The Best Material from the VII Congress of Russian Biophysicists.

The purpose of this Special Issue is to demonstrate the current state of research in the field of biophysics in the Russian Federation [...].

[Russian Medical Academy of Continuing Professional Education - the leading educational institution in the country for the training of forensic medical personnel (for the 90th anniversary from the establishment of the department of forensic medicine)]. / Rossiiskaya meditsinskaya akademiya nepreryvnogo professional'nogo obrazovaniya ­ vedushchee obrazovatel'noe uchrezhdenie strany po podgotovke sudebno-meditsinskikh kadrov (k 90-letiyu so dnya obrazovaniya kafedry sudebnoi meditsiny).

The article presents a detailed analysis of the stages of formation, development and achievements of the forensic medicine department of the Russian Medical Academy of Continuing Professional Education of the Ministry of Health of the Russian Federation, established in 1933 yr. More than 100 resident doctors and 15 PhD students have been trained in the department for 90 years. As a part of additional professional education implementation, more than 800 cycles of training courses for forensic medical and forensic experts and more than 30 cycles of professional retraining for doctors of other specialties have been carried out. More than 160 thous. specialists have been trained at the department since its establishment. Many employees of the department were directly involved in the performance of the most complicated and socially significant forensic medical examinations. The article describes the main achievements and scientific directions of the department's staff activity, directions and prospects of improving the training of forensic medical personnel in the country.

[Mechanical asphyxia in the structure of violent death in the Russian Federation from 2013 to 2022 years]. / Mekhanicheskaya asfiksiya v strukture nasil'stvennoi smerti v Rossiiskoi Federatsii s 2013 po 2022 g.

The objective of the study is to examine the death incidence from mechanical asphyxia in the Russian Federation in the period from 2013 to 2022 yr., to determine the dynamics of changes in indicators of its main types and to reveal territorial specificity. The results obtained with the use of medical statistics methods can be applied to implement measures for health protection, prevent risk factors of fatal outcome among population, to improve the training of forensic medical experts.

[Review of age assessment methods of children and adolescents by teeth X-rays]. / Obzor metodov otsenki vozrasta detei i podrostkov po rentgenogrammam zubov.

Interest in the topic of age assessment for forensic medical identification of personality has not decreased for over the past decade. Establishing an exact age have a critical importance for law enforcement authorities, for example in case of wrongdoing by illegal migrants without identity documents. The search and systemic analysis of published researches devoted to age assessment by dental status in children and adolescents with subsequent updating of the directions of development in this scientific subject theme and the possibility of their realization in practice in the Russian Federation were carried out in order to have an objective concept of used methods of dental status assessment in the world practice.

[International Classification of Health Interventions of World Health Organization as the basis for a new nomenclature of medical rehabilitation services]. / Mezhdunarodnaya klassifikatsiya meditsinskikh vmeshatel'stv Vsemirnoi organizatsii zdravookhraneniya kak osnova novoi nomenklatury uslug po meditsinskoi reabilitatsii.

The development of health care system, including medical rehabilitation, in the Russian Federation is required updating nomenclature of simple and complex medical services and establishing its detailed list. The latter should integrate international experience and features of domestic health care system. OBJECTIVE: To analyze the structure of International Classification of Health Interventions (ICHI) of World Health Organization (WHO) and the possibilities of its practical application in domestic medical rehabilitation system. MATERIAL AND METHODS: The role of ICHI and its structural logical correlations with other classifications of the WHO international classifications section has been determined. Analysis of ICHI application areas, comparison of ICHI codes and new nomenclature of medical services were performed. RESULTS: Analysis of ICHI and new nomenclature project of medical services in the Russian Federation showed, that ICHI formed the basis for the development of a new medical services nomenclature, including a section on medical rehabilitation. The basic principles of ICHI (structure by axes: aim, action, means; codes uniqueness; hierarchical method of classification formation) and ICHI fragment associated with purposes for systems and organism functions are presented in the new nomenclature of medical services. It has been established that ICHI can be a basis for developing domestic list of rehabilitation services, the formation of which is planned in the near future. CONCLUSION: The development of medical services nomenclature in the Russian Federation will significantly increase the availability, funding and effectiveness of medical rehabilitation assistance.

[Healthy and harmonic childhood - foundation of the «Health of healthy¼ concept]. / Zdorovoe i garmonichnoe detstvo ­ fundament kontseptsii «Zdorov'e zdorovykh¼.

Within the framework of the «Health of Healthy¼ concept (A.N. Razumov) a medical, psychological and pedagogical «Sonatal-pedagogy¼ system (M.L. Lazarev) aimed at harmonizing the mental and physical development of children from the prenatal age has been developed In Russia. The system has been tested since 1983 on population of more than 70 thous. children. The results showed its high effectiveness and safety (in relation to pregnancy, childbirth, breastfeeding, somatic health, psychomotor development and children's abilities). Scaling of the Sonatal-pedagogy, in particular the system of prenatal education, will contribute to the sanitation of the Russian gene pool, demography improvement and formation of responsible parenthood.

[The Childhood Decade in Russia: legal securing of health care applying information technologies].

In conditions of impetuous development of national digital technologies and necessity for their legal regulation, significance and possibilities of their implementation in protecting health of rising generation during childhood decade in Russia are demonstrated. The conceptual apparatus related to discussed problem is considered. The emphasis is made on preventive aspect of intersectoral state protection of health care and rights of children and adolescents aged 0-17 years. The scale of problem is especially impressive considering number of contingent over 30 million people and interests of about 24 million of family members with children. The purpose of the study is applying analytical method, content analysis and SWOT analysis to monitor main problems of intersectoral health care and rights of rising generation in Russia in conditions of implementation of information technologies; to evaluate application of legislation in force in context of their role and effect during the Decade of Children (2018-2027); to demonstrate significance of the institution of the Commissioner for rights of child under the President of the Russian Federation.

[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.

[The on-line turnover of biologically active additives. Part I. Legal regulation of on-line market of imported biologically active additives in Russia].

The interest of population to biologically active additives drastically increased both due to consequences of the COVID-19 corona-virus infection and dynamic development of online trade and active propaganda of healthy lifestyle through mass media. Such production contains in its compound substances that are necessary for maintaining normal vital activity of organism and increasing human immunity. In other cases it can be used as additional and auxiliary agent of treatment of various diseases. In Russia, biologically active additives can be sold through three channels: pharmacies, on-line market and network marketing. In Russia, the results of monitoring of on-line market in 2021-2022 testifies that purchasing of such biologically active additives at on-line platforms turned out to be the riskiest action for human life and health. The biologically active additives were sold at on-line market with serious violations that confirms their danger to health and in some cases for human life. The study demonstrated that nowadays there is no clear-cut legal regulation of turn-over of imported biologically active additives at on-line market. The article presents detailed analysis of normative legal field that regulates in Russia on-line trade of imported biologically active additives and relevant conclusions and recommendations.

[The mental health of Russians in "post-pandemic": the empirical studies review].

The article presents review of empirical social medical and sociological studies of mental health of Russians in "post-pandemic" (2022 - first half of 2023). The purpose of the study is to generalize results of corresponding studies. The review covers the articles in national scientific journals indexed in the RSCI, the results of monitoring surveys carried out by both all-Russian research organizations handling analysis of public opinion and by Federal research and educational organizations. The criteria of selection of studies included the study field stage was implemented in January 2022 - June 2023; sociological survey technique was applied; the study object was whole population of the Russian Federation or its subject or a separate social group. it was established, on the basis of all-Russian and regional data, that in mentioned period public mental health of residents of Russia is characterized by wave dynamics. The increasing of anxiety level in beginning of March and in the end of September 2022. The level of depressive symptomatic prevalence still exceeded "pre-pandemic" values. The increased level of anxiety is more typical in the youth and women. The vulnerable groups are also residents of territories bordering on zone of special military operation, members of families of combatants and Ukraine refugees. In conditions of law demand of population for psychological psychiatric care the issue of searching alternative tools of psychological safety of Russian citizen is actualized.

[The analysis of dynamics of indicator of mortality of population of the Siberian Federal Okrug resulted from toxic impact of alcohol in 2011-2020].

The purpose of the study is to investigate dynamics of mortality of population of the Siberian Federal Okrug resulted from toxic impact of alcohol in 2011-2020 and to comparatively analyze mortality of population of the regions of the Siberian Federal Okrug with general Okrug values. The study uses statistical data of the Federal State Statistics Service of the Russian Federation. The analysis was applied to mortality of population of the Russian Federation, the Siberian Federal Okrug and the regions of the Siberian Federal Okrug (the Republic of Altai, the Republic of Tuva, the Republic of Khakassia, the Altai Kray, the Krasnoyarsk Kray, Irkutsk, Kemerovo, Novosibirsk, Omsk and Tomsk Oblast) resulted from toxic impact of alcohol. The comparative analysis of regional and general Okrug indicators of mortality was implemented. The statistical processing of data included common methods of calculating extensive and intensive indicators, indicator average error and evaluation of reliability of differences. It was established that in 2011-2020, mortality of population of the Siberian Federal Okrug resulted from toxic impact of alcohol decreased by 3.3 times. The decrease of mortality of the population was registered in all regions of the Siberian Federal Okrug. The fastest decreasing of mortality of population occurred in the Altai Kray (7.7 times), the Republic of Tuva (7.0 times), the Krasnoyarsk Kray (6.4 times). The investigation of dynamics of mortality of population in the regions of the Siberian Federal Okrug resulted from toxic impact of alcohol permits to identify characteristics of toxicological situation at the regional level and to determine strategic directions of the regional policy of chemical safety and population health protection.

[The world experience of monitoring of satisfaction with medical care: the analytical review].

The satisfaction of patients is one of key indicators used to assess quality of medical care and its effectiveness from point of view of achieving patient-oriented results. Nowadays, the tools assessing patient satisfaction with medical care are largely applied all over the world. The world experience of monitoring satisfaction of population with medical care is necessary for better understanding of dynamics of indicator and possible forecasting of its level in Russia. The purpose of the study is to analyze existing national systems of monitoring satisfaction of patient with medical care and to identify particular established trends. The search for free access publications was implemented using such databases as PubMed, Google Scholar, ResearchGate and eLibrary. The keywords patient satisfaction, national monitoring, satisfaction trends, The sampling included 55 publications. The analysis established that in many countries measurement of degree of satisfaction of patient with medical care become routine practice and integral part of of evaluation of efficacy of both medical organizations and health care in a whole. The initial level of satisfaction with medical care depends on multitude of population variables, including predominant race, culture and nationality of population, gender and age structure, social economic conditions, level of incomes and prevalence of urban or rural population. The dynamics of satisfaction level in most countries demonstrates steady, but slow and statistically insignificant increasing of indicators, though different in various domains of satisfaction. The identified factors are to be considered both at the Federal level to formulate correct conclusions and at the regional level to develop corresponding measures.

[The methodological approaches to evaluation of effect of tuberculosis as socially significant infection on decreasing of public health quality].

The study reveals main methodological approaches in monitoring and evaluating role of socially significant infectious diseases in reducing quality of public health in the Russian Federation. The article proposes at population level the grouping of main risk factors affecting quality of public health, exemplified by epidemiology of tuberculosis. The purpose of the study is to develop methodology of exploration of impact of socially significant infections on decreasing of quality of public health exemplified by epidemiology of tuberculosis as infectious disease that is well studied in medical social aspects and having fully functioning TB control and high level monitoring system. The informational analytical methodology was applied conjointly with critical analysis of national and foreign publications, normative legal acts, selected through scientific search systems PubMed, Medline, www.base-search.net, www.refseek.com, E-library, CiberLeninka, "Garant" and "ConsultantPlus". The depth of search was limited by 15 years and more. The data from the federal statistical observation form No. 8 "Information about diseases with active tuberculosis" for 2021 was also evaluated. For the first time, the grouping of main risk factors of socially significant infections , affecting decrease of quality of public health at population level are proposed. The mentioned factors are grouped as epidemiological; social economic (including economic damage caused directly by tuberculosis); demographic; behavioral; biomedical (presence of diseases not associated with tuberculosis, but reducing immunity); climatic geographical, etc. The further analysis and listing of specific indicators of each group of factors is required in order to monitor and quickly assess impact of socially significant infectious diseases on public health in the Russian Federation and its Subjects. The analysis of scientific literature demonstrated that, despite breadth of studying tuberculosis risk factors, they are non-systematized and fragmented. The methodological approaches to studying impact of socially significant infectious diseases on public health in foreign countries and in the Russian Federation, are practically absent. The compilation and actualization of listing of indicative indicators for each group of factors with the choice of statistical methods of their calculation, evaluation and interpretation will permit to develop methodological approaches to monitoring and assessing role of tuberculosis (hereinafter - HIV infection, parenteral viral hepatitis, etc.) in altering quality of public health in the Russian Federation with development of rapidly updated database of selected indicators at the level of each Subject of the Russian Federation.

[The long 1992 year in medicinal (non-)security of Russia. Report I. Market trial].

The year 1992 is an important landmark in the history of Russian pharmaceutical market. It began not in January, but in December 1991, when orders of the President and the Government to open free market of medications were promulgated. The Yeltsin advisers conceived that market economy was infallible means to combat medication shortages, corruption and bureaucratic monopoly. However, panacea did not work. Moreover, it gave rise to completely new problems. The human and state security implies protection from threats of dependence. The unprepared dive into market plunged Russians and the country into deep dependence on imported medications and foreign pharmaceutical companies. The proposed study proceeds our publications in this journal and in journal "Pharmacia" in 2022. At that time, analysis of medication "famine" was implemented on basis of published sources and relied on journalistic evidences. The current study was carried out on the basis of archive documents of the Ministry of Health of the Russian Federation and authors interviews of representatives of the regulator. The first report reveals administrative mechanism that engendered crisis of medication supply in the first post-Soviet year of our country.

[The personnel maintenance of primary health care physicians in condition of challenges from menaces to population health].

In condition of challenges from menaces to health due to COVID-19 the role of primary health care physicians increases that requires development of management decisions at the regional level. The purpose of the study. On the basis of analysis of medical demographic indicators and data concerning provision of primary health care personnel in the Russian Federation, proposals were made related to reforming of primary health care system in conditions of implementation of general medical practice with purpose to counteract menaces to population health. The analytical and statistical methods were applied. The official statistics data from the Minzdrav of the Russian Federation and Rosstat, results of original researches with content analysis and interpretation were used. The COVID-19 pandemic negatively impacted population health. The indicator of newly detected morbidity in the Russian Federation in 2020 decreased as compared to 2019 from 78024.3 to 75989.7‰oo (by 2.6%). This is the result of decreasing of dispensary and preventive activities among population. In next COVID-19 year (2021), as compared to 2020, indicator of primary morbidity increased to 85531.6‰oo that 12.6% higher than in 2020. The increase occurred in all classes of diseases that caused necessity of rehabilitation of these patients. The COVID-19 morbidity increased up to 2.4 times i.e. from 3391.1 in 2020 to 8085.7‰oo in 2021. The provision of physicians in the Russian Federation was 37.7‰o in 2021. Across the Federal Okrugs differences in indicators made up to 1.3 times and in subjects of the Russian Federation - up to 2.7 times. In conditions of COVID-19 significance of menaces to population health worsened. The situation requires both enhancement of primary health care and implementation of physicians of new formation - general practitioners responsible for patient health. The general practice (GP) widely developed in Russia in the 1990s during last ten years loses its significance in most subjects of the Russian Federation. In 2021, provision of general practitioners in the Russian Federation made up to 0.67‰o. In the Federal Okrugs, difference between indicators made up to 5.6 times. In the subjects of the Russian Federation the difference is enormous - 141.5 times. The article presents and scientifically substantiates prospective functional organizational models of general practice. The established situation with COVID-19 infection requires development of management decisions and measures at the regional level concerning improvement of organization of primary health care and implementation of general practice in conditions of counteracting risks of menaces to population health and health preservation.

[The birthing chair, obstetric bed and gynecological chair in obstetrics and gynecology in Russia of XVIII-XX centuries].

The purpose of the study is to investigate material culture of obstetrics in New and Modern history of Russia. The most important objective of research is to involve into scientific circulation Russian empirical material in order to study transformation of culture of childbirth during transition from traditional to biomedical model of childbirth exemplified by material culture items (maternity beds, chairs, armchairs). The key approaches were those of historical anthropology, social history of medicine, theory of social control and medicalization. The methods of content analysis, narrative and interpretive analysis were applied to analyze empirical data. In the Russian folk tradition included no such special devices as maternity beds and birth chairs that was explained by dominance of vertical maternity pose. The first birth chairs were brought into Russia by foreign midwives. With development of clinical obstetrics horizontal position of woman in labor was approving that was conditioned by convenience of physicians. Since last quarter of the XIX century, Russian physicians began to experiment, inventing most convenient version of maternity beds and gynecological chairs. The Soviet system of obstetrics was mass and publicly accessible, but consolidated technocratic model of childbirth. In maternity wards, the "Rakhmanov obstetric bed" became widespread. The chairs were not used during childbirth, being used exclusively in gynecology. The material culture of Soviet maternity hospitals turned out to be extremely stable and conservative. In modern Russian obstetrics, with transition to holistic model of childbirth and actualization of free positioning of woman in labor, transformer beds and fitballs began to be applied to provide optimal course of birth process. The material culture of obstetrics is closely related to dominant type of maternity culture.

[The Russian priority of development of intravenous anesthesia (Report I).]

The article analyses research activities of the discoverers of "Russian narcosis" from the Military Medical Academy of St. Petersburg: the head of the Department of Pharmacology N. P. Kravkov, the head of the Department of Hospital Surgery S. P. Fedorov and his resident A. P. Eremich. They for the first time in the world developed ideas of comprehensive experimental substantiation and then safe clinical administration of preparation "hedonal" to achieve stage of safe general anesthesia and implementation of long-term and traumatic operations. The scientific works of Russian discoverers indicated fundamentally new direction in formation of anesthesiology in the Russian Empire and in the world. A. P. Eremich at stage of preparatory tests, working out technique of intravenous infusion, determination of range of safe therapeutic doses and creation of special installation facilitating work with hedonal during operations of Professor S. P. Fedorov, can be recognized as the first Russian anesthesiologist and also as the first National resuscitator.

Validation of SCORE2 on a sample from the Russian population and adaptation for the very high cardiovascular disease risk region.

SCORE2 (Systematic COronary Risk Evaluation 2) is a risk assessment scale for cardiovascular events, presented in 2021 by the European Society of Cardiology. Both for training and validation of the SCORE2 model, representative samples from the Russian population were not used. Therefore, we aimed to validate SCORE2 on a such sample. For this purpose, we used a sample from the ESSE-RF epidemiological study consisting of 7251 participants aged 40-69 years without history of CVDs. We performed the validation by comparing SCORE2 risk estimates for ESSE-RF participants with the observed incidence of cardiovascular events in the study, adjusted for event information losses. The validation demonstrated that SCORE2 risk estimates were accurate for Russian men and inaccurate for Russian women. Together with the quantitative assessment of risk, SCORE2 offers its interpretation in terms of 10-year CVD risk group: low-moderate, high, and very high. For Russian men we considered the original interpretation of the SCORE2 estimates to be questionable because almost none of the men would be categorized as having "low-to-moderate" 10-year CVD risk. This problem would be typical for all countries of the very high CVD risk region. Therefore, we proposed a new interpretation of the SCORE2 risk estimates for men from the very high risk region. According to the proposed interpretation, the fraction of men in ESSE-RF in "low-to-moderate" 10-year CVD risk increased from 2% to 18% and the fraction of men in "very high" CVD risk decreased from 63% to 20% as compared to the original interpretation. The proposed interpretation would allow a more personalized approach to CVD treatment and optimize the burden on primary healthcare in the very high risk region countries.

State-of-the-Art Molecular Biophysics in Russia.

Thirty years ago, scientists' attention was focused on studying individual molecules, as well as their structure and function [...].

[Emergency surgical care in the Volgograd region between 2017 and 2021]. / Sravnitel'nye rezul'taty okazaniya neotlozhnoi khirurgicheskoi pomoshchi naseleniyu Volgogradskoi oblasti v period 2017­2021 gg.

OBJECTIVE: To analyze the indicators of emergency surgical care in the Volgograd region between 2017 and 2021. MATERIAL AND METHODS: We summarized and analyzed primary statistical data presented in annual analytical collections of the chief surgeon of the Ministry of Healthcare of Russia «Surgical care In Russian Federation¼ (Revishvili A.Sh. et al.) and the Rosstat collections «Regions of Russia. Socio-economic indicators¼. RESULTS: According to analytic system outworked in the Vishnevsky National Research Medical Center of Surgery, surgical service in the Volgograd region dropped from the 64th to the 82nd place among other entities between 2017 and 2021. Insufficient innovative development of surgical service is evidenced by small number of surgeons, common part-time work, no dynamics in introduction of laparoscopic surgeries and high in-hospital mortality in some acute abdominal disease. Work of regional surgical service was compared with socio-economic development of region and monitoring indicators in the «Health¼ national project. CONCLUSION: Improving the efficacy of surgical service in the Volgograd region requires joint efforts of the entire regional healthcare system.