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Abstract. Bulgarian animal husbandry has undergone several transformations since the country's accession to the EU. The declining levels of institutional support in recent years have necessitated the optimization of activities and the rational use of available resources. This requires the introduction of modern digital management methods for livestock farms. The aim of the present study is to assess the digitalization in supply planning for optimization of stocks in animal husbandry. To achieve this goal it is necessary to solve the following tasks: to analyze the problems in the cyclical supply of feed stocks; to study the models for optimization of stocks in animal husbandry; to assess the possibilities for digitalization of the processes of supply and management of feed stocks. The expectations from the research are that digitalization of the processes will optimize the supplies and stocks in animal husbandry, which is a prerequisite for efficiency and continuity of the production process. The results of the study show that consistently optimizing the existing, warranty, and preparatory stock is crucial for enhancing efficiency on any animal husbandry farm. Integrating digital technologies to monitor, analyze, optimize, and schedule these stocks can enhance farm efficiency, mitigate risks, and safeguard the environment.

The natural and climatic conditions in Bulgaria are a prerequisite for the cultivation of quality fruits with unique taste characteristics, but after the country's accession to the EU, there is a permanent tendency to decrease the areas on which fruit crops are grown. The consumption of fresh fruits and vegetables in developed and developing countries is far below the recommended norms, and yet production in the country cannot satisfy the needs of the population with fresh fruits and the canning industry with raw materials. The purpose of this paper is to analyze the characteristics of the fruit market in Bulgaria.

The cooperative as a legally organizational form of farming in agriculture is directly related to the social and economic development of the regions and the country. Not only large producers, but also small farms can participate in cooperation, which contributes to increasing their competitiveness. The cooperative is a good form of interaction between agricultural producers and an effective way to ensure sustainable development of agriculture. The purpose of this paper is to explore the possibilities of the cooperation of different individuals with aim to achieve sustainable agriculture.

Natural and synthetic polymers are widely explored for improving seed germination and plant resistance to environmental constraints. Here, for the first time, we explore stabilized nanomicelles composed of the biocompatible triblock co-polymer Pluronic P85 (SPM) as a priming agent for Pisum sativum (var. RAN-1) seeds. We tested a wide concentration range of 0.04-30 g(SPM) L-1. Applying several structural and functional methods we revealed that the utilized nanomicelles can positively affect root length, without any negative effects on leaf anatomy and photosynthetic efficiency at 0.2 g L-1, while strong negative effects were recorded for 10 and 30 g(SPM) L-1 concerning root length, leaf histology, and photoprotection capability. Our data strongly suggest that SPM can safely be utilized for seed priming at specific concentrations and are suitable objects for further loading with plant growth regulators.

Introduction The neurocognitive deficit model as a characteristic of patients with borderline personality disorder (BPD) has been the focus of research for the past 20 years. However, no such studies have been performed in Russia. Objectives The aim of the present study was to investigate the neurocognitive profile of patients with BPD. Methods Fifty patients with BPD (according to DSM-V criteria) in stable mental state (72% women; mean age 22.44±4.32) were examined. BPD symptom severity was assessed using the Borderline Personality Disorder Questionnaire (PBQ-BPD), which was validated in the Russian population (34 points or more indicated a higher probability of BPD diagnosis). The Brief Assessment of Cognition in Schizophrenia (BACS) was used to assess cognitive function (in order to use these data for differential diagnosis with schizophrenia spectrum disorders). The study was approved by the ethical committee of Saint Petersburg State University. Results On the PBQ-BPD results, 38% of patients (n=19) scored over 34 points, despite being stable. BACS subscales T-scores (presented as median [Q1; Q3]) were within normal limits (Verbal memory - 49.81 [46.56; 53,06]; Working memory - 43.73 [38.0; 47.50]; Motor function - 44.08 [41.0; 47.25]; Coding - 45.56 [42.50; 48.63]; Verbal fluency - 48.14 [46.0; 52.0]; Tower of London test - 52.33 [47.0; 57.0]). A number of patients had low scores on the BACS subscales (T-score < 40), particularly working memory (33.3%), coding (20.8%), and verbal memory (18.8%). The BACS Composite T Score (46.02 [43.65; 48.39]) correlated with the PBQ-BPD score (32.00 [27.00; 36.00]; r=-0.316; p=0.028). To better characterize the cognitive functioning of patients with BPD, patients were divided into two groups: those who scored less than 34 on the PBQ-BPD (group 1) and those who scored more than 34 on the PBQ-BPD (group 2). Group 2 patients had a lower BACS Composite T-score (42.32 [38.06; 46.58]; 48.45 [45.87; 51.03]; p=0.009) and nominally lower mean scores on all BACS subscales, compared with Group 1 patients. We found significant differences in T-scores values on the Working Memory subscale (Group 1 - 45.0 [41.0; 49.0]; Group 2 - 38.0 [33.0; 43.5], p=0.003), Verbal Fluency (49.0 [47.25; 53.75]; 48.0 [44.0; 49.0]; p=0.047), Tower of London Test (57.0 [52.0; 57.0]; 48.0 [42.0; 57.0]; p=0.036). Conclusions Neurocognitive impairment was detected in 33.3% of patients with BPD. The dominant cognitive impairments in the patients were decreased working and verbal memory and information processing speed. The severity of BPD symptoms has been confirmed to correlate with the neurocognitive functioning of these patients. Disclosure of Interest None Declared

Introduction Despite the high prevalence of borderline personality disorder (BPD) in the population, the evidence regarding approaches to therapy for BPD is inconsistent. No psychopharmacological medications are approved for the treatment of BPD, yet most patients with BPD are treated with pharmacotherapy. Meanwhile, psychotherapy is the method of choice for the treatment of BPD. Little is known about the clinical practice of BPD treatment in Russia, since most studies have been conducted in Western countries. Objectives The aim of the study: analysis of approaches to treatment of BPD in real outpatient clinical practice in Saint-Petersburg, Russia. Methods Fifty patients (72% female; n=36; mean age 22.4±4.3) who were treated in an outpatient community care were included in the study. Diagnosis was made according to the ICD-10 criteria (F60.31), as it does in clinical practice in Russia. Research methods included a clinical-catamnestic method. Results All examined patients received pharmacotherapy. Twenty-four patients (48.0%) received monotherapy with a selective serotonin reuptake inhibitor antidepressant. The remaining patients (52.0%) received two or more psychotropic medications simultaneously. The most frequent combination of psychopharmacotherapeutic agents was a combination of an antidepressant and a mood stabilizer. Analysis of therapy revealed that antipsychotics (always of the second generation) as well as mood stabilizers were prescribed to target emotional instability and impulsivity as symptoms of BPD, as well as increased self-harming behavior in order to reduce impulsivity. Despite the assumption that the simultaneous prescription of several medications to patients with BPD was due to the presence of a comorbid psychiatric diagnosis, this was not confirmed (p>0.05). Most of the patients (n=42; 84.0%) received individual and group psychotherapy (cognitive-behavioral with elements of dialectical-behavioral therapy). It was found that patients who received psychotherapy had a faster response to pharmacotherapy (p

Detailed studies of the Li4GeО4-Li2CaGeО4 system by solid-phase syntheses of various compositions from pure Li4GeО4 to pure Li2CaGeО4 in the temperature range from 25 to 1125 °C is investigated for a first time. Solid state synthesis powders are characterized by X-ray and DSC/TG methods. Concentration and temperature two-phase regions of Li4GeО4 and Li2CaGeО4 as well as two-phase regions of Li2CaGeО4 and Li2+2xCa1-xGeO4 are established. Region of pure Li2+2xCa1-xGeO4 solid solution are detected too and it structure is investigated. Being structural analog to Li2+2xZn1-xGeO4 and Li2+2xMg1-xGeO4, Li2+2xCa1-xGeO4 has own specific local environment of the metal ions. The obtained results are compared with those for Li4GeО4-Li2ZnGeО4 system and for Li2+2xZn1-xGeO4 solid solution. The differences of the phase diagrams and structural features of the solid solutions are discussed.

Introduction Borderline personality disorder (BPD) has a significant presence in outpatient psychiatric practice worldwide, but data on the clinical features of patients with BPD in Russia are limited. Clinicians experience a number of difficulties in diagnosing BPD, which is also due to the high comorbidity of BPD with other mental disorders (affective, anxiety, other personality and addictive disorders). Objectives The aim of this pilot study was to investigate clinical characteristics of mental health care for patients с BPD in real clinical practice in community in Saint-Petersburg, Russia. Methods Fifty patients (72% female; n=36; mean age 22.4±4.3) who were treated in an outpatient community care were included in the study. Diagnosis was made according to the ICD-10 criteria (F60.31), as it does in clinical practice in Russia. Research methods included a clinical-catamnestic method. Results The age of onset of BPD symptoms was 14.9±2.7. It was found that 50% of patients had previously received inpatient (20%, n=10) and outpatient (30%, n=15) psychiatric care unrelated to the current mental condition, that is, not due to the BPD. 16% of patients (n=8) referred for the first time for psychiatric care in adolescence. The vast majority of patients (86%; n=43) were not diagnosed with BPD when they first consulted a psychiatrist. Prior to the diagnosis of BPD, patients were diagnosed with mental disorders due to organic brain injury (4%), affective disorders (44%), schizophrenia spectrum disorders (12%), anxiety disorders (20%) and other personality disorders (6%). On average, it took 7.5±4.0 years from the date of first psychiatric assessment before the diagnosis of BPD was confirmed. At the time of inclusion in the study, patients were diagnosed with the following comorbid mental health conditions: affective disorders (12%), anxiety disorders (6%), eating disorders (4%), and addictive disorders (2%). Conclusions The hypodiagnosis of BPD in the early stages of the disorder has been identified, making it challenging to obtain high quality mental health care in a timely manner. The frequent comorbidity between BPD and other mental disorders has been confirmed. The study demonstrates the relevance of introducing programs (including education) to improve the diagnosis and study of comorbidity of BPD in real clinical practice. The pilot study results provide the basis for a project to investigate approaches to differential diagnosis and evaluation of treatment strategies for patients with BPD. Disclosure of Interest None Declared

Supply chain management is a critical aspect of conducting any business. In this article, we provide an overview of some the methods for supply management and their use in animal husbandry. In this paper, we introduce a version of Wilson`s model. The illustration of the proposed model, showing economic effects to the farm, reducing its expenses (by 2.5%) compared to farms that do not utilize this model.

Short food supply chains have the potential of improving local food production and provide the population with high quality fresh food. The sustainability of these chains has come under question last year (2020) due to the disruption caused by the pandemic and the lack of preparation for it. The goal of this study is to analyze the sustainability of short food supply chains in Bulgaria and identify the main sources for their disruptions. In order to achieve this goal, the following tasks must be solved: to analyze the state of short food supply chains in Bulgaria; to evaluate the level of sustainability of these chains, and to discover and present the main sources for disruptions of short food supply chains in Bulgaria.

Introduction The question of the involvement of inflammatory and autoimmune processes in schizophrenia pathogenesis has become the most relevant in the last decade and yet is not fully understood. Objectives The study included 60 patients with paranoid schizophrenia (age 18 - 55 y.o.) and 30 healthy control group participants. Patients were in a stabilization state without a history of organic brain disorder or another verified somatic disease in the exacerbation phase. Methods Research methods included follow-up method, neuropsychological (PANSS, BAC-S), laboratory (enzyme immunoassay, flow cytometry), and statistical. Results Patients with schizophrenia had significant structural disorders of thinking, passive, apathetic withdrawal, negativism, impaired attention, psychomotor speed, volitional impulses. Cognitive impairment was detected in all study participants. Severe impairments are noted in the executive functioning, hand-eye coordination, attention, psychomotor speed. The severity of cognitive impairments correlated with the severity of clinical symptoms. Patients with schizophrenia had a significant decrease in central memory T-regulators levels, and an increase in Th1 and Th2 subsets, «double-positive» and «сlassic» Th17, Tfh2, «classic» Tfh17, and in Tfh17.1 (Pic.1). Picture. 1. T-helper subsets in patients with schizophrenia. They also had high levels of CCL20, IL-10, IL-12, IL-1β, IL-27, IL-31, IL-4, IL-13, IL-6, IL-9, TNFα in comparison with a control group. A significantly decreased levels of IL-17A, IL-17F, IL-2, IL-22, and TNFβ were also described in this group of patients. Conclusions Patients with schizophrenia may be characterized by the presence of an inflammatory process and a high chance of autoimmunity. Aknowledgement. This work was supported by the grant of the Russian Federation Government, contract 14.W03.31.0009 Disclosure No significant relationships.

Introduction The majority of researchers agree that transgender people have an increased burden of mental disorders compared to the general population. However, it is strongly suggested that transgender people still do not receive mental health care that they need. Objectives To assess the mental health care needs of transgender people living in Russia. Methods An anonymous online survey was conducted throughout November 2019. 588 transgender adults living in all Federal Districts of Russia (mean age 24.0±6.7) were included in the final analysis. Results It was found that 308 respondents (52.4%) had visited mental health professional prior to gender transition. 150 people (25.5%) reported to had been diagnosed with a mental disorder before gender transition, and a further 77 respondents (13.1%) indicated that they had been diagnosed with a mental disorder after transition began. 157 people (26.7%) received treatment from a mental health professional. 222 respondents (37.8%) had experience of taking medication off-prescription to improve mental wellbeing. 464 people (78.9%) reported being in need of psychological care. 289 people (49.1%) indicated that they were experiencing barriers in obtaining psychiatric (psychotherapeutic, psychological) care, which was associated with a perceived need for psychological support (OR=4.33 [95% CI: 2.49;7.80], p

Introduction Clinical practice has shown that SARS-CoV-2 viral infection increases the likelihood of developing mental disorders.Clinical practice has shown that SARS-CoV-2 viral infection increases the likelihood of developing mental disorders. Objectives To analyze clinical indicators of patients with COVID-19 with mental disorders and to identify predictors of adverse outcomes associated with mental state on its basis. Methods The study included 97 patients, 41 men and 56 women (62.3±15.3 years of age). During the observation period, 26 people died and 71 people recovered. Data collection was carried out using a questionnaire (109 variables). Binary logistic regression and Cox proportional hazards regression were used. Results In the study group, death occurred on average after 11.5 days. In this group, the mental state of patients was more severe with a predominance of cases of delirium. With age, the probability of a fatal outcome increased by 1.03 with each year of life. The severity of mental disorder had a greater impact on the risk of death compared to age (p=0.003). Improvement of the mental state of patients during psychotropic therapy was associated with a reduction in the risk of an unfavorable outcome of coronavirus infection by 11.11 times. The greatest contribution to the unfavorable outcome was made by the severity of infection: the risk of death increased by 33.17 times. Conclusions A severe or extremely severe mental state increased the risk of death by 4.55 times. The most significant factor in predicting mortality was associated with the severity of the underlying disease. Disclosure No significant relationships.

Introduction Despite the long history of burnout studies, the problem of burnout among psychiatric specialists in Russia is insufficiently studied. The risk of burnout is the highest among psychiatrists in the first 10 years of their career. Objectives To assess the prevalence and severity of burnout in early career psychiatrists (ECPs) in Russia. Methods An anonymous online survey of ECPs in Russia was conducted in July-August 2019 with a screening for burnout using the Maslach Burnout Inventory (MBI). The final sample consisted of 165 people (61.2% women; mean age 31.05±3.88). 95.2% of respondents lived in urban areas. Results A high level of burnout according to at least one of the MBI scales was revealed in 71.5% of ECPs: in 79 (78.2%) women and 39 (60.9%) men (χ2(1)=5.74; p=0.017). Mean values of the MBI Emotional Exhaustion scale corresponded to 23.33±8.97 and 17.97±8.49 (U=1999.5; p=0.003), the MBI Depersonalization scale – 10.46±4.81 and 9.16±4.22 (U=2598.5; p=0.083), and the MBI Personal Accomplishment scale – 33.02±5.98 and 35.32±5.75 (U=2409.5; p=0.026) for women and men, respectively. The following risk factors for professional burnout were identified: female sex (OR=3.54 [95% CI: 1.96; 6.39], p

This paper reviews the authors’ theoretical and empirical views on the factors influencing wine production. The theoretical framework indicates the presence of many factors affecting the vine growing and winemaking enterprises. The indicators are summarised in terms of terroir, the competitiveness of the enterprise, its ability to innovate, the production quality and the quality of wine product intended for the market. The analysis assists in highlighting the following more important conclusions: evolution of the object of study from an enterprise to a whole supply chain; regarding the subject of study, many factors that affect the object, combined into leading factors and indicators characterising the factors, can be identified; the terroir and the human factor are the main factors influencing the quality of the wine produced.

Light is a major factor controlling plant growth and development. To assess the impact of the applied light conditions, we aimed to sort out a tool for early diagnostics of the plant physiological state. We investigated the effect of a blue:red:far-red LED light formula recommended for improved plant performance (flowering). High (BR) and low (BRS) light intensity variants were compared to normal (W) and 'shadowed' (WS) white fluorescent controls. The efficiency of the JIP-test to determine changes during early growth of pea plants was compared to additional physiological characteristics (growth parameters, thermal stability of the thylakoid membranes, chlorophyll content, CO2 assimilation, transpiration). Our data showed the onset of growth inhibition under BR light, while BRS light stimulated plants to reach the flowering stage similarly as the W control. We concluded that the JIP-test is appropriate for early, reliable, and nondestructive analysis of light recipes for plant growth and flowering.

One of the major questions in photosynthesis research is related to the role of the ultrastructure of thylakoid membranes in higher plants for their functional performance at optimal and stress environmental conditions. In this work, we compared the drought stress response of pea plants grown at moderate and low light conditions, based on our recent findings that they differ in the extent of grana stacking and in the thermal stability of the major light-harvesting complex of PSII that plays important regulatory role for plant survival. Our data demonstrate that low light-adapted plants are structurally and functionally less affected by the water deficit, strongly suggesting a major role of thylakoid structural organization for drought stress response.

Introduction The prevalence rates of mental health issues, particularly anxiety and depression, is high among transgender people. However, the incidence of anxiety and depression in transgender people living in Russia is unclear until now. Objectives To examine the frequency of anxiety and depression in transgender people living in Russia. Methods The Hospital Anxiety and Depression Scale (HADS) was used for online screening for symptoms of anxiety and depression in transgender people living in Russia throughout November 2019. 588 transgender adults living in all Federal Districts of Russia (mean age 24.0±6.7) were included in the final analysis. 69.6% (n=409) of the survey participants indicated the direction of transition as transmasculine (TM), 23.1% (n=136) – as transfeminine (TW), and 7.3% (n=43) – as other (TO). Results It was found that 45.1% (n=265) and 24.0% (n=141) of transgender people had clinically significant levels of anxiety and depression, respectively (HADS score of 11 or higher). The rates of anxiety (TM=10.21±4.68; TW=8.72±3.91; TO=10.72±4.43) and depression (TM=7.53±4.09; TW=7.40±4.19; TO=7.74±4.33) did not have statistically significant differences within the direction of transition. The anxiety and depression mean scores in all subgroups were statistically significantly higher than in the general Russian population (p

The consumption and purchasing power of the population are key factors in the development of domestic production and sales and an important indicator of the standard of living of the population. The aim of the article is to investigate the development of the consumption and purchasing power of the population of basic food products. The methods used are systematic and comparative analysis; Method of statistical groupings, expert assessments, inductive and deductive methods for generalizing summaries.

Hypothyroidism is a decrease or complete loss of thyroid function. In childhood, congenital hypothyroidism is the most common, which can be either permanent or transient. One of the reasons for the development of hypothyroidism in newborns may be the mother's intake of large doses of iodine during pregnancy and, as a consequence, the occurrence of the Wolf–Chaikoff phenomenon to prevent the synthesis of large amounts of thyroid hormones by the thyroid gland of the fetus and newborn. We present a clinical observation of a rare form of hypothyroidism with goiter in a child born to a mother who took narcotic drugs containing large doses of iodine. In the presented observation, hypothyroidism was transient in nature; a feature of the disease was a long-lasting enlargement of the thyroid gland. Taking into account that even a temporary decrease in the level of thyroid hormones can negatively affect the neuropsychic development of the child, the newborn patient was prescribed replacement therapy with levothyroxine sodium at a dose of 25 mcg/day. The patient's long-standing goiter served as the reason for prolonging replacement therapy until the age of 1 year and subsequent resumption of therapy twice until the volume of the thyroid gland normalized.

The peculiarities of mapping land recreational purposes, taking into account their potential gidroresursnogo the example of the Altai Republic. We propose two types of cards on the territory of the republic: the hydrogeological zones groundwater recreation; areas of relatively equal conditions of development gidroobektov.

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The review is devoted to the classification, diagnosis and differential diagnosis of transient loss of consciousness. The pathophysiology of transient loss of consciousness is described. It is concluded that the criteria for the differential diagnosis of transient disorders of consciousness need further development and validation. The problem of paroxysmal disorders of consciousness is interdisciplinary in nature and requires the combined efforts of doctors of different specialties to develop a unified algorithm for clinical, laboratory and instrumental diagnostics, determine management tactics and correct patient routing.

The aim of the study was to investigate the structure of delirium in elderly patients with different outcomes of coronavirus infection.Materials and Methods. The study was carried out on the basis of Hospital for War Veterans, St. Petersburg. The study involved 30 patients: 13 male and 17 female (median age (Med) 70.5, interquartile range (IQR) 62-83) with clinical diagnosis: "New coronavirus infection COVID-19 (PCR+), F05.86 other delirium in association with other viral and bacterial neuroinfections. Peculiarities of delirium manifestations were studied using Delirium Rating Scale-Revised-98 (DRS-R-98). Current physical condition was monitored using The National Early Warning Score (NEWS2) for COVID-19.Results: All patients had moderate to severe disorders of the wake-sleep cycle on the DRS-R-98 scale. In addition, perceptual and long-term memory impairments were common. A significant correlation (p

The results of studies on elderly patients with COVID-19 indicate presence of serious comorbidities, including cerebrovascular disease, infection of the central nervous system, and cognitive deficits. Impaired cognitive functioning may be due to neurological damage, combined and potentially reversible effects of depression, anxiety and sleep disturbances.The purpose of the study: to identify characteristics of cognitive impairment of elderly patients hospitalized for COVID-19.Material and methods: the study involved 35 patients: 15 men and 20 women (median age 61.0 years, interquartile range (IQR, 25.0-75.0 percentiles) — 50.0-69.0 years, established clinical diagnosis: “New coronavirus infection COVID-19 (PCR+)”. Inclusion criteria were: 1) confirmation of the diagnosis of COVID-19 by clinical and PCR methods, 2) absence of mental disorders, incl. cognitive impairment prior to COVID-19. The exclusion criterion was age under 40 and over 90 years. The severity of COVID-19 was assessed in accordance with the criteria of the Interim Guidelines of the Ministry of Health of the Russian Federation. Clinical and psychopathological method, psychometric testing using the MMSE scale were used. Monitoring of current physical condition was carried out using The National Early Warning Score (NEWS2) for COVID-19. MMSE testing and monitoring of NEWS2 were carried out twice: upon presentation of cognitive complaints in the first days of hospitalization (1st measurement) and at discharge (2nd time point) Statistical processing was carried out using the STATISTICA 12 package. When comparing features, two-tailed Fisher’s test and Wilcoxon’s test were used. Correlation analysis was carried out using Kendall’s test. The level of statistical significance was p

The opinion article is devoted to the analysis of a large-scale 24-week multinational observational prospective cohort study «The effectiveness of vortioxetine in depression in real clinical practice» (BELIEVE). The study demonstrated the achievement of functional recovery of patients with depressive disorder when using vortioxetine, good efficacy and tolerability of the drug for the treatment of depression in a large and heterogeneous patient population representative of everyday psychiatric practice. A significant improvement in depressive and cognitive symptoms, productivity and quality of life of patients was achieved, while the greatest effect was observed when using vortioxetine as the first line of therapy. The results of the study confirmed the data of numerous RCTs devoted to the use of vortioxetine in the treatment of depressive disorder, and they can be used when choosing tactics of antidepressant therapy in conditions of routine psychiatric.

BACKGROUND: Exploring the professional values and educational needs of future and practicing mental health specialists is required to develop effective measures aiming at improving their skills and interest in their work. AIM: Our aim was to explore professional values and educational needs of mental health specialists in Russia. METHODS: We conducted a survey that captured socio-demographic data, professional characteristics, professional values, and educational needs. Fisher's exact test, logistic regression, and the k-means cluster analysis were used in our statistical analysis. RESULTS: The survey included 133 participants, 71% of whom had completed their postgraduate education. The following items were mentioned as important professional values by the respondents: Job opportunities, Stimulation of intellectual activity, and Work-life balance. The most popular options for educational activities were English language (63.4%), the principles of evidence-based medicine (63.4%), and developing skills for conducting scientific research (59.4%). In comparison with practicing specialists, respondents who had not yet completed their postgraduate education were more interested in developing their curriculum vitae (39% vs. 60%, p=0.044) and communication skills (49% vs. 77%, p=0.0048). Compared to male respondents, female respondents were more interested in developing skills in conducting scientific research (47 vs. 70%, p=0.0165). A cluster analysis showed that specialists who attached more importance to almost all professional values, in comparison to those who did not, were more interested in activities aimed at developing their research skills (64% vs. 41%, p=0.0287), learning about the principles of evidence-based medicine (70% vs. 41%, p=0.0063), and participating in journal clubs (39% vs. 11%, p=0.0193). CONCLUSION: The present study suggests that job opportunities, intellectual stimulation, and work-life balance are the most important professional values for future and practicing mental health specialists. These findings might be used as a basis for developing educational activities for mental health specialists.

The review article provides data on the prevalence and treatment problems of depression, highlights the issues of adherence to antidepressant therapy, investigation of the safety and efficacy of agomelatine in real clinical settings. The results of a prospective observational multicenter cohort study of agomelatine in clinical practice are analyzed in detail, taking into account the effect of treatment on the social functioning of patients. The results obtained in a sample representative for depression, including patients with comorbidities, confirm the long-term efficacy and good tolerability of agomelatine in daily practice, which is the basis for adherence to therapy and achievement of the goal of depression treatment

The aim of the present study was to examine the characteristics of early career psychiatrists’ (ECP) work in Russia and to assess the prevalence and severity of burnout in them. Material and methods. The Early Career Psychiatrists Council of the Russian Society of Psychiatrists conducted an anonymous online survey of ECP in Russia in July-August 2019, consisted of a structured survey and screening for professional burnout using the Maslach Burnout Inventory (MBI). The final sample consisted of 165 people. Results. A high level of burnout according to at least one of the MBI scales was revealed in 79 (78.2%) women and 39 (60.9%) men (p=0.017). Mean values of the MBI Emotional Exhaustion scale corresponded to 23.33±8.97 and 17.97±8.49 (p=0.003), the MBI Depersonalization scale — 10.46±4.81 and 9.16±4.22 (p=0.083), and the MBI Personal Accomplishment scale — 33.02±5.98 and 35.32±5.75 (p=0.026) for women and men, respectively. The following risk factors for professional burnout were identified: female sex, overlapping of several working positions, difficulties in work due to changes in documentation requirements introduced since the start of professional career. Protective factors of burnout development were: work in private clinic, satisfaction with work atmosphere, subjective estimation of quality of life as above average or as good as possible. Conclusion. Burnout was established in 71.5% of ECP in Russia, which corresponds to one of the highest burnout rates in psychiatrists according to international and national studies. Further research is needed to assess the prevalence and severity and ways to prevent burnout in psychiatrists in Russia.

The article provides a review of the scientific literature devoted to postcoid conditions. The concept of postcovid syndrome, its structure, and epidemiology are disclosed. The article contains the results of 2 meetings of experts (psychiatrists, psychotherapists, neurologists) from different regions of Russia who had experience in providing care to persons with postkovid syndrome. Particular attention is paid to postcovid depression, its clinical characteristics, and the experience of therapy. It was noted that the severity of the post-coV syndrome did not depend on the severity of the infectious disease suffered. The leading variants of depressive syndromes observed in SARS-CoV-2 patients were: astheno-depressive, apato-depressive and anxious-depressive syndromes. Anhedonia, anxiety, cognitive disorders, insomnia, and hypochondria occupied a significant place in the structure of postcovid mental disorders. It is emphasized that persons with postcovid syndrome, as a rule, initially found themselves in the field of vision of internists, therefore, their training in the diagnosis of postcovid mental disorders is relevant. Clinical experience has demonstrated the feasibility of antidepressant therapy for postcovid depression and the high efficacy and safety, including the risk of drug interactions, of using vortioxetine, including prescribing the drug to the elderly and the somatically impaired. The article is illustrated with clinical examples.

Objective: to analyze clinical and follow-up indicators in patients with mental disorders and COVID-19 and to identify on their basis predictors of poor outcomes associated with mental state.Patients and methods. We conducted a prospective study in a multidisciplinary hospital. The severity of coronavirus infection was determined according to the temporary guidelines. Data collection was carried out using a patient chart consisting of 109 variables. Predictors of poor outcomes were determined using predictive models (logit regression, Cox model). The study included 97 patients: 41 men (42.3%) and 56 (57.7%) women, mean age – 62.3±15.3 years. 26 patients died; 71 patients recovered.Results and discussion. The death occurred on 11.5 day. The mental state of these patients was severe, with a predominance of delirium cases. With increasing age, the probability of non-lethal outcome decreases [hazard ratio (HR) 1.03; 95% confidence interval (CI) 1.00–1.06; p=0.037]. The risk of death increased by 1.03 (p=0.037) for each year of life. An improvement in the mental state of patients during psychotropic therapy is associated with an 11.11-fold decrease in the risk of poor outcome of coronavirus infection (HR 0.09; 95% CI 0.01–0.76; p=0.027). Delirium is a predictor of low patient survival, especially in prolonged hospitalizations (HR 4.55; 95% CI 1.66–12.48; p=0.003). The severity of coronavirus infection makes the greatest contribution to the poor outcome: the risk of death increases by 33.17 times (CR 33.17; 95% CI 4.01–274.65; p

Objective: to analyze the diagnostic significance of clinical and phenomenological characteristics of affective disorders in patients with chronic somatic pathology.Patients and methods. The analysis included the results of a clinical evaluation of 131 patients with chronic somatic pathology, including 96 patients suffering from cardiovascular diseases and 35 patients with cerebral small vessel disease. Clinical assessment included Primary care evaluation of mental disorders (PRIME-MD) and Hamilton Depression Rating Scale.Results and discussion. Despite the significant frequency and transparent clinical symptoms, general practitioners diagnosed mental disorders in only 30% of patients with depression. We observed a higher prevalence of somatic rather than psychological complaints during the clinical survey. According to the screening using PRIME-MD, 74% of patients were diagnosed with mood disorders, anxiety, and somatoform disorders. We also noted their significant comorbidity with a predominance of a depression and anxiety combination (p < 0.001). Hypertensive patients had the highest depression prevalence (87%) and severity. Moderate depression was the most frequent diagnosis in the study participants, corresponding to major depressive disorder (61.5%).Conclusion. In general, the symptoms of anhedonia, depression, and anxiety were most pronounced in patients with affective disorders. The high prevalence of somatic symptoms complicates depression evaluation. It is possible to highlight depression and anhedonia as significant symptoms for the detection of depression in patients with somatic disorders.

Objective: to discuss problems of diagnostics and psychopharmacotherapy of associated depressive disorders and anxiety circle disorders.Material and methods. The article is an analysis of a clinical case with the use of clinical and catamnestic method.Results. Diagnostics of Generalized Anxiety Disorder, issues of its comorbidity with other mental disorders including anxiety and depressive disorders are discussed. The principles of panic disorder diagnosis are analyzed. Diagnostic criteria of associated anxiety and depression in ICD-10, DSM-5 and ICD-11 are considered. Modern approaches to the choice of therapeutic tactics in comorbidal anxiety and depression are given. The analysis of the patient’s treatment is carried out with the justification of the choice of drugs. The possibilities of combined therapy of associated anxiety and depression disorders using vortioxetine are demonstrated. Achievement of qualitative remission of mental disorder without residual symptomatology and full restoration of social functioning of the patient with associated depressive and anxious disorders is shown.Conclusion. The clinical case demonstrates a characteristic chronic fluctuating course of GTR both in combination with different depths of depression and with other anxiety disorders (panic attacks). Diagnostic difficulties and therapeutic possibilities of a patient with double diagnosis: Generalized Anxiety Disorder and Depressive Episode have been analyzed.

Background. Extramedullary infiltration (EI) is relatively common in children with acute myeloid leukemia (AML) (up to 20-25 %). However, its clinical and prognostic significance remains poorly understood.Objective: to describe clinical features and to define prognostic significance of EI in children with AML.Materials and methods. The subjects of retrospective observational study were 228 children with de novo AML. The median age was 6.6 years. All of them were treated according to the protocol AML-MM-2006 from April 2007 to June 2018.All patients with EI were divided into three cohorts according to the localization of the lesions: 1) central nervous system (CNS) involvement (CNS group), 2) other localizations apart from CNS (myelosarcomas (MS) group), 3) combined lesions (CNS + MS group).Results. EI was diagnosed in 84 patients (36.84 %) with de novo AML. Among them 47 (55.95 %) had CNS involvement, 20 (23.81 %) had MS, 15 (17.86 %) had both CNS involvement and MS. 5-year overall survival (OS) rate was slightly higher in patients with CNS involvement than in children without EI - 80 ± 12 % vs 71 ± 9 %, p = 0.26, however OS in patients with MS was significantly lower - 45 ± 16 % vs 71 ± 9 %, p

In result of a comprehensive analysis of the geological, geophysical and geochemical data, the lower Tutleim Formation in well №1 was classified as an oil source with the industrial potential for hydrocarbon generation. In order to estimate the resources of shale oil by the volumetric genetic method, the method of reconstruction the Total Organic Carbon content according to the Gamma-Ray data was used. A probabilistic assessment of resources by the Monte-Carlo method was performed with the determination of forecast resources at probability P90, P50 and P10. The conclusion is drawn about the development of a shale oil deposit in the lower Tutleim formation in the context of well №1.

Disturbances in immune and endocrine regulation are closely interrelated with development of psychiatric diseases, including affective disorders. Depression may be a characteristic of at least 23 autoimmune diseases. Negative influence on the depression development have: an increased level of proinflammatory cytokines, impairment of T-regulatory cells, kynurenine pathway shift towards production of its potentially neurotoxic metabolites, overproduction of stress hormones, hyperleptinemia, hyperprolactinemia, hypothyroidism, as well as vitamin D, calcidiol and calcitriol deficiency. In this review we analysed the development and accumulation of ideas and facts regarding the interrelation between autoimmune and affective pathology.

In the article the questions of modeling of the system of continuous professional education of specialists in the sphere of social work at the Federal and regional levels. The basic principles and approaches to formation of system of continuous education, the data of sociological research.

Objective: to make a clinical-scale assessment of remission in patients with recurrent depression. Patients and methods. The clinical and functional characteristics of remission were investigated in 121 patients with recurrent depression. The investigators used the following tests: the Montgomery-Asberg Depression Rating Scale (MADRS), the Brief Assessment of Cognition in Affective Disorders (BAC-A), the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), and the 36-item Short Form Health Survey (SF-36) questionnaire. They systematized remission, by identifying its four types: asymptomatic, that with asthenic symptoms, that with anxiety symptoms, hypothymic. Results and discussion. The criteria for complete remission with its average duration of 6 months were met in 58.6% of patients. Impaired social functioning was observed in all patients in remission. The predictors of incomplete remission were a family history; male gender; complex pattern of depression; and the presence of comorbid anxiety. The anxious variant of incomplete remission predominated, suggesting that it is advisable to choose anxiolytic antidepressants for maintenance therapy. New-generation antidepressant therapy is more frequently associated with complete remission. Whether therapy with different antidepressants might achieve functional remission was studied using agomelatine as an example. Conclusion. When assessing the results of treatment for depression, it is necessary to take into account not only clinical changes, but also social functioning in patients and, as a target of therapy to identify positive affect as one of the psychological parameters of quality of life. When choosing an antidepressant for the maintenance therapy of recurrent depression, its positive efficacy on the social functioning of patients should be an important criterion.

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Tyrosine kinase inhibitors have radically changed the course of chronic myeloid leukemia, significantly increasing survival and reducing the risk of disease progression. Nearly 50–70 % of patients achieve a consistently low or undetectable level of minimal residual disease – a deep molecular response. The long-term tyrosine kinase inhibitors treatment in about one-third of patients is accompanied by toxicity which impairs the quality of life. Therefore, the safe treatment discontinuation is relevant. The results of clinical trials have shown 40-60% possibility of maintaining treatment-free remission in patients with long-term deep molecular respons; however, all patients with molecular relapse regain molecular remission after the resumption of tyrosine kinase inhibitors therapy. Currently, clinical and biological factors associated with maintaining treatment-free remission are being studied. It is assumed that cessation of tyrosine kinase inhibitors therapy can improve the quality of life, but approximately 30 % of patients are reporting musculoskeletal pain – so called “withdrawal syndrome” – that begins or worsens after stopping tyrosine kinase inhibitors therapy. The mechanisms for the development of this phenomenon are currently unclear. Thus, many aspects concerning treatment-free remission require to be studied, which determines the importance of clinical trials in this area.

To assess the dynamics of doctors ‘ opinions on continuing medical education (CME) in 2016 and 2018 was conducted an anonymous online survey, which was attended by 52 psychiatrists (in 2016 year, from 14 regions of Russia) and 203 psychiatrists (in 2018 year, from 46 regions of Russia). There is the growth of skeptical views on the feasibility of introducing a new system (in 2016 it was supported by 55,8% of respondents, in 2018 — only by 38,3%). Also in the 2-year term increased the number of difficulties in accessing to attend conferences, increased availability of online modules and has not changed significantly the availability of training in the departments in universities. The most difficult for doctors is to find attending conferences (average score in assessing difficulties 3,6), which requires the search for funds for travel expenses and separation from work, the most convenient — online training (average score in assessing difficulties 3,0). The effectiveness of all three types of educational activities of CME (conferences, online modules and courses in the departments) is estimated at a relative average level (about 3 points on a 5-point scale). The impact of CME on the solution of actual organizational and methodological problems of health care is also rather skeptical.

The article is devoted to the problem of search of biomarkers of suicidal behavior and includes literature review, as well as the results of own research of features of suicidal behavior of young age patients with depression (18—27 years) depending on the concentration of calcidiol.

Background. The feasibility of creating a screening Index for the comorbidity of mental disorders and cardiovascular diseases in the practice of the cardiologist dictates the need to validate existing algorithms.Aim. To validate the previously proposed Index of psychocardiac comorbidity in prediction of outpatient recommendation of psycho-pharmacotherapy for cardiology patients.Materials and methods. Medical records of 302 consecutive patients of cardiac in-patient department were retrospectively analyzed with ROC-curve to estimate the predictive value of previously proposed Index of psychocardiac comorbidity for out-patient recommendation of psycho-pharmacotherapy.Results. The prevalence of outpatient psycho-pharmacotherapy in the examined patients was 15.2 %; this group of patients was more polymorbid and was characterized by a higher proportion of women and a higher prevalence of a labile course of arterial hypertension. The sedative antipsychotics, non-benzodiazepine tranquilizers and mood stabilizers were predominant pharmacological groups. An analysis of reproducibility of Index of psychocardiac comorbidity was provided on a cohort of cardiology in-patient department (n = 302). Index calculated by using the formula I = C + 3(6)×Q + 3×W + 8×A (C – number of Comorbid diagnoses, Q – Quake in the chest, palpitations or arrhythmia, onset before 55 (3 points) or 50 (6 points) years; W – Women; A – labile Arterial hypertension). Area under ROC-curve in validation cohort was 0.828 ± 0.035 (p < 0.001). Positive predictive value of Index was maximal for the score of ≥ 13.Conclusion. The proposed Index of psychocardiac comorbidity is a valid tool to predict the prescription of psychopharmacotherapy in cardiology patients.

Background. Today the prevalence of mental disorders have grown significantly, so it is urgent to diagnose and correct them as early as possible. Mental disorders in patients with cardiovascular diseases aggravate the course and outcomes of the underlying disease, which necessitates their investigation in clinical practice.Aim: to study the frequency and phenomenology of mental disorders in patients with cardiovascular diseases.Materials and methods. Sixty patients of the Cardiology Department of St. Petersburg Multidisciplinary Hospital became the objects of the study, and comprised 2 groups. The first group included 30 patients with cardiovascular diseases, such as coronary artery disease and hypertension I–III stages, among them 10 men and 20 women aged 43.1 ± 11.7 years. The second group consisted of 30 patients with chronic heart failure in stabilization period (mean age 65.6 ± 10.8 years). The study included clinical and scale assessment.Results. We found that in patients with cardiovascular diseases mild disorders of affective spectrum prevail, with a typical comorbidity of anxiety and depression. Mental disorders and personal features in patients with chronic heart failure are different from those in patients with uncomplicated cardiovascular conditions. Mental disorders are detected in cardiological practice only in one third of patients, which reveals the problem of training internists, who could diagnose the most common mental disorders.Conclusions. Complex clinical and scale assessment in combination with the results of patients’ self-assessment showed a significant prevalence of affective disorders in the patients with cardiovascular diseases, who underwent treatment in the Cardiology Department of St. Petersburg Multidisciplinary Hospital. The results demonstrate that cardiac pa tients have personal risk factors for mental disorders development, predominantly anxiety and depressive disorders of neurotic level, both nosogenic and non-nosogenic, which requires a comprehensive psychological, psychotherapeutic and psychiatric care for these patients.

Clinical study report is one of the main documents during the drug development. The preparation of the clinical study report requires knowledge of Russian and foreign legislation, awareness of guidelines and recommendatioins issued by the professional associations as well as the effective process management. This article provides an overview of the current Russian and international regulatory documents and recommendations of professional organizations on the content and structure of the clinical study report, and describes an example of an algorithm for preparing the report from the earliest stages (data processing) to writing the final report with interpretation of study results.

Structure analysis of the dynamics of fuel energy resources production, export and consumption in the Sakha Republic (Yakutia) for the period from 2006 to 2015 has been conducted based on the compiled annual fuel and energy balances, trends in energy production and consumption are identified as well.