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Managing the Russian health resort industry: Key challenges and development trends
No full text. Amid the COVID-19 pandemic, the need for effective government decisions in the field of public health is becoming increasingly urgent. The article discusses the issues of the Russian health resort industry management as a complex system that plays a key role in the preservation and qualitative improvement of the country’s human potential. The concepts of sustainable development, human potential development, rehabilitation medicine and the system-based approach in management constitute the methodological basis of the research. The methods of analysis, synthesis, systematization and statistical observation are applied. We juxtapose the official statistical data that reflect the state and trends in the health resort industry’s development during the pre-pandemic period. The study identifies the challenges in the health resort industry management and develops the ways to create conditions for qualitative shifts in the field of public well-being and health, and human potential development. The authors substantiate the need to create a modern health resort industry in Russia with a new rest / treatment infrastructure, a regulatory and legislative framework, and information systems for data exchange. Solving this problem requires fundamental changes in the fields of finance and taxation, as well as the training of management staff. We conclude that amid the pandemic, along with serious negative effects, there also emerge incentives to reconstruct the health resort system, which should be founded on long-term government policy measures and system-based management decisions
A concept of operational lawmaking technology
No full textThe technology of operational lawmaking is a subtype of lawmaking technology; the latter is a type of legal technology. The technology of operational lawmaking is characterized by an emergency, extraordinary content; suddenly emerging social relations are the main characteristic of this phenomenon, the core and basis of operational lawmaking. There is no doubt that there is a peculiar nature of operational lawmaking (phenomenon). “Challenge accepted” – a heading of T. Zamakhina’s article: The State Duma and the Federation Council promptly adopted a package of laws aimed at implementing the initiatives of the President of the Russian Federation to support citizens and the state's economy in connection with the spread of COVID-19 [1]. The subject of this study is the technology of operational lawmaking. The objective of this study is to prove that there is a separate, independent “operational lawmaking technology” along with the current (usual) technology of lawmaking. The study used the following methods: dialectical, logical, systemic, comparative, structural-functional, and statistical. The following results were achieved: it was revealed that the “operational lawmaking technology” exists as an independent phenomenon with its own specific features, has its own content and form, and, accordingly, the concept is produced in crisis situations, presupposes a special strategy, tactics, approaches and methods
Socio-economical aspects of countering agressive information policy against Russia in the conditions of new challenges and threats
No full textIn the article socio-economical, political and other issues of information aggression against the Russian Federation during the pandemic are considered. Likely trends dealing with the socio-economic consequences of COVID-19 outbreak and its influence on the situation in NATO and Russia are described. Measures on the resistance to the external information agression with due regard to new challenges and threats are justified. New ways of likely usage of digital technologies in patriotic education, formation of positive personality under the circumstances of information agression
Peculiarities of The Students’ Conceptual Structures and Basic Beliefs Correlation
No full textThe research is basically aimed at studying the students’ conceptual structure and basic beliefs being formed and correlated as well as at their classifying in accordance with the level of integration and coherence. The students’ conceptual structures and basic beliefs are analyzed in the article; special attention is paid to semantic, categoric and conceptual abilities coherence (homogeneity) and formedness. If speaking about methodology of the research, it includes theoretical and empirical methods. Theoretical, cluster and factor analyses as well as the Kruskal-Wallis rank sum test allowed us to define 5 clusters (groups) with low, medium-low, mean (average), high and extraordinary indices of the students’ conceptual structure and basic beliefs formedness. These clusters significantly differ at levels from p≤0.01 to p≤0.05. The students’ conceptual structure and basic beliefs correlations form the level systems classification characterized by different coherence of these levels. It is sufficient to conclude that different basic beliefs are the core of the students’ subjective inner world and are correlated with these beliefs conceptual structures specificity. The attained results prove the phenomenon of the intellectual resource “splitting”: the intellectual resource can split into productive and non-productive components in case of high-level intelligence, i.e. if the intelligence level is too high the intellectual resource and its basic components can be insufficiently formed and/or poorly developed
Low Circulating Vitamin D in Intensive Care Unit-Admitted COVID-19 Patients as a Predictor of Negative Outcomes.
No full textBackground Vitamin D deficiency has been associated with an increased risk of respiratory infections. Objectives The study aimed to evaluate the serum 25-hydroxyvitamin D [25(OH)D] concentration in patients admitted to the intensive care unit (ICU) as a predictor of coronavirus disease 2019 (COVID-19) mortality. Methods A single-center retrospective observational study was conducted. Forty adult patients (50% men) with confirmed COVID-19 who were admitted to the ICU were enrolled. The primary endpoint was mortality at day 60. Serum 25(OH)D concentration was measured on the day of admission to the ICU. We used the Mann-Whitney test, Fisher's exact test, Kaplan-Meier analysis, and receiver operator characteristic (ROC) analysis to assess serum 25(OH)D concentration as a predictor of COVID-19 mortality. Results All 40 patients had a low median (IQR) serum 25(OH)D concentration at admission [12 (9-15) ng/mL]. The median (IQR) serum 25(OH)D concentration was greater in survivors [13.3 (10.0-17.1) ng/mL, n = 22] than in nonsurvivors [9.6 (7.9-14.2) ng/mL; n = 18], P = 0.044. The area under the ROC curve was 0.69 (95% CI: 0.52, 0.86; P = 0.044). The 60-d mortality rate of those with serum 25(OH)D concentrations ≤9.9 ng/mL (n = 14, 71%) tended to be greater than that of those with concentrations >9.9 ng/mL (n = 26, 31%) (P = 0.065), and they had a 5.6-fold higher risk of death (OR: 5.63; 95% CI: 1.35, 23.45; P = 0.018). Conclusions The ICU patients had a low serum 25(OH)D concentration. Serum 25(OH)D concentrations ≤9.9 ng/mL on admission can be used to predict in-hospital mortality in patients with COVID-19.This trial was registered at clinicaltrials.gov as NCT04450017
Bromhexine Hydrochloride Prophylaxis of COVID-19 for Medical Personnel: A Randomized Open-Label Study
No full textBackground: Bromhexine hydrochloride has been suggested as a TMPRSS2 protease blocker that precludes the penetration of the SARS-CoV-2 into cells. We aimed to assess the preventive potential of regular bromhexine hydrochloride intake for COVID-19 risk reduction in medical staff actively involved in the evaluation and treatment of patients with confirmed or suspected SARS-CoV-2 infection.
Methods: In a single-center randomized open-label study medical staff managing patients with suspected and confirmed COVID-19 were enrolled and followed-up for 8 weeks. The study began at the initiation of COVID-19 management in the clinic. We enrolled 50 participants without a history of SARS-CoV-2 infection: 25 were assigned to bromhexine hydrochloride treatment (8 mg 3 times per day), and 25 were controls. The composite primary endpoint was a positive nasopharyngeal swab polymerase chain reaction (PCR) test to SARS-CoV-2 or the signs of clinical infection within 28 days and at week 8. Secondary endpoints included the symptomatic infection rate and positive nasopharyngeal swab (PCR) tests.
Results: The rate of the combined primary endpoint did not differ significantly between the active treatment group (2/25 [8%]) and control group (7/25 [28%]); P = 0.07. A fewer number of participants developed symptomatic infection (confirmed COVID-19) in the treatment group compared to controls (0/25 vs 5/25; P = 0.02).
Conclusion: Bromhexine hydrochloride prophylaxis was associated with a reduced rate of symptomatic COVID-19. However, the prophylactic treatment was not associated with a lower combined primary endpoint rate, a positive swab PCR test and/or COVID-19. (ClinicalTrials.gov number, NCT04405999
Effects of Mutations in the Receptor-Binding Domain of SARS-CoV-2 Spike on its Binding Affinity to ACE2 and Neutralizing Antibodies Revealed by Computational Analysis
No full textSARS-CoV-2 causing coronavirus disease 2019 (COVID-19) is responsible for one of the most deleterious pandemics of our time. The interaction between the ACE2 receptors at the surface of human cells and the viral Spike (S) protein triggers the infection making the receptor-binding domain (RBD) of the SARS-CoV-2 S-protein a focal target for the neutralizing antibodies (Abs). Despite the recent progress in the development and deployment of vaccines, the emergence of novel variants of SARS-CoV-2 insensitive to Abs produced in response to the vaccine administration and/or monoclonal ones represents upcoming jeopardy. Here, we assessed the possible effects of single and multiple mutations in the RBD of SARS-CoV-2 S-protein on its binding energy to various antibodies and the human ACE2 receptor. The performed computational analysis indicates that while single amino acid replacements in RBD may only cause partial impairment of the Abs binding, moreover, limited to specific epitopes, some variants of SARS-CoV-2 (with as few as 8 mutations), which are already present in the population, may potentially result in a much broader antigenic escape. We also identified a number of point mutations, which, in contrast to the majority of replacements, reduce RBD affinity to various antibodies without affecting its binding to ACE2. Overall, the results provide guidelines for further experimental studies aiming at the identification of the high-risk RBD mutations allowing for an antigenic escape
Risk factors for invasive and non-invasive ventilatory support and mortality in hospitalized patients with COVID-19.
No full textRole of the State in Agricultural Development
No full textThe peculiarities of agriculture, which require the creation of conditions for its development, retain the importance of the role of the state in supporting the industry. The need for such participation is reinforced by the latest trends in economy. Export orientation, digitalization, the coronavirus pandemic reinforce the political and economic causes of state intervention. The purpose of this work is to consider key methods and priorities of state support for agriculture and the possibility of their improvement and expansion under the influence of new requirements. Having studied the mechanism of concessional lending to agriculture, it was concluded that it was effective and identified some problems that served as a basis for identifying opportunities for its further improvement. It was concluded that the state plays a dominant role in the development of small forms of agribusiness and the expansion of agricultural export potential. The unique features of the COVID-19 pandemic, which faced not only the world but also Russian economy, have opened up opportunities and created threats to agricultural development. The coronavirus pandemic has given a powerful impetus to the massive introduction of digital technologies. The article considers possible directions of developing methods and directions of state participation in agriculture
Risk factors for long covid in previously hospitalised children using the ISARIC Global follow-up protocol: A prospective cohort study
No full textBackgroundThe long-term sequelae of coronavirus disease 2019 (Covid-19) in children remain poorly characterised. This study aimed to assess long-term outcomes in children previously hospitalised with Covid-19 and associated risk factors. MethodsThis is a prospective cohort study of children ([≤]18 years old) admitted with confirmed Covid-19 to Z.A. Bashlyaeva Childrens Municipal Clinical Hospital in Moscow, Russia. Children admitted to the hospital during the first wave of the pandemic, between April 2, 2020 and August 26, 2020, were included. Telephone interview using the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Covid-19 Health and Wellbeing paediatric follow up survey. Persistent symptoms (>5 months) were further categorised by system(s) involved. FindingsOverall, 518 of 853 (61%) of eligible children were available for the follow-up assessment and included in the study. Median age was 10.4 years (IQR, 3-15.2) and 270 (52.1%) were girls; median follow-up since hospital discharge was 256 (223-271) days. At the time of the follow-up interview 126 (24.3%) participants reported persistent symptoms among which fatigue (53, 10.7%), sleep disturbance (36, 6.9%,) and sensory problems (29, 5.6%) were the most common. Multiple symptoms were experienced by 44 (8.4%) participants. Risk factors for persistent symptoms were: age "6-11 years" (odds ratio 2.74 (95% confidence interval 1.37 to 5.75) and "12-18 years" (2.68, 1.41 to 5.4), and a history of allergic diseases (1.67, 1.04 to 2.67). InterpretationA quarter of children experienced persistent symptoms months after hospitalization with acute covid-19 infection, with almost one in ten experiencing multi-system involvement. Older age and allergic diseases were associated with higher risk of persistent symptoms at follow-up. Our findings highlight the need for replication and further investigation of potential mechanisms as well as clinical support to improve long term outcomes in children. FundingNone. O_TEXTBOXResearch in contextO_ST_ABSEvidence before this studyC_ST_ABSEvidence suggests that Covid-19 may result in short- and long-term consequences to health. Studies in children and adolescents are limited and available evidence is scarce. We searched Embase for publications from inception to April, 25, 2021, using the following phrases or combinations of phrases "post-covid condition" or "post-covid syndrome" or "covid sequalae" or "post-acute covid" or "long covid" or "long hauler" with "pediatric*" or "paediatric*" or "child*" or "infant*" or "newborn*" or "toddler*" or "neonate*" or "neonatal" or "adolescent*" or "teen*". We found small case series and small cohort studies looking at Covid-19 consequences in children. No large cohort studies of previously hospitalised children, assessing symptom duration, categorisation or attempting multivariable analyses to identify independent risk factors for long Covid development were identified. Added value of this studyTo our knowledge, this is the largest cohort study with the longest follow-up since hospital discharge of previously hospitalised children. We found that even months after discharge from the hospital, approximately a quarter of children experience persistent symptoms with one in ten having multi-system involvement. Older age and allergic diseases are associated with Covid-19 consequences. Parents of some children report emotional and behavioural changes in their children after Covid-19. Implications of all the available evidenceOur findings highlight the need for continued global research of Covid-19 consequences in the paediatric population. Older children admitted to the hospital should be carefully monitored upon discharge. Large, controlled studies aiming to identify risk groups and potential intervention strategies are required to fill knowledge gaps. C_TEXTBO