Arthritis with Systemic Onset Is a Marker of Interstitial Lung Disease: The Results of Retrospective Cohort Study Analysis.

Background: Pulmonary involvement in systemic juvenile idiopathic arthritis (SJIA) is a rare but dangerous complication. The main risk factors are already known, such as macrophage activation syndrome, a refractory course of systemic juvenile arthritis, infusion reaction to interleukin 1 and/or interleukin 6 blockers, trisomy 21, and eosinophilia. However, information about respiratory system involvement (RSI) at the onset of SJIA is scarce. Our study aimed to evaluate the specific features of children with SJIA with RSI and their outcomes. Methods: In a single-center retrospective cohort study, we compared the information from the medical records of 200 children with SJIA according to ILAR criteria or SJIA-like disease (probable/possible SJIA) with and without signs of RSI (dyspnea, shortness of breath, pleurisy, acute respiratory distress syndrome, and interstitial lung disease (ILD)) at the disease onset and evaluated their outcomes (remission, development of chronic ILD, clubbing, and pulmonary arterial hypertension). Results: A quarter (25%) of the SJIA patients had signs of the RSI at onset and they more often had rash; hepato- and splenomegaly; heart (pericarditis, myocarditis), central nervous system, and kidney involvement; hemorrhagic syndrome; macrophage activation syndrome (MAS, 44.4% vs. 9.0%, p = 0.0000001); and, rarely, arthritis with fewer active joints, compared to patients without RSI. Five patients (10% from the group having RSI at the onset of SJIA and 2.5% from the whole SJIA cohort) developed fibrosing ILD. All of them had a severe relapsed/chronic course of MAS; 80% of them had a tocilizumab infusion reaction and further switched to canakinumab. Unfortunately, one patient with Down's syndrome had gone. Conclusion: Patients with any signs of RSI at the onset of the SJIA are required to be closely monitored due to the high risk of the following fibrosing ILD development. They required prompt control of MAS, monitoring eosinophilia, and routine checks of night oxygen saturation for the prevention/early detection of chronic ILD.

In Vitro Effects of Fentanyl on Aortic Viscoelasticity in a Rat Model of Melatonin Deficiency.

Melatonin influences arterial biomechanics, and its absence could cause remodeling of the arterial wall, leading to increased stiffness. Direct effects of fentanyl on the aortic wall have also been observed previously. This study aimed to evaluate in vitro the effects of fentanyl on aortic viscoelasticity in a rat model of melatonin deficiency and to test the hypothesis that melatonin deficiency leads to increased arterial wall stiffness. The viscoelasticity was estimated in strip preparations from pinealectomized (pin, melatonin deficiency) and sham-operated (sham, normal melatonin) adult rats using the forced oscillations method. In the untreated aortic wall pin, the viscoelasticity was not significantly altered. However, combined with 10-9 M fentanyl, the pin increased the natural frequency (f0) and modulus of elasticity (E') compared to the sham-operated. Independently, fentanyl treatment decreased f0 and E' compared separately to untreated sham and pin preparations. The effects of fentanyl were neither dose-dependent nor affected by naloxone, suggesting a non-opioid mechanism. Furthermore, an independent effect of naloxone was also detected in the normal rat aortic wall, resulting in reduced E'. Additional studies are needed that may improve the clinical decisions for pain management and anesthesia for certain patients with co-occurring chronic low levels of blood plasma melatonin and some diseases.

BCD020 rituximab bioanalog compared to standard treatment in juvenile systemic lupus erythematosus: The data of 12 months case-control study.

BACKGROUND: Systemic lupus erythematosus (SLE) is the most frequent and serious systemic connective tissue disease. Nowadays there is no clear guidance on its treatment in childhood. There are a lot of negative effects of standard-of-care treatment (SOCT), including steroid toxicity. Rituximab (RTX) is the biological B-lymphocyte-depleting agent suggested as a basic therapy in pediatric SLE. AIM: To compare the benefits of RTX above SOCT. METHODS: The data from case histories of 79 children from the Saint-Petersburg State Pediatric Medical University from 2012 to 2022 years, were analyzed. The diagnosis of SLE was established with SLICC criteria. We compared the outcomes of treatment of SLE in children treated with and without RTX. Laboratory data, doses of glucocorticosteroids, disease activity measured with SELENA-SLEDAI, and organ damage were assessed at the time of initiation of therapy and one year later. RESULTS: Patients, treated with RTX initially had a higher degree of disease activity with prevalence of central nervous system and kidney involvement, compared to patients with SOCT. One year later the disease characteristics became similar between groups with a more marked reduction of disease activity (SELENA-SLEDAI activity index) in the children who received RTX [-19 points (17; 23) since baseline] compared to children with SOCT [-10 (5; 15.5) points since baseline, P = 0.001], the number of patients with active lupus nephritis, and daily proteinuria. During RTX therapy, infectious diseases had three patients; one patient developed a bi-cytopenia. CONCLUSION: RTX can be considered as the option in the treatment of severe forms of SLE, due to its ability to arrest disease activity compared to SOCT.

Simultaneous Catechol and Hydroquinone Detection with Laser Fabricated MOF-Derived Cu-CuO@C Composite Electrochemical Sensor.

The conversion of metal-organic frameworks (MOFs) into advanced functional materials offers a promising route for producing unique nanomaterials. MOF-derived systems have the potential to overcome the drawbacks of MOFs, such as low electrical conductivity and poor structural stability, which have hindered their real-world applications in certain cases. In this study, laser scribing was used for pyrolysis of a Cu-based MOF ([Cu4{1,4-C6H4(COO)2}3(4,4'-bipy)2]n) to synthesize a Cu-CuO@C composite on the surface of a screen-printed electrode (SPE). Scanning electron microscopy, X-ray diffractometry, and Energy-dispersive X-ray spectroscopy were used for the investigation of the morphology and composition of the fabricated electrodes. The electrochemical properties of Cu-CuO@C/SPE were studied by cyclic voltammetry and differential pulse voltammetry. The proposed flexible electrochemical Cu-CuO@C/SPE sensor for the simultaneous detection of hydroquinone and catechol exhibited good sensitivity, broad linear range (1-500 µM), and low limits of detection (0.39 µM for HQ and 0.056 µM for CT).

Rituximab Biosimilar BCD020 Shows Superior Efficacy above Conventional Non-Biologics Treatment in Pediatric Lupus Nephritis: The Data of Retrospective Cohort Study.

BACKGROUND: Pediatric lupus nephritis (LN) is one of the most serious manifestations of systemic lupus erythematosus (SLE) in children, determining the outcomes of the disease. There are no standardized treatment protocols for pediatric LN, and the role of biologics has not yet been conclusively defined. OBJECTIVES: analyze the safety and efficacy of rituximab biosimilar BCD020 in pediatric patients with lupus nephritis. METHODS: in a retrospective cohort study, the data from the case histories of 25 patients with LN (10 boys and 15 girls) with an onset age of 13 (9-16) years, who failed conventional non-biologic treatment or developed corticosteroid dependence/toxicity, were included. The diagnosis was made using Systemic Lupus International Collaborating Clinics (SLICC) classification criteria. Rituximab biosimilar BCD020 was prescribed in a dosage of 375 mg/m2 every week (2-4 infusions) with repeated courses every 6-12 months (2-4 infusions) according to disease activity, B-cell depletion, and IgG levels. The dynamics of clinical and laboratory data, the activity of the disease by SLEDAI, and corticosteroid doses were assessed at the onset and during the rituximab trial. RESULTS: The main patient's characteristics were: Pre-rituximab non-biologic conventional treatment included: cyclophosphamide 15 (60%), MMF 8 (32%), azathioprine 3 (12%), hydroxychloroquine 12 (48%), and pulse therapy of methylprednisolone followed by oral methylprednisolone 25 (100%). The time before rituximab was 7.0 (3.0-24.0) months, and the whole observation period was 7.0 (0; 24) months. The initial pre-rituximab treatment slightly reduced SLEDAI levels and the proportion of patients with LN. A significant reduction of SLEDAI, the anti-dsDNA level, proteinuria, hematuria, C4 complement, ESR, and the median corticosteroid dose by 80% from the initial value, as well as the proportion of patients without corticosteroids, was observed after rituximab administration. Two deaths were observed due to catastrophic SLE with macrophage activation syndrome, accompanied by a severe infection (invasive aspergillosis, n = 2). Three patients developed serious adverse events: pneumonia (n = 2), transient agranulocytosis (n = 1) after the third rituximab infusion, and meningitis, caused by Listeria monocytosis, after the first rituximab infusion. Eight patients received antibacterial treatment for different respiratory infections without hospital admissions. CONCLUSIONS: Rituximab biosimilar BCD020 showed effectiveness in LN, whereas previous non-biologic treatment was insufficiently effective. Randomized controlled trials are required to evaluate the efficacy and safety of rituximab and evaluate the benefits when compared with conventional SLE treatment.

Temporomandibular Joint Involvement in Juvenile Idiopathic Arthritis: The Results from a Retrospective Cohort Tertial Center Study.

Our study aimed to evaluate the clinical and laboratory features of juvenile idiopathic arthritis (JIA) children with temporomandibular joint (TMJ) arthritis. In the retrospective cohort study, we analyzed data of 753 patients with JIA aged 2-17 years, depending on TMJ arthritis or not. TMJ arthritis can to be diagnosed in the presence of at least two of the following clinical signs of inflammation: pain in TMJ, jaw opening limitation, jaw opening deviation, and micrognathia. We compared clinical, laboratory, and treatment features in JIA patients depending on the involvement of TMJ. TMJ arthritis was detected in 43 (5.7%) of our patients and associated with a longer course of the disease, polyarticular JIA category, treatment with systemic corticosteroids, and longer achievement of the remission and involvement of cervical spine, hip, and shoulder. Active joints >8 (OR = 14.9, p = 0.0000001), delayed remission >7 years (OR = 3.1; p = 0.0004), delayed hip involvement (OR = 4.6; p = 0.041), hip osteoarthritis (OR = 4.0; p = 0.014), cervical spine arthritis (OR = 10.3, p = 0.000001), and corticosteroid treatment (OR = 2.3, p = 0.0007) were associated with TMJ involvement. Patients with TMJ arthritis require more biologics (OR = 3.2, p = 0.0006, HR = 2.4, p = 0.005) and have decreased probability of remission achievement (p = 0.014). Consequently, TMJ arthritis was associated with a severe disease course. Early biologic treatment and corticosteroid avoidance might decrease TMJ involvement.

Direct Synthesis of Mn3[Fe(CN)6]2·nH2O Nanosheets as Novel 2D Analog of Prussian Blue and Material for High-Performance Metal-Ion Batteries.

Rechargeable metal-ion batteries (RMIBs) are prospective highly effective and low-cost devices for energy storage. Prussian blue analogues (PBAs) have become a subject of significant interest for commercial applications owing to their exceptional specific capacity and broad operational potential window as cathode materials for rechargeable metal-ion batteries. However, the limiting factors for its widespread use are its poor electrical conductivity and stability. The present study describes the direct and simple synthesis of 2D nanosheets of MnFCN (Mn3[Fe(CN)6]2·nH2O) on nickel foam (NF) via a successive ionic layer deposition (SILD) method, which provided more ion diffusion and electrochemical conductivity. MnFCN/NF exhibited exceptional cathode performance for RMIBs, delivering a high specific capacity of 1032 F/g at 1 A/g in an aqueous 1M NaOH electrolyte. Additionally, the specific capacitance reached the remarkable levels of 327.5 F/g at 1 A/g and 230 F/g at 0.1 A/g in 1M Na2SO4 and 1M ZnSO4 aqueous solutions, respectively.

Socioeconomic and Behavioral Determinants of Cardiovascular Risk in Russia: A Structural Equation Modeling Approach.

Purpose: Despite much attention within the literature, the multiple risk factors associated with CVD mortality in Russia are still not fully understood. Drawing on the Health Belief Model as a theoretical framework, we aim to elicit socioeconomic and behavioral determinants of cardiovascular risks in Russian men and women. Methods: Using the Know Your Heart project data, we utilize regression analysis and then structural equation modeling (latent class analysis and mediation analysis) to study the determinants of CVD risks. Results: OLS and ordered logit regressions show that the key factors defining cardiovascular health behaviors in Russia are health-related actions to reduce the perceived threat of diseases (physical activity and GP visits), perceived barriers to behavioral change (financial constraints), and cues to action (awareness of the federal health check-up program). The latent class analysis further identifies three distinct groups of the population with different CVD risk levels. Over one-third of respondents belong to the "high CVD risk" class characterized by the highest share of smokers and alcohol abusers who evade contact with primary care and face financial constraints. In the mediation analysis, we find that employment mediates the relationship between physical activity and CVD risks: physically active individuals have a greater chance of employment, and employment further mitigates CVD risks. We also find an indication of the selection of the healthy into employment in the causal relationship between GP visits, having a job, and CVD risks. Conclusion: A corresponding set of policy actions stem from these findings. These include reinforcing the change of perceptions of CVD risks and lowering barriers to health care; raising awareness of the free preventive check-up program in the "high CVD risk" group; making sports and exercise accessible to the elderly; and using off-putting labels on alcohol products as behavioral nudges among "physically active but drinking" males.

Cost-benefit analysis for health project evaluation (example of a Russian outpatient clinics' project in the Novosibirsk region).

Introduction: The development of social infrastructure projects in medicine corresponds to transforming public priorities toward social development in general and health care in particular. Therefore, there is a need to develop comprehensive quantitative methods for evaluating such projects. Methods: This paper uses a combination of two approaches: first, cost-benefit analysis taking into account the relationship between financial and economic efficiency; second, the study of the efficiency of participation in a public-private partnership concerning project efficiency. The model's financial bloc is focused on analyzing the return on investment in fixed and working capital, considering the terminal value. The economic bloc includes social and tax effects (along with environmental, price, indirect, and other specific public effects). We apply fixed effects regression models to calculate multipliers used to estimate the social effects. Multipliers are based on: public health expenditure, human development index, and life expectancy. The proposed methodology has been adapted for evaluating the Seven Polyclinics' project as a flagship project for developing social infrastructure in the Novosibirsk Region. Results and discussion: The evaluation results revealed a deficient level of financial efficiency of the project characterized by negative net present value and low internal rate of return. Simultaneously, the efficiency of participation in the project for private investors using the public-private partnership mechanism is characterized by high rates of return on private investment. In the transition to the economic analysis, the results fundamentally change, taking into account social and tax effects and detecting an exceptionally high level of all economic indicators of the project. As the project's primary beneficiaries, the economic analysis identified polyclinic patients who received the opportunity to acquire new medical services. At the same time, within the financial analysis framework, the mechanisms for implementing the project were determined, ensuring the consistency of interests. The distribution of effects among the project participants was compared for various funding methods, including the public-private partnerships mechanism. It is shown that the project implementation leads to significant social effects and provides a noticeable improvement in population health. The proposed methodology can be used for decision making on the implementation of similar projects.

Labour market status and depression in Russia: A longitudinal study, 2011-2017.

AIMS: This is the first longitudinal study to examine the relationship between depression and the labour market in Russia. Using data from 2011 to 2017, we identify the impact that not being in employment has on mental distress, and we explore the mechanism underlying the observed association. METHODS: Using data from the Russia Longitudinal Monitoring Survey - Higher School of Economics, we employ random-effects regression models to estimate the impact of employment conditions on the likelihood of reporting mental distress in Russia. This method allows us to distinguish between the selection effect associated with mental distress and direct causation. RESULTS: Controlling for a range of socio-economic and demographic characteristics, we find that unemployment and labour market inactivity are strong predictors of the likelihood of reporting depression and serious nervous breakdown. However, we find that rather than negative labour market events giving rise to mental distress, the selection effect actually dominates, and the direction of causality therefore operates in reverse. CONCLUSIONS: Knowledge of the underlying mechanism that links unfavourable labour market outcomes with mental distress is crucial for designing policies that can address this link. We argue that our findings provide grounds for the initiation of anti-stigma campaigns among employers, policymakers, health practitioners and politicians as well as the general population. Eradication of the perception that mental disorders are somehow different to 'real' illnesses will not only prevent Russians from self-selection into unemployment but may also transform outdated approaches to mental health care in Russia.

The Safety and Efficacy of Tofacitinib in 24 Cases of Pediatric Rheumatic Diseases: Single Centre Experience.

JAK-inhibitors are small molecules blocking the JAK-STAT pathway that have proven effective in the treatment of different immune-mediated diseases in adults and juvenile idiopathic arthritis (JIA). AIM OF STUDY: To evaluate the safety and efficacy of tofacitinib in children with different rheumatic diseases. MATERIAL AND METHODS: We extracted information from 24 children with the following diagnosis: JIA (n = 15), undifferentiated systemic autoinflammatory diseases (SAIDs) (n = 7), and juvenile dermatomyositis (JDM) (n = 2) who have been treated with tofacitinib for a period of longer than 6 months. The treatment outcomes were classified according to the opinion of the attending physicians as having a complete response (CR), i.e., the absence of disease activity, or a partial response (PR)-a significant improvement of symptoms and disease activity, or no response (NR)-no changes in disease activity. RESULTS: CR was achieved in 10/24 patients; 7/15 among JIA patients, 1/2 among JDM patients, 4/7 among SAID patients, and PR in 5/15 of JIA, 1/2 of JDM, and 3/7 of SAID patients. Three non-responders with JIA discontinued tofacitinib. Corticosteroids were successfully tapered off in 11/14 patients and discontinued in 2/14 patients. Four patients had side effects not requiring treatment discontinuation: liver enzyme elevation (n = 2), hypercholesterolemia (n = 1), lymphadenitis (n = 1). CONCLUSION: JAK-inhibitors are effective new therapies for the treatment of multiple immune-mediated diseases. Our experience has shown the best results in patients with JIA and JIA-associated alopecia, and type I interferonopathies. More data from randomized controlled clinical trials are needed to use JAK-inhibitors safely in pediatric rheumatic diseases.

Influence of the time of bilberry (Vaccinium myrtillus L.) addition on the phenolic and protein profile of beer.

BACKGROUND: In recent years, there has been an increased fruit addition to the brewing process, especially in craft breweries. Fruit addition leads to changes in the organoleptic characteristics and chemical composition of beers. Bilberries are rich in phenolic compounds and possess significant antioxidant capacity. The effects of bilberry addition and brewing process parameters on the changes in the phenolic and protein profile of beer have not been sufficiently studied. The aim of this research was to investigate the changes in the individual phenolic compounds and the protein fractions in beer when bilberries were added at different maturation stages. METHODS: An infusion mashing method was applied for the purpose of obtaining wort with an original extract of 14°P after boiling. Pilsner malt, bitter and aromatic hops 60/40 (Perle and Cascade, respectively), dry yeast Saccharomyces pastorianus (carlsbergensis) Saflager W 34/70, and bilberries (Vaccinium myrtillus L.) were used. All processes were conducted in a Home Brew 50 all-in-one 50 dm3 brewing system. The fermentation was carried out in a stainless steel cylindroconical fermenter at a temperature of 14°C. The “green beer” was transferred to small stainless-steel fermenters after 60% of the original wort extract had been fermented. The maturation continued for 14 days at 14°C, and the beer lagering for 5 days at 2°C. The bilberries were pasteurised in a water bath for 10 minutes at 70°C. After cooling, they were added to small fermenters at a concentration of 167 g/dm3 at the beginning and on the seventh day of beer maturation. All variants were carried out in duplicate. After lagering, the beer was bottled using a “beer gun”. The beer samples from the experiments were filtered on the day of bottling and frozen until analysis. HPLC/UV-VIS and electrophoresis were used to determine the phenolics and proteins, respectively. The total monomeric anthocyanins were determined by the pH differential method. The original wort extract and alcohol concentration were evaluated, and the sensory analysis was performed according to EBC standard methods. RESULTS: The changes in 10 phenolic acids, 7 flavonoids, and 10 protein fractions in beer with bilberries added at the beginning and on the seventh day of maturation were studied. The addition of bilberries led to an increase in the phenolic acid (3-fold) and flavonoid (6.2-fold) concentrations. The highest enrichment was observed in terms of rutin, chlorogenic, caffeic, and 3,4-dihydrobenzoic acids. Rosmarinic acid and monomeric anthocyanins were only detected in the bilberry beers. Chlorogenic and neochlorogenic acids, rutin, and catechin dominated in the bilberry beers. Neochlorogenic and gallic acids, epicatechin, and catechin dominated in the bilberry-free beers. The addition of bilberries reduced the protein content by 93 to 96%. The number of protein fractions decreased from 10 to 4. The influence of the bilberry addition time on the phenolics and proteins was different, and it affected the individual protein fractions in a different way. More phenolic acids and flavonoids were determined when bilberries were added at the beginning of maturation. The losses of some protein fractions were higher at the beginning of maturation and of others on the seventh day of maturation, whereas the addition time did not matter for some of the fractions. CONCLUSIONS: This study provides new information related to the changes in the phenolic and protein profile of beer with bilberries depending on the time of bilberry addition during beer maturation. The protein concentration and number of protein fractions decreased dramatically. In spite of the significant protein losses, the bilberry addition improved the phenolic profile of the beer and its organoleptic characteristics. The presence of more phenolic compounds is related to the antioxidant capacity respective to the biological value of beer. Further research in this direction is needed.

Comparative study of chemical and topological structure of macromolecules of lignins of birch (Betula verrucosa) and apple (Malus domestica) wood.

Recent advances in investigations of chemical structure of lignin give rise to questions about relationship between chemical structure and topology of the macromolecules. In this paper, we made a comparison of results of the studies of chemical and topological structures of lignins. The features of topological structure of lignins of birch and apple wood were identified on the basis of the study of dilute solutions of the lignins by the sedimentation-diffusion analysis and viscometry. The number of branches of macromolecules in the birch and apple lignins was calculated by the Zimm-Kilb equation. Quantitative characteristics of chemical structure of the lignins were obtained by 2D NMR spectroscopy and nitrobenzene oxidation. The structural analysis and the calculations based on the hydrodynamic data gave estimation of the degree of branching of macromolecules, which fit well in the theory on the role of dibenzodioxocin and 4'-O-5 structures in branching of lignin macromolecules.

Attitudes to reform: Could a cooperative health insurance scheme work in Russia?

As for all health systems, in Russia, the demand for medical care is greater than its health system is able to guarantee the supply of. In this context, removing services from the state guaranteed package is an option that is receiving serious consideration. In this paper, we examine the attitudes of the Russian population to such a reform. Exploiting a widely-used methodology, we explore the population's willingness to pay for cooperative health insurance. Distinguishing between socioeconomic and demographic factors, health-related indicators and risk aversion we find, consistent with other literature, positive income and risk aversion effects. We interpret the former as evidence that the Russian population is not opposed to the idea of progressive redistribution, to pool the costs of health-related risks; and the latter as evidence that risk-averse individuals demand more insurance coverage. In exploring these results further, we show that cognitive bias is important: overestimating the benefits leads to the purchase of additional insurance, while underestimating lowers demand for insurance. Our overall conclusion is that the introduction of a supplementary cooperative health insurance scheme in Russia could increase the accessibility of healthcare, lower the tendency for informal payments, incentivize the personal maintenance of good health and create a new source of funding for public healthcare.

The effect of chronic conditions and multi-morbidity on self-assessed health in Russia.

AIMS: Chronic disorders, such as cardiovascular disease, cancer, respiratory diseases and diabetes, are the leading cause of mortality globally, representing 68% of all recorded deaths. The incidence of chronic disease and multiple chronic disease is rising across the world, but relatively little is known about the impact of multi-morbidities on the life experiences of those individuals who encounter them. In this paper, we examine and quantify the relationship between chronic illness, multi-morbidity and the individual self-assessed health of the Russian population using individual-level Russian data and a novel quantitative technique. METHODS: We apply a partial proportional odds framework to a rich data set incorporating demographic, socio-economic and health indicators in Russia. RESULTS: We find that individuals with chronic conditions report significantly lower levels of health than those without chronic conditions, but that the strength of the effect is much more pronounced for males than for females (e.g. neurological disease: odds ratio [OR]=4.81 for men; OR=1.86 for women)). As the number of co-morbidities increases, there is a dramatic decrease in the likelihood of reporting good health for both males and females, but for males there is a greater increase in the likelihood of reporting bad health (OR=49.31 for males with ≥5 diseases; OR=28.05 for females). CONCLUSIONS: More than 40% of Russians currently live with multi-morbidity, and this group is at the highest risk of reporting poor self-rated health. This research adds to the body of evidence demonstrating the challenges facing health-care systems as new patterns of disease take hold in contemporary society.

Reforming voluntary drug insurance in Russian healthcare: does social solidarity matter?

With low take-up of both private health insurance and the existing public drug reimbursement scheme, it is thought that less than 5% of the Russian population have access to free outpatient drug treatment. This represents a major policy challenge for a country grappling with reforms of its healthcare system and experiencing low or no economic growth and significant associated reductions in spending on social services. In this paper, we draw on data from a 2011 Levada-Center survey to examine the attitudes and social solidarity of the Russian population towards drug policies in general and towards the introduction of a proposed voluntary drug insurance system in particular. In addition to being among the first to explore these important questions in the post-Communist setting, we make three important contributions to the emerging policy debates. First, we find that, if introduced immediately and without careful planning and preparation, Russia's voluntary drug insurance scheme is likely to collapse financially due to the over-representation of high-risk unhealthy individuals opting in to the scheme. Second, the negative attitude of higher income groups towards the redistribution of wealth to the poor may further impede government efforts to introduce voluntary drug insurance. Finally, we argue that Russia currently lacks the breadth and depth of social solidarity necessary for implementing this form of health financing.

Encapsulation of brewing yeast in alginate/chitosan matrix: lab-scale optimization of lager beer fermentation.

Two mathematical models were developed for studying the effect of main fermentation temperature (TMF), immobilized cell mass (MIC) and original wort extract (OE) on beer fermentation with alginate-chitosan microcapsules with a liquid core. During the experiments, the investigated parameters were varied in order to find the optimal conditions for beer fermentation with immobilized cells. The basic beer characteristics, i.e. extract, ethanol, biomass concentration, pH and colour, as well as the concentration of aldehydes and vicinal diketones, were measured. The results suggested that the process parameters represented a powerful tool in controlling the fermentation time. Subsequently, the optimized process parameters were used to produce beer in laboratory batch fermentation. The system productivity was also investigated and the data were used for the development of another mathematical model.