["Whether the Lord putted Moscow and neighbouring cities empty?": Moscow pest of 1654].

The first ten years of the reign of Tsar Alexei Mikhailovich were distinguished by extreme turbulence. The unsuccessful actions of the "government" of the boyar Morozov provoked chain of city riots which reached their apogee in famous "Salt Riot" in the capital. After that, religious feuding began that in near future resulted in the Schism. Afterwards, Russia, after long hesitation, entered the war with the Polish-Lithuanian Commonwealth that as it turned out, prolonged 13 years. Finally, in 1654, after long break, the plague again visited Russia. The plague pestilence of 1654-1655 was relatively transient (it began in summer and gradually faded away with the onset of winter), however very deadly and shook both the Russian state and Russian society to the ground. It disrupted habitual regular way of life and unsettled all and everything. The authors propose original version of origin of this epidemic and reconstruct its course and consequences on the basis of evidence of contemporaries and extant documents.

[Polizeistaat and police against pestilence: Russian authorities and law in the fight against the threat of epidemics in the 1st third of the 18th century].

The beginning of the 18th century in the history of the Russian state and society was marked by the beginning of large-scale transformations initiated by Peter I. As a result of these reforms, the patriarchal Moscow kingdom turned into a "regular" Russian empire, the political, legal and administrative structure of which differed significantly from what it was before. It is no coincidence that Peter is often referred to as a «revolutionary on the throne.¼ In his actions, Peter was guided by the idea of the "common good" and the ideas of the "regular" state and Polizeistaat. He drew them in Western Europe, in the countries of the Protestant circle - Prussia, Denmark, Sweden. One of the leading ideas of the Polizeistaat doctrine was the state's active policy to form a welfare society, which was supposed to be achieved through the active intervention of the authorities in the daily life of citizens, its regulation and regulation through various regulations, instructions and instructions. A regular, properly organized police force was one of the most important instruments of such intervention, which had as its ultimate goal the creation of conditions for the growth of the well-being of subjects and their number. This growth in the number of subject population was also achieved through the creation of a system of measures to prevent epidemics and their consequences. In this article, the authors, relying on the materials of the Petrine legislation, reconstruct the course of the gradual formation of sanitary legislation in Petrine Russia.

Porous matrix materials in optical sensing of gaseous oxygen.

The review provides comparison of porous materials that act as a matrix for luminescent oxygen indicators. These include silica-gels, sol-gel materials based on silica and organically modified silica (Ormosils), aerogels, electrospun polymeric nanofibers, metal-organic frameworks, anodized alumina, and various other microstructured sensor matrices. The influence of material structure and composition on the efficiency of oxygen quenching and dynamic response times is compared and the advantages and disadvantages of the materials are summarized to give a guide for design and practical application of sensors with desired sensitivity and response time.

[ORGANIZATION OF EPIDEMIOLOGICAL MONITORING OF TUBERCULOSIS IN THE CITY OF MOSCOW].

Ensuring effective epidemiological surveillance of tuberculosis is essential and one of the paramount tasks for any national tuberculosis control program. The article analyzes the organization of the tuberculosis epidemiological monitoring system at the level of the subject, based on the experience of implementing such a system in the city of Moscow in 1996-2020, defines its tasks and principles of its construction. The systems of epidemiological monitoring of tuberculosis, implemented taking into account the developed principles, provide an analysis of the epidemiological situation in the territory, the results of which can be successfully used for making managerial decisions, program-target planning and evaluating the effectiveness of the measures taken.

[The horseman on pale horse: the plague of Ivan the Terrible].

Since the ancient times, epidemics affect the processes proceeding in various spheres of life of human society. Hence, steadfast attention of historians to this biological phenomenon and its investigation. Quite a lot of of research studies is devoted to the first-rate epidemics, for instance, the famous «Black Death¼ in the middle of XIV century. At the same time, far from all such occurrences were properly interpreted in historical literature. Among little-studied and factually unknown epidemics, the pestilence, the plague, that struck the Russian state in the second half of 60s-early 70s of XVI century, stands out for. The article considers this occurrence, demonstrates its origin, time and geographical limits and also analyzes its consequences.

Prostatotropic Action of Glycyrrhizic Acid Disodium Salt in Benign Prostatic Hyperplasia Models.

The prostatotropic activity of glycyrrhizic acid disodium salt (Na2GA) was studied in the models of benign prostatic hyperplasia (BPH) induced by chronic injection of sulpiride (40 mg/kg intraperitoneally for 8 weeks) or testosterone propionate (20 mg/kg subcutaneously for 4 weeks) in the Wistar rats. The oral administration of Na2GA in a dose of 100 mg/kg produced a moderate antiproliferative effect in both BPH models resulting in reduced volume density of prostatic epithelium (in the testosterone model) and increased volume density of the glandular lumen (in both models). The observed prostatotropic effects of Na2GA were similar to those of Permixon and finasteride, but they were less pronounced as confirmed by smaller drops in epithelial volume density and epithelial-to-stromal ratio compared to the effects of both reference drugs.

[The domestic violence as factor of disorder of social and mental health].

The article considers domestic violence as a factor of derangement of social and mental health of family members. There is no open access to statistical indices of cases of domestic violence. The data of population mental health is rather conditional. There is no aggregated information on social health of citizens at all. The sociological study of families of the Belgorod region was carried out in January-March 2019. The collection of primary sociological data was done using the questionnaire survey. The respondents consisted of two groups: minors and adult family members. The study established that in children-victims of violent actions, recollections remain that negatively impact their social and mental health in the present and future. Most often there is not one type of violence but whole complex. The effect of domestic violence is deterioration not only of mental and social health of victims, but physical (psychosomatic) health too. There is co-dependency of social and mental health conditions of all family members involved into violence actions. In case of domestic violence related to the elderly and disabled ones their social and mental health is deteriorating much faster than in case of similar alterations of age-related or medical causes.

Clinical standards for the management of adverse effects during treatment for TB.

BACKGROUND: Adverse effects (AE) to TB treatment cause morbidity, mortality and treatment interruption. The aim of these clinical standards is to encourage best practise for the diagnosis and management of AE.METHODS: 65/81 invited experts participated in a Delphi process using a 5-point Likert scale to score draft standards.RESULTS: We identified eight clinical standards. Each person commencing treatment for TB should: Standard 1, be counselled regarding AE before and during treatment; Standard 2, be evaluated for factors that might increase AE risk with regular review to actively identify and manage these; Standard 3, when AE occur, carefully assessed and possible allergic or hypersensitivity reactions considered; Standard 4, receive appropriate care to minimise morbidity and mortality associated with AE; Standard 5, be restarted on TB drugs after a serious AE according to a standardised protocol that includes active drug safety monitoring. In addition: Standard 6, healthcare workers should be trained on AE including how to counsel people undertaking TB treatment, as well as active AE monitoring and management; Standard 7, there should be active AE monitoring and reporting for all new TB drugs and regimens; and Standard 8, knowledge gaps identified from active AE monitoring should be systematically addressed through clinical research.CONCLUSION: These standards provide a person-centred, consensus-based approach to minimise the impact of AE during TB treatment.

[Features of formation of postvaccinal immunity in the population of one-company towns and rural settlements 1].

When assessing the risk of developing non carcinogenic effects, the authors calculated the summary danger indices for the Orenburg Region's population living in the urbanized and rural areas. The risk of developing harmful effects for children from monotowns and rural settlements was also determined. The findings lead to the conclusion that monotowns are the most unfavorable in terms of their risk of non carcinogenic effects. The next stage of the investigation was to study the strength of postvaccinal measles immunity, which revealed a close relation between the ecological state of a dwelling area and the formation of postvaccinal immunity.

Clinical standards for drug-susceptible pulmonary TB.

BACKGROUND: The aim of these clinical standards is to provide guidance on 'best practice´ for diagnosis, treatment and management of drug-susceptible pulmonary TB (PTB).METHODS: A panel of 54 global experts in the field of TB care, public health, microbiology, and pharmacology were identified; 46 participated in a Delphi process. A 5-point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all 46 participants.RESULTS: Seven clinical standards were defined: Standard 1, all patients (adult or child) who have symptoms and signs compatible with PTB should undergo investigations to reach a diagnosis; Standard 2, adequate bacteriological tests should be conducted to exclude drug-resistant TB; Standard 3, an appropriate regimen recommended by WHO and national guidelines for the treatment of PTB should be identified; Standard 4, health education and counselling should be provided for each patient starting treatment; Standard 5, treatment monitoring should be conducted to assess adherence, follow patient progress, identify and manage adverse events, and detect development of resistance; Standard 6, a recommended series of patient examinations should be performed at the end of treatment; Standard 7, necessary public health actions should be conducted for each patient. We also identified priorities for future research into PTB.CONCLUSION: These consensus-based clinical standards will help to improve patient care by guiding clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment for PTB.

Cosmic-ray electron flux measured by the PAMELA experiment between 1 and 625 GeV.

Precision measurements of the electron component in the cosmic radiation provide important information about the origin and propagation of cosmic rays in the Galaxy. Here we present new results regarding negatively charged electrons between 1 and 625 GeV performed by the satellite-borne experiment PAMELA. This is the first time that cosmic-ray e⁻ have been identified above 50 GeV. The electron spectrum can be described with a single power-law energy dependence with spectral index -3.18 ± 0.05 above the energy region influenced by the solar wind (> 30 GeV). No significant spectral features are observed and the data can be interpreted in terms of conventional diffusive propagation models. However, the data are also consistent with models including new cosmic-ray sources that could explain the rise in the positron fraction.

[Clinico-morphological characteristics of pulmonary mycobacteriosis].

According to the criteria of the American Thoracal Societypulmonary mycobacteriosis has been diagnosed at 40patients without clinically important immunosupression (MAC--35%, Mkansasii--25%, M. xenopi--20%, M. fortuitum--12.5% and M. chelonae--7.5%). 95% patients have had clinically important symptomatology with polymorphic radiologic development such as a deformation of a lung pattern and focal dissemination (75%), locus and infiltration (52.5%), cavities (42.5%), marked pneumosclerosis (60%) and bronchiectasis (17.5%). 75% patients have had some changes of the bronhial tree. As opposed to tuberculosis the morphology of mycobacteriosis is more homogeneous and includes inflammation with epithelioid giant-cell granuloma and fibrosis, pneumogenic and bronchogenic cavernous cavities, mycobacterial endobronchitis. The polymorphism of clinic-radiologic developments, a similarity of lung diseases morphology caused by nontuberculous mycobacteria makes difficulties to diagnose theirs.

Clinical standards for the assessment, management and rehabilitation of post-TB lung disease.

BACKGROUND: Increasing evidence suggests that post-TB lung disease (PTLD) causes significant morbidity and mortality. The aim of these clinical standards is to provide guidance on the assessment and management of PTLD and the implementation of pulmonary rehabilitation (PR).METHODS: A panel of global experts in the field of TB care and PR was identified; 62 participated in a Delphi process. A 5-point Likert scale was used to score the initial ideas for standards and after several rounds of revision the document was approved (with 100% agreement).RESULTS: Five clinical standards were defined: Standard 1, to assess patients at the end of TB treatment for PTLD (with adaptation for children and specific settings/situations); Standard 2, to identify patients with PTLD for PR; Standard 3, tailoring the PR programme to patient needs and the local setting; Standard 4, to evaluate the effectiveness of PR; and Standard 5, to conduct education and counselling. Standard 6 addresses public health aspects of PTLD and outcomes due to PR.CONCLUSION: This is the first consensus-based set of Clinical Standards for PTLD. Our aim is to improve patient care and quality of life by guiding clinicians, programme managers and public health officers in planning and implementing adequate measures to assess and manage PTLD.

Outcome of treatment of MDR-TB or drug-resistant patients treated with bedaquiline and delamanid: Results from a large global cohort.

The World Health Organization (WHO) recommends countries introduce new anti-TB drugs in the treatment of multidrug-resistant tuberculosis. The aim of the study is to prospectively evaluate the effectiveness of bedaquiline (and/or delamanid)- containing regimens in a large cohort of consecutive TB patients treated globally. This observational, prospective study is based on data collected and provided by Global Tuberculosis Network (GTN) centres and analysed twice a year. All consecutive patients (including children/adolescents) treated with bedaquiline and/or delamanid were enrolled, and managed according to WHO and national guidelines. Overall, 52 centres from 29 countries/regions in all continents reported 883 patients as of January 31st 2021, 24/29 countries/regions providing data on 100% of their consecutive patients (10-80% in the remaining 5 countries). The drug-resistance pattern of the patients was severe (>30% with extensively drug-resistant -TB; median number of resistant drugs 5 (3-7) in the overall cohort and 6 (4-8) among patients with a final outcome). For the patients with a final outcome (477/883, 54.0%) the median (IQR) number of months of anti-TB treatment was 18 (13-23) (in days 553 (385-678)). The proportion of patients achieving sputum smear and culture conversion ranged from 93.4% and 92.8% respectively (whole cohort) to 89.3% and 88.8% respectively (patients with a final outcome), a median (IQR) time to sputum smear and culture conversion of 58 (30-90) days for the whole cohort and 60 (30-100) for patients with a final outcome and, respectively, of 55 (30-90) and 60 (30-90) days for culture conversion. Of 383 patients treated with bedaquiline but not delamanid, 284 (74.2%) achieved treatment success, while 25 (6.5%) died, 11 (2.9%) failed and 63 (16.5%) were lost to follow-up.

PAMELA results on the cosmic-ray antiproton flux from 60 MeV to 180 GeV in kinetic energy.

The satellite-borne experiment PAMELA has been used to make a new measurement of the cosmic-ray antiproton flux and the antiproton-to-proton flux ratio which extends previously published measurements down to 60 MeV and up to 180 GeV in kinetic energy. During 850 days of data acquisition approximately 1500 antiprotons were observed. The measurements are consistent with purely secondary production of antiprotons in the Galaxy. More precise secondary production models are required for a complete interpretation of the results.

[Legal aspects of compulsory hospitalization of incompliant patients with tuberculosis].

The main task of an antituberculosis service is to treat patients with tuberculosis and to follow up needy persons in order to prevent the spread of tuberculosis among the population. However, phthisiatricians are unable to solve some problems without assistance from the government as they are associated with social and behavioral causes--no or partial patient's motivation for treatment. Early therapy discontinuation in patients with tuberculosis, latent or obvious interruption of chemotherapy, patients' use of a partial dose of drugs give the vast majority of Russian phthisiatricians concern. These lower the efficiency of treatment, increase the likelihood of drug resistance in Mycobacterium tuberculosis, and contribute to the chronic pattern of the tuberculosis process, continuously replenishing the pool of untreatable patients with tuberculosis and bacterial discharge. An incompliant tuberculosis patient discharging bacteria may be compulsorily taken to a tuberculosis hospital by the court decision. This is in line with Article 10, the 18 June, 2001 Federal Law No. 77--"On Prevention of Tuberculosis Spread in the Russian Federation". This investigation was undertaken to enhance the effectiveness of involvement of incompliant bacteria-discharging patients with tuberculosis to compulsory examination and treatment. The mechanism of realization of Article 10 of the abovementioned Law was analyzed from the experience of an antituberculosis service of the Ryazan Region (178 writs). At present, it is impossible to fulfill this Article 10 in corpore due to there is an improper legal base that is in no subordinate legislation and actuate sentences for non-implementation of court decisions. Subordinate legislation regulating a compulsory hospitalization procedure by officers of justice should be elaborated. It is necessary to introduce amendments into the base to make patients with infectious tuberculosis who have not carried a court decision on compulsory hospitalization. Tuberculosis facilities should be used to set up social centers for the complex work and treatment of socially dysadapted patients with tuberculosis (including those who have been released from confinement institutions). For this, tuberculosis institutions should be staffed by social workers, psychologists, psychiatrists, lawyers, and narcology experts with the appropriate funds being allocated.

[Diagnosis of respiratory tuberculosis at multidisciplinary hospital].

Data on 104 patients with pneumonia treated at Moscow multidisciplinary hospitals for suspected respiratory tuberculosis (RT) show that general practitioners have lost tuberculosis-diagnosing skills and phthisiological alertness. This is suggested by frequent failures to collect medical historical data, neglect of risk factors for RT, poor orientation in the differential diagnosis of pneumonia and tuberculosis, violation of diagnostic standards of pulmonary tuberculosis, specifically a paucity of sputum microscopic studies and lateral lung X-ray studies. Upgrading the recognition quality of tuberculosis makes it necessary to observe the propedeutic rules for examining and studying a patient, to reveal important anamnestic and clinical data, and to follow instructions. At the same time, there is no need for new equipment and technologies, but it is critically important to increase the level of tuberculosis knowledge in physicians of all specialties and to create motivation for qualitative diagnostic work.

[Cardiac damage in sarcoidosis: clinical features and impact of steroid therapy].

Twenty-seven sarcoidosis patients with signs of cardiac damage were examined to study the clinical features of cardiac sarcoidosis and the impact of systemic glucocorticosteroid (GCS) therapy on its course. ECG and echoECG changes were observed in 21 (78%) and 17 (63%) patients, respectively; abnormal perfusion was seen in 25 (93%) patients at single-photon emission myocardial computed tomography using 99mTc-MIBI. Three clusters (clinical types) of patients were identified, which differed in the pattern and degree of cardiac disorders. The use of systemic GCSs in 13 of 20 patients resulted in myocardial perfusion recovery and clinical improvement, the degree and duration of which depended on what cluster it belonged to. Seven GCS-untreated patients had progressive perfusion disorders with subsequent or synchronous clinical deterioration (p < 0.05). The degree and duration of the positive effect of a GCS differed depending on the clinical type of cardiac damage.

[A social backing program and motivation provision in patients with tuberculosis].

The purpose of the study was to obtain information on tuberculosis patients' needs, perception, and expectations from health care as a whole and social backing in order to improve the implementation of a program for enhancing tuberculosis patients' motivation for recovery and treatment. Anonymous voluntary questioning using the standard questionnaire was carried out among new tuberculosis cases registered to be treated in 4 subjects of the Russian Federation (the Oryol, Vladimir, and Belgorod Regions, and the Republic of Mariy-El). Eighty-seven patients who had stopped being treated before the appointed time and 1302 patients who were receiving chemotherapy at the time of questioning were interviewed using the questionnaire. The main reasons for treatment discontinuance in those who stopped treatment before the appointed time were the necessity of earning their living (30%), alcohol consumption (30%), inadequate health education of the patients who considered themselves to be healthy (25%). Most patients (67%) preferred rewards as social backing, products/hot food (41%), and fare (32%). Among the proposed social backing schemes, the most popular ones were those that envisaged small daily rewards (23%) or a large final bonus (21%). The majority (67%) of patients preferred outpatient treatment. Thus, patients with tuberculosis face a great deal of problems that affect their motivation for treatment. To satisfy some of these problems is not the direct duties of an antituberculosis service due to the fact that the manning table lacks appropriate posts and an item of expenses. Therefore additional funds should be allocated from the budgets of a subject of the Russian Federation and/or municipal entities for adequate organization of social backing of patients with tuberculosis to enhance the efficiency of their treatment. Collaboration of antituberculosis services of the Russian Federation's subjects with social organizations and an addiction service along the availability of psychological and legal consultations to patients is the most optimum variant of social backing organization to improve the patients' motivation for treatment.

Red light-excitable oxygen sensing materials based on platinum(II) and palladium(II) benzoporphyrins.

New optical oxygen-sensing materials make use of highly luminescent NIR platinum(II) and palladium(II) complexes with benzoporphyrins. Bulk optodes based on polystyrene and sensing nanobeads based on poly(styrene-block-vinylpyrrolidone) and polysulfone are prepared and characterized. The versatility of the new materials is demonstrated. The features include excellent compatibility with most common excitation sources, high brightness, and suitability for subcutaneous oxygen monitoring.