[The social hygienic aspects of reproductive behavior of women aged 40-45 years].

In the context of forecasted decreasing of natality, actuality of studying its causes for organizational decision-making increases. The purpose of the study was to determine factors affecting reproductive behavior of women aged 40-45 years residing in areas with different natality levels in 2020-2021. The cohort, analytical, sociological methods were applied. The results of study demonstrated that in areas with high natality level most of urban women with higher education and high income resides in conditions of dormitory or mortgage flat and working in profile of their specialty. They are characterized by belated marriage that results in postponed child-bearing. The areas with low natality are characterized by dwelling of rural women with secondary or secondary specialized education. They reside in their own homes and work in other occupations than their specialty. The analysis of social status of women of different age groups will permit more selective approach in developing measures of increasing natality in modern conditions.

[The functioning of call-center in conditions of COVID-19 pandemic].

In conditions of persisting high morbidity of COVID-19, issues related to prompt and timely medical care of population remains actual ones. The purpose of the study to analyze activities of the call-center of the Ministry of Health Care of the Udmurt Republic related to organization of medical care of COVID-19 patients in the Udmurt Republic. MATERIALS AND METHODS: The statistical (descriptive statistics) and descriptive methods were applied. The indicators of functioning of the call-center of the Ministry of Health Care of the Udmurt Republic in 2020-2022 were analyzed. The psychological characteristics of telephone counseling were studied. The satisfaction of medical organizations and citizens with services of call-center operators was assessed. THE RESULTS: The main principles of telephone counseling are confidentiality, maintenance of framework of working conversation, respect to personality of addressee. In 2020 the call center phone line received 34160 calls, in 2021 - 128339 calls, in 2022 - 65618 calls. In 25 months of operation the call-center operators received 228,117 calls from citizens related to issues of new coronavirus infection. The number of patient calls to the hot-line increases significantly when incidence of new coronavirus infection increases (r=0.885; p<0.05). Most frequently (25.1%) citizens contacted the call-center of the Ministry of Health Care of the Udmurt Republic due to inability to reach the polyclinic and on issues related to primary before-doctor care. The second place in terms of frequency (18.5%) took issues related to PCR-test results. The third place (14.1%) took issues related to duration of quarantine for patients and persons residing with them, possibility for children to attend preschool and educational institutions. The number of outgoing calling in 2020 was 16146, in 2021 - 89269 and in 2022 9936 calls. During 25 months of operation, call-center operators made 204,782 calls to citizens to monitor their health status and invite them to vaccinations and health screenings. More than half of outgoing calls (58.3%) were related to audio-monitoring of patients undergoing outpatient treatment with making-up of electronic protocol. CONCLUSIONS: During the period of increasing of COVID-19 morbidity, the call-center becomes an independent structural unit of organizing patient care. The medical organizations and citizens are satisfied with functioning of the call-center of the Ministry of Health Care of the Udmurt Republic organized in order of improving the organization of medical care of patients with COVID-19.

[The becoming and development of the academic subject and scientific discipline "public health and health care organization" (to the centenary of the academician Yu. P. Lisitsyn Chair of Public Health and Health Care). Report I (beginning of XX century - 1963)].

The article presents analysis of becoming of academic subject and scientific discipline "Public Health and Health Care Organization" in Russia from beginning of the 20th century to 1963. The special attention was paid to the role in their becoming and development that played the Chair of Public Health and Health Care Organization of the Pirogov Russian National Research Medical University that is celebrating its centenary in 2023-2024 academic year. The contribution into this process of its prominent scientists and heads is considered.

[The common morbidity of children population in conditions of propagation of new coronavirus infection COVID-19 in 2017-2019].

The health of children population is one of the indicators of the social and epidemiological well-being of society. The purpose of the study was to study main trends of propagation of various classes of diseases in children population in conditions of propagation of the new coronavirus infection. The data of Rosstat for the Udmurt Republic covering the pre-COVID period (2017-2019) and the period of COVID-19 propagation (2020-2021). The analytical method, descriptive statistics technique, the calculation of intensive and extensive indicators were applied. It is established that in 2017-2019, general morbidity of the children population aged 0-7 years decreased by 8.7%, while in conditions of higher propagation of COVID-19 (2020-2021) there was an increase by 11.0 %. In the children population aged 0-14 years, general morbidity decreased by 10%, and hereinafter it increased on 12.1%. At that, in the pre-COVID period in children population aged from 0 to 17 years, morbidity rate decreased for 14 classes of diseases, for 15 classes in children population aged from 0 to 14 years. During the period of higher propagation of COVID-19 morbidity rate for only 5 classes of diseases decreased in both age groups of children population.

[Achieving global academic leadership: an analysis of the highly cited segment of surgery publications]. / Dostizhenie mirovogo akademicheskogo liderstva: analiz naibolee chasto tsitiruemogo segmenta publikatsii po khirurgii.

In the Strategic Academic Leadership Program, the number of publications included in the 1% of the most cited ones in the Web of Science Core Collection database over previous 10 full years is used as an indicator of research potential of universities and scientific centers. The purpose of this study was to analyze the segment of Highly Cited Papers and Hot Papers on surgery using the Essential Science Indicators (ESI) analytical application. According to ESI data, relevant for March 2020, highly cited publications on medicine have formed 2.425 research fronts including 211 ones in surgery. We have analyzed the directions of researches in surgery characterized by the greatest number of citations.

[Analysis of the internationalized highly cited segment of national surgery publications]. / Analiz internatsionalizirovannogo vysokotsitiruemogo segmenta otechestvennykh publikatsii po khirurgii.

The internationalized segment of manuscripts on surgery published in top-rated journals indexed in the Web of Science Core Collection (WoS CC) was analyzed. Presence of national publications in surgical journals of different quartiles was estimated. It was shown that 59.6% of surgical articles of Russian authors, indexed in the WoS CC, were published in high-ranking journals (Q1 and Q2). The number of such articles has been increased by more than 3 times (from 23 in 2010 to 86 in 2018) on the background of no growth in the fourth quartile. We formed a rating of national educational and academic organizations, which have made the greatest contribution to a portfolio of publications on surgery, indexed in Q1-Q2 quartiles of WoS CC, as well as in the segment of highly cited publications.

[The trends of population general morbidity in the subjects of the Central Federal Okrug of the Russian Federation].

The article presents the results of analysis of indices of total morbidity of population of the Central Federal Okrug (CFD) of the Russian Federation in 2010-2017. The significant differences in indices of total morbidity between the CFD subjects in certain ICD-10 classes were established. The indices of total morbidity of population during study period (8 years) in the Central Federal District factually didn't altered, while dynamics of indices in other subjects was characterized by multidirectionality. The gap in levels of total morbidity of population in the subjects was significant: from 115,123.6 per 100,000 of population in the Kursk Oblast to 194,404.1 per 100,000 of population in the Orel Oblast. The significant difference in rates of increase/ decrease of indices is noted. Thus, in Moscow decrease rate made up to 10%, while in the Orel Oblast morbidity increased up to 13.1%. Besides, in 2017, the Orel Region took a leadership in rate of increasing of total morbidity in such classes of diseases as infectious and parasitic diseases (39.3%), diseases of blood and blood-forming organs (49.1%), diseases of endocrine system (59,1%), diseases of nervous system (26.8%), diseases of respiratory system (28.2%), diseases of musculoskeletal system (16%), malformations (56%). It is very likely that this trend developed under influence of demographic situation in the subject due to significant increasing of percentage of people older than able-bodied age. The city of Moscow occupies leading position in decreasing of rate of prevalence of diseases and last but one place in level of total morbidity being inferior only to the Kursk Oblast. Thus, in Moscow was noted the most significant decreasing of morbidity in classes of infectious and parasitic diseases (26%) and diseases of digestive system (20.6%). The diseases of blood and blood-forming organs (235.2 per 100,000 population) and mental disorders (2353.5 per 100,000 population) were registered the less. The main contribution into trends of increasing or decreasing of indices is made by persons aged 18 years and older (74.1%).

[Evaluating justification of choice for priority directions in the field of biomedicine in the national project 'SCIENCE']. / Otsenka obosnovannosti vybora prioritetnykh napravlenii v oblasti biomeditsiny v natsional'nom proekte 'NAUKA'.

The purpose of the present research was to analyze the validity of the choice for biomedical disciplines fixed by the passport of the national project 'Science' for the following priority of the Strategy for the scientific and technological development of the Russian Federation: 'the transition to personalized medicine, high-tech medical care and health saving technologies ...'. We assessed the degree of relevance of this choice to great challenges facing the Russian Federation, as well as trends in the development of global biomedicine. The hypothesis of this study was the assumption that when determining priority areas it is necessary to proceed from the analysis and comparison of two arrays: the list of nosologies which account for the maximum morbidity, mortality, disability level of, primarily, the able-bodied population of Russia, and scientometric data identifying trends in the development of global biomedicine.

[Estimation of the place of the Russian Federation in the world publication activity ranking on priority trends in biomedicine]. / Otsenka pozitsii Rossiiskoi Federatsii v mirovom reitinge publikatsionnoi aktivnosti po prioritetnym napravleniiam v oblasti biomeditsiny.

During 2012-2018 in the Russian Federation, pursuant to Presidential Decree No. 599 of 05.07.2012, a set of state support measures was implemented aimed at increasing the specific gravity of Russian publications indexed in international databases. The national project 'Science' (NPS) designed to realize the goals set by Presidential Decree No.204 of 05.07.2018 'On the National Goals and Strategic Tasks for Development of the Russian Federation until 2024' continues and develops the theme of increasing the publication activity of the Russian Federation in the internationalized space. One of the six NPS targets is 'The place of the Russian Federation in terms of specific gravity in the total number of articles in areas defined by the priorities of scientific and technological development in publications indexed in international databases'. The purpose of this study was to evaluate the basic value of this indicator for biomedical disciplines related to the priority direction (paragraph 20c) of the Strategy for Scientific and Technological Development of the Russian Federation. We compared volumes of publication flows of the Russian Federation in 20 biomedical disciplines with a similar indicator of countries ranked fifth in the number of publications on the subject area under consideration, indexed in the Web of Science Core Collection (WoS CC). A 5-10 fold lag of the Russian Federation was recorded for the most part of the priority areas in the field of biomedicine identified by the NTS passport. The impact of public policy measures aimed at increasing the national biomedical publication stream for the period of 2012-2018 was estimated as insufficient to meet the considered NTS target.

[Multimorbidity of elderly persons in urban and rural areas of the Nizhny Novgorod region.]

The article compares the prevalence of pathological changes in different organs and systems among city and rural residents of the next ages: elderly (60-74 years for men and 55-74 years for women), senile (75-84 years) and advanced (85 years and older) ages. The results of the continuous survey of all persons of the retirement age of one urban (7 809 people) and two rural areas (14 749) of the Nizhny Novgorod region were analyzed. The region is comparatively homogeneous in terms of the national composition of the population. In the city, the number of chronic pathologies of different organs and systems per one person of elderly age are: 2,83 for man and 2,76 for woman of elderly ages, 3,06 and 3,07 respectively for senile ages, 2,71 and 2,75 of advanced ages. In rural areas, the analyzed indicators for men and women are respectively 1,64 and 1,58 for elderly ages, 1,84 and 1,78 for senile ages, 1,86 and 1,84 for advanced ages. Demonstrating the difference in the phenotypic manifestations of the genes of predisposition to chronic diseases in old age between the city and village, the results make it possible to produce the following assumptions. First, better access to medical care does not guarantee the better health status of the elderly, while it contributes to an increase in the life expectancy of men. Second, in spite of better access to health care, urban lifestyle contributes to the accumulation of chronic diseases in population of a region. Third, if chronic pathology of three different classes of diseases presented, then the probability of a long life is fundamentally determined by the access to health care. Fourth, the probability of longevity is significantly reduced in result of illness by neoplasms, cardiovascular, respiratory, endocrine or genitourinary diseases in ages of working or beginning of retirement period.

Obesity prevalence and accuracy of BMI-defined obesity in Russian firefighters.

BACKGROUND: No data exist on obesity or the accuracy of body mass index (BMI) in Russian Federation firefighters. AIMS: To determine the prevalence of obesity and rates of misclassification of BMI-based obesity status. METHODS: Career firefighters in the Moscow region completed anthropometric assessments including height, weight, BMI, body fat per cent (BF%) and waist circumference (WC). Using these three methods, we defined obesity as BMI ≥30, BF% >25 and WC >102, respectively. RESULTS: The study group consisted of 167 male firefighters. Obesity prevalence was 22% for BMI [95% confidence interval (CI) 16.9-28.5], 60% for BF% (95% CI 52.5-67.3) and 28% for WC (95% CI 21.3-34.9). False positive rates for BMI-based obesity status were low, with 3% (95% CI -1.1 to 7.1) and 6% (95% CI 1.6-9.9) of non-obese participants defined by BF% and WC standards misidentified as obese using BMI. However, 65% (95% CI 55.7-77.4) of BF%-defined obese participants and 36% (95% CI 22.5-49.9) of WC-defined obese participants were misclassified as non-obese using BMI (i.e. false negatives). CONCLUSIONS: Rates of BMI-based obesity in Russian male firefighters were similar to that of males in the general Russian adult male population. Compared with BF% or WC standards, BMI-based obesity classi- fication produced low rates of false positives but demonstrated high rates of false negatives.

[Russian and regional performance indices of local therapists].

AIM: To analyze the statistical indicators of a local therapist's performance in the Russian Federation and its districts in the 2008- 2012 period. MATERIALS AND METHODS: The authors analyzed staffing and understaffing in the federal districts with respect to the Russian Federation, a doctor's actual function and its deviation ratio, staffing of local therapists, secondary employment coefficient, and the total number of physician visits with the ratio of the number of home/polyclinic ones. RESULTS: The staffing of local therapists was steady-state in the country as a whole in the period analyzed. At the same time, there was a decline in staffing. The performance of doctors everywhere is greater than the recommended one since 2009. There was a reduction in the number of visits to local therapists in both the country as a whole and its regions, with more visits being made by rural dwellers. CONCLUSION: The current approach to the standards for the load and number of physicians should determine needs for specialists of this profile and become a major part to solve the problem of delivering available and high-quality primary outpatient care to the population of Russia.

[Evaluation of possibility of using new financial instruments for supporting biomedical projects].

Analysis of selection criteria on projects of Russian medical research centers for funding in Russian scientific fund and Federal program "Research and innovations" was done. It was noted that a high degree of uncertainty of such concepts as "priority direction", "applied" and "search" research and "industrial partner" in regards to research of biomedical theme. Analysis of classified "Medicine and health care" "Forecast of scientific-technological development of Russian Federation till 2030 year" were completed.

[The problems of expertise of biomedical projects and assigning them status of breakthrough and world-class].

There was a sharp increase in the number of scientific fields, research fronts, publications and patents in biomedicine in the last five years, which complicates the work of the experts on the selection of projects for priority funding. The approaches to the identification of perspective directions of research used in the world were examined. An attempt was made of formalization of the concepts of "breakthrough research" and "world level research" in relation to the Russian biomedical projects. The rationale for information support of expert decision-making about the prospects of development of individual areas of research in biomedicine is outlined.

[A study of scientific output of the Russian Academy of Medical Sciences in 2011 and its qualitative and quantitative growth prospects (in concordance with official indicators and policy targets)].

The scope of bibliometric research is focused on academic output of the Russian Academy of Medical Sciences (RAMS) in 2011 by analyzing the data extracted from the Web of Science database and InCites application Research Performance Profile of RAMS. Using these analytical tools trends in dynamics of publications and citing of the RAMS researchers were calculated and the level of scientific output in some biomedical subject areas was estimated. Studies revealed the great importance of international collaboration and international coauthorship for RAMS in producing papers published in established scholarly journals. Basic metrics of scientific performance that should be required to achieve the goals declared in the recent governmental policy papers were measured for RAMS institutions as well. Another problem investigated in this research is the problem of low citedness ofRAMS journal papers indexed in WoS. Factors and reasons influenced on low citedness were discovered In conclusion authors set out priorities and reasonable goal-oriented efforts to achieve better results in publication activity.

[Publication activity of the Russian medicine in focus of national science policy: estimating the feasibility of policy targets].

A comprehensive review of National research policy papers issued over the past 6 years was carried out. A set of problems concerning the quality of predicted values of some bibliometric indicators reflecting the level of research performance and publication activity that were declared in governmental documents was discussed. Basic metrics of scientific performance that should be required to achieve the goals declared in the recent governmental policy papers including President's Executive Order No 599 of May 7, 2012 (increasing the share of Russian researchers' publications in the total number of publications in international scientific journals indexed in the Web of Science up to 2.44% in 2015). Taking into account the current structure of modern global science in which papers in biomedical subjects make up for approximately one third of the total world scientific output, it becomes obvious how difficult is the governmental task set up to the researchers--to double the number of journal publications indexed in Web of Science in the short-term period of the nearest three years. The priorities and reasonable goal-oriented efforts to meet the targets are proposed in the paper.

[World level of competitiveness of national researches in the field of clinical medicine].

There is proposed formalization of concepts ,world research levelb and "leading scientific technological directions" of global science used in program documents which define main trends of reformation of Russian science. Use of bibliographic index as an example of "normalized citation in related area" for analyzing various subject areas for Russian clinic medicine it was shown that there is a different correlation of some areas of some national subject areas to their world levels. It was noted that it's necessary to develop national methodology of Russian science audit considering its national aspect which is a real problem while application world-acclaimed methods.

[The methodological prerequisites of elaboration of advanced regional patterns of medical care provision to population].

The article deals with the characteristics of medical demographic indicators, morbidity indicators, public health resources indices and medical care volumes in Federal okrugs. The analysis provided a basis to develop the designed and adjusted standards of main volumetric indicators for territorial programs of public guarantees of free-of-charge medical care to population of the Russian Federation according the Federal okrugs.

[Health preservation for workers is one of the most important objectives of health services].

Based on profound analysis of medical supplies, morbidity, work conditions and work safety during this period of economic reforms in Russia, the authors justified priority directions, goals and tasks of health care system in protection and improvement of workers' health state.