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A neonatal vaccination against the Hepatitis B virus (HBV) infection was initiated in Russia 20 years ago, with catch-up immunization for adolescents and adults under the age of 60 years launched in 2006. Here, we have assessed the humoral immunity to HBV in different regions of Russia, as well as the infection frequency following 20 years of a nationwide vaccination campaign. We have also evaluated the role of immune-escape variants in continuing HBV circulation. A total of 36,149 healthy volunteers from nine regions spanning the Russian Federation from west to east were tested for HBV surface antigen (HBsAg), antibodies to HBV capsid protein (anti-HBc), and antibodies to HBsAg (anti-HBs). HBV sequences from 481 chronic Hepatitis B patients collected from 2018–2022 were analyzed for HBsAg immune-escape variants, compared with 205 sequences obtained prior to 2010. Overall, the HBsAg detection rate was 0.8%, with this level significantly exceeded only in one study region, the Republic of Dagestan (2.4%, p < 0.0001). Among the generation vaccinated at birth, the average HBsAg detection rate was below 0.3%, ranging from 0% to 0.7% depending on the region. The anti-HBc detection rate in subjects under 20 years was 7.4%, indicating ongoing HBV circulation. The overall proportion of participants under 20 years with vaccine-induced HBV immunity (anti-HBs positive, anti-HBc negative) was 41.7% but below 10% in the Tuva Republic and below 25% in the Sverdlovsk and Kaliningrad regions. The overall prevalence of immune-escape HBsAg variants was 25.2% in sequences obtained from 2018–2022, similar to the prevalence of 25.8% in sequences collected prior to 2010 (p > 0.05). The population dynamics of immune-escape variants predicted by Bayesian analysis have remained stable over the last 20 years, indicating the absence of vaccine-driven positive selection. In contrast, the wild-type HBV population size experienced a rapid decrease starting in the mid-1990s, following the introduction of mass immunization, but it subsequently began to recover, reaching pre-vaccination levels by 2020. Taken together, these data indicate that it is gaps in vaccination, and not virus evolution, that may be responsible for the continued virus circulation despite 20 years of mass vaccination. [ABSTRACT FROM AUTHOR]

The factors influencing hepatitis E virus (HEV) circulation remain largely unexplored. We investigated HEV seroprevalence in humans and the prevalence of infection in farm pigs and rabbits in different regions of the Russian Federation, as well as the genetic diversity and population dynamics of the HEV. The anti-HEV IgG antibody detection rates in the general population increase significantly with age, from 1.5% in children and adolescents under 20 years old to 4.8% in adults aged between 20 and 59 years old to 16.7% in people aged 60 years and older. HEV seroprevalence varies between regions, with the highest rate observed in Belgorod Region (16.4% compared with the national average of 4.6%), which also has the country's highest pig population. When compared with the archival data, both increases and declines in HEV seroprevalence have been observed within the last 10 years, depending on the study region. Virus shedding has been detected in 19 out of the 21 pig farms surveyed. On one farm, the circulation of the same viral strain for five years was documented. All the human and animal strains belonged to the HEV-3 genotype, with its clade 2 sequences being predominant in pigs. The sequences are from patients, pigs, and sewage from pig farms clustered together, suggesting a zoonotic infection in humans and possible environmental contamination. The HEV-3 population size that was predicted using SkyGrid reconstruction demonstrated exponential growth in the 1970s–1990s, with a subsequent decline followed by a short rise around the year 2010, the pattern being similar to the dynamics of the pig population in the country. The HEV-3 reproduction number (Re) that was predicted using birth–death skyline analysis has fluctuated around 1 over the past 20 years in Russia but is 10 times higher in Belgorod Region. In conclusion, the HEV-3 circulation varies both geographically and temporally, even within a single country. The possible factors contributing to this variability are largely related to the circulation of the virus among farm pigs. [ABSTRACT FROM AUTHOR]

Simple Summary: The interplay between histological subtype and tumor microenvironment, especially the presence of tumor-infiltrating immune cells (TIIC), in adrenocortical cancer remains unclear. Here, we perform a comparative analysis of TIIC composition in conventional and oncocytic histological variants of adrenocortical cancer (ACC) using cases from The Cancer Genome Atlas database and the Endocrinology Research Centre collection (Moscow, Russia) and provide strong evidence that oncocytic ACC is characterized not only by improved survival but also by intensive immune infiltration compared to conventional ACC. Thus, these two histological variants should be independently analyzed to determine the potential role of TIIC in survival and tumor progression. The analysis of the tumor microenvironment, especially tumor-infiltrated immune cells, is essential for predicting tumor prognosis, clinical outcomes, and therapy strategies. Adrenocortical cancer is a rare nonimmunogenic malignancy in which the importance of the presence of immune cells is not well understood. In our study, we made the first attempt to understand the interplay between the histology of adrenocortical cancer and its immune landscape using cases from The Cancer Genome Atlas database and the Endocrinology Research Centre collection (Moscow, Russia). We showed that the oncocytic variant of adrenocortical cancer is characterized by intensive immune infiltration and better survival, and it is crucial to analyze the effect of immune infiltration independently for each histological variant. [ABSTRACT FROM AUTHOR]

Aims. The main aim of the research is to develop a preliminary offer of special medical tours to Thailand for the citizens of Russian Federation; to evaluate the limits of demand for Thai national medical tour-product in Russia, the potential key features of promotion and sales of Thai medical tours in Russia under the current economic conditions. Introduction. The relevance of the study is due to the fact that more than 50 countries of the world see the provision of medical services to international patients as the top-priority area of their national development. Leading approach to the study of this problem is the comparative method that has afforded revealing peculiarities of promoting Thai medical tours and potential sales to foreign patients. Results. The paper identifies the role of medical services in the process of Thai national tourist product differentiation and describes some of the special medical tours in Thailand specifically designed for overseas markets. The authors also evaluate the limit of demand for the national medical tour product of Thailand. Inerpretation. The authors emphasized the importance of promoting an excellent and high-tech service in promoting the Thai wellness product. The article also suggests checking the economic and marketing effectiveness of the business model of a sanatorium in Thailand. This model will be somewhat more expensive than a traditional hotel, but, unlike a hotel, it will have a number of strong competitive advantages in terms of Russian sales and will be able to actively earn additional services. The materials of the paper imply the practical significance for the university teachers of the economic specializations. [ABSTRACT FROM AUTHOR]

The Astrakhan region of Russia is endemic for the number of arboviruses. In this paper, we describe the results of the detection of the list of neglected arboviruses in the Astrakhan region for the 2018 season. For the purpose of the study in-house PCR assays for detection of 18 arboviruses have been developed and validated using arboviruses obtained from Russian State Collection of Viruses. Pools of ticks (n = 463) and mosquitoes (n = 312) as well as 420 samples of human patients sera have been collected and analyzed. Using developed multiplex real-time PCR assays we were able to detect RNA of eight arboviruses (Crimean-Congo hemorrhagic fever virus, Dhori (Batken strain) virus, Batai virus, Tahyna virus, Uukuniemi virus, Inkoo virus, Sindbis virus and West Nile fever virus). All discovered viruses are capable of infecting humans causing fever and in some cases severe forms with hemorrhagic or neurologic symptoms. From PCR-positive samples, we were able to recover one isolate each of Dhori (Batken strain) virus and Crimean-Congo hemorrhagic fever virus which were further characterized by next-generation sequencing. The genomic sequences of identified Dhori (Batken strain) virus strain represent the most complete genome of Batken virus strain among previously reported., (Copyright © 2021 Elsevier B.V. All rights reserved.)

The incorporation of glycemic index (GI) and glycemic load (GL) is a promising way to improve the accuracy of postprandial glycemic response (PPGR) prediction for personalized treatment of gestational diabetes (GDM). Our aim was to assess the prediction accuracy for PPGR prediction models with and without GI data in women with GDM and healthy pregnant women. The GI values were sourced from University of Sydney's database and assigned to a food database used in the mobile app DiaCompanion. Weekly continuous glucose monitoring (CGM) data for 124 pregnant women (90 GDM and 34 control) were analyzed together with records of 1489 food intakes. Pearson correlation (R) was used to quantify the accuracy of predicted PPGRs from the model relative to those obtained from CGM. The final model for incremental area under glucose curve (iAUC120) prediction chosen by stepwise multiple linear regression had an R of 0.705 when GI/GL was included among input variables and an R of 0.700 when GI/GL was not included. In linear regression with coefficients acquired using regularization methods, which was tested on the data of new patients, R was 0.584 for both models (with and without inclusion of GI/GL). In conclusion, the incorporation of GI and GL only slightly improved the accuracy of PPGR prediction models when used in remote monitoring., Competing Interests: The authors declare that there is no conflict of interest.

The system of providing therapeutic care within a united system of staged treatment of wounded and sick and evacuation was established during the Great Patriotic War of 1941-1945 and helped to return 90,6% of casualties to duty. In terms of local wars and armed conflicts the most important task of military field therapy is to improve the provision of therapeutic support through regional and territorial principles, echeloning of forces and facilities, optimization of allocation of medical institutions in accordance with their capabilities, evacuation routes, etc. The organization of therapeutic assistance should be guided primarily by the size and structure of sanitary losses. In modern local wars cannot exclude the occurrence of massive sanitary losses with limited use of weapons of mass destruction, as a result of failure (with a conventional weapon or as a result of sabotage) of nuclear power plants, chemical plants, and transport containers containing toxic chemicals.

In clause the analysis of the rendering medical help military is reflected in article with frostbites in military conflict on North Caucasus (1994-1996, 1999-2001). Efficient rendering medical help military with frostbites possible only under simultaneous observance united principle on terminological glances and provision to receivership approach to organizations of the rendering medical help damaged military. It is generalised and analysed own experience of the rendering medical help military with frostbites during military conflict on territory of the Chechen Republic (2003-2005).

Hereditary hemochromatosis (HH) is a common cause of primary iron overload induced by genetic impairment of iron metabolism. More than 80% of HH patients in populations of European origin are homozygotes for a single mutation C282Y, or compound heterozygotes for C282Y and H63D mutations in the HFE gene. However, in the majority of Asian, African, Australasian, and Amerindian populations, frequencies of C282Y are close to zero. Data on the prevalence of HFE mutations in Russian population and in Russian patients with HH are very limited. In this work, we determined frequencies of C282Y and H63D in ethnical Russians living in the Central European region of Russia. Furthermore, we tested whether homozygocity for C282Y is the major cause of HH in Russians. We found that, in the Russian population, the frequency of C282Y mutation in the HFE gene is relatively high and corresponds to mean European levels. However, in contrast to the majority of European populations, homozygocity for C282Y is found only in a small proportion (5%) of patients with biochemical and clinical signs of HH. These data suggest that either the penetrance of C282Y in Russia is lower than in Western countries, or that a more frequent non-HFE dependent mechanism of primary iron overload dominates in Russian population.

One of most widely spread causes of hypertrophic cardiomyopathy (HCMP) is mutation in cardiac beta-myosin heavy chain gene. Data on contribution of this mutation to development of HCMP in Russian patients are very limited. We conducted screening of beta-myosin heavy chain gene for the presence of mutations in 116 patients with confirmed HCMP (probands). DHPLC was used with subsequent sequencing of DNA fragments. Genetic defects of beta-myosin heavy chain were found more than in every 10-th patient. These defects were represented by 13 mutations (Ala729Pro mutation was found twice). Phenotypes of majority of known mutations in Russian population did not differ substantially from their phenotypes in other populations. Six mutations had not been previously described; most of them were associated with especially severe clinical and hemodynamic signs and relatively unfavorable course of the disease. Thus beta-myosin heavy chain gene mutation play important role in etiology of HCMP in patients in Russia.

Valuable-and-semantic spheres of Navy servicemen called-up for military service were investigated. For the servicemen with "psychical discomfort" the behavior "disadaptation" strategy is characteristic: the unrealistic orientation towards the freedom and material security; the problem of difficult choice between the interest in unofficial contact and the necessity to defer to rank; the "internal vacuum" state connected with little value of cognitive orientations and their relative accessibility, and on the contrary, the "internal conflict" state conditioned by the inaccessibility of vital and social values. The most of investigated persons are not oriented towards the highest levels of behavior self-regulation that are connected with the search for sense and choice freedom. They are characterized by the regulation lowest levels connected with stereotype and comfort in observing the social standards (the group of "relative" psychical comfort) or by the non-adequate ways of behavior self-regulation that aggravate the disadaptation, morbidity and person's deformation (the group of "psychical discomfort").

Threat of accident development at the chemical industry objects, as well as tasks of medical support in chemical weapon destruction necessitate improvement of the toxicant biological indication methods, creation of protective-decontaminating prescriptions to protect open areas of skin, and also development of etiotropic and pathogenetic therapy agents for poisonings The Scientific-Research-Test Center (Medicobiologic Protection) studies of every of the above trends have allowed to create and introduce into table medical support of the RF Armed Forces some new indication-means samples, antichemical packets, antidotes and means of pathogenetic therapy for convulsive and bronchospastic syndromes, to motivate use of pharmacological agents to stop toxic pulmonary edema and cardio-vascular failure.

The article studies the informative value of test objects for the evaluation of potable water which contains toxic substances. A number of test objects is proposed by the authors to estimate the chemical harmlessness of water: tetrachimens, Daphnia and peroxide ferment system. The data obtained with the help of test-objects possess a sufficient selective sensibility as far as maximum allowable concentration of various toxic substances is concerned. The authors stress that these methods of biological testing may complement or precede the traditional methods of water evaluation.

Two outbreaks of virus hepatitis were etiologically and epidemiologically interpreted. In this work the original method of obtaining washings, with their subsequent concentration, from the suspected foodstuff was used and hepatitis A virus was then detected in concentrated washings in the enzyme immunoassay, which made it possible to confirm the contribution of the alimentary factor of the transfer of infection (sun-cured melon) in the above-mentioned outbreaks. The data thus obtained are indicative of the necessity to conduct epidemiological investigation, taking into account the possibility of contacting hepatitis A when using foodstuffs not subjected to preliminary treatment.