Evaluation of the effect of the use of the drug ticagrelor in patients with acute coronary syndrome on achieving the target indicator “reduction of mortality from diseases of the circulatory system” in 2022-2024

Aim. To evaluate the effect of the use of the double antiplatelet therapy (DAT) with ticagrelor compared to DAT with clopidogrel and antithrombotic therapy with acetyl salicylic acid (ASA) in patients with acute coronary syndrome and patients with high coronary risk on the target indicator (CP) of the state program (GP) “Development of Healthcare” and the federal project “Fight against cardiovascular diseases” — reducing mortality from diseases of the circulatory system (BSC).Material and methods. All adult Russian patients with a diagnosis of ACS eligible for DAT were considered as the target population; in the second and third years, only patients with high coronary risk continued treatment. The calculation of the number of deaths that can be prevented using DAT ticagrelor 90 mg + ASA vs DAT of clopidogrel + ASA within 1st year from the date of diagnosis was based on the clinical efficacy data of the PLATO study. The number of deaths that can be prevented with the use of DAT ticagrelor 60 mg + ASA — instead of ASA monotherapy patients with a history of myocardial infarction was made based in the clinical efficacy results of the PEGASUS study. It was calculated what proportion of the target indicators could be achieved in 2022-24 years by using DAT with ticagrelor instead of clopidogrel or ASA monotherapy.Results. The use of DAT with ticagrelor vs DAT with clopidogrel or ASA for the treatment of patients with ACS will prevent additional 5389, 5704 and 6012 deaths in 2022-2024, that will ensure the implementation of the CP “reduction of mortality from BSC” GP “Development of healthcare” in the Russian Federation by 36,9%, 26,0% and 20,6% respectively.Conclusion. The use of DAT with ticagrelor for the treatment of patients with acute coronary syndrome ensure the implementation of the CP “reduction of mortality from BSC” GP “Development of healthcare” in the Russian Federation in 2024 by 20,6%.

Influence of Healthcare Organization Factors on Cardiovascular Diseases Mortality

One serious pandemic can nullify years of efforts to extend life expectancy and reduce disability. The coronavirus pandemic has been a perturbing factor that has provided an opportunity to assess not only the effectiveness of health systems for cardio-vascular diseases (CVD), but also their sustainability. The goal of our research is to analyze the influence of public health factors on the mortality from circulatory diseases using machine learning methods. We analysed a very large dataset that consisted of the information collected from the national registers in Russia. We included data from 2015 to 2021. It included 340 factors that characterize organization of healthcare in Russia. The resulting area under receiver operating characteristic curve (AUC of ROC) of the Random Forest based regression model was 92% with a testing dataset. The models allow for automated retraining as time passes and epidemiological and other situations change. They also allow additional characteristics of regions and health care organizations to be added to existing training datasets depending on the target. The developed models allow the calculation of the probability of the target for 6–12 months with an error of 8%. Moreover, the models allow to calculate scenarios and the value of the target indicator when other indicators of the region change.

Assessment of the representation of non-resource export priorities in the conceptual documents of the NWFD region

The problem of dependence of the Russian economy on raw materials remains. The growth of non-primary non-energy exports was approved as one of the priorities in Russia. Updating the national project increases the importance of its institutional support in legislation. The question arises of the sufficiency of institutional reflection of non-resource exports. The purpose of the article is to generalize approaches to the priorities of non-resource exports, to develop methodological tools and to assess the representation of the topic in conceptual documents on the example of the regions of the North-Western Federal District. The research methodology is based on the content analysis of documents using the Istio service. The basis of the study was the conceptual documents of the NWFD regions with export topics. The categories of non-primary exports are highlighted. The socio-economic Development Strategy is the main document approving the region’s non-resource exports. A research program and methodological support for assessing the representation of non-primary exports in documents have been developed. The differences in the institutional support of non-primary exports are revealed. Of the 11 regions, 8 contain a target indicator of non-primary non-energy exports. Kaliningrad and Murmansk oblasts are recommended to include it in the Strategy in order to form institutional support for overcoming the problem of commodity dependence. A classification of regional documents providing institutional support for the export strategy has been developed. For the first time, the assessment contains scientific novelty and can help to understand the need to form a scientific concept of non-resource exports.

Study of the dynamics of the qualitative indicator of champignons during storage after treatment with UV radiation in the A range

Представлены результаты исследования влияния обработки свежих шампиньонов ультрафиолетовым излучением в диапазоне А различными дозами на изменение текстуры. Построена математическая модель зависимости предельной хранимоспособности по целевому показателю грибов от дозы облучения, и установлены оптимальные режимы обработки. The results of a study of the effect of processing fresh champignons with ultraviolet radiation in the A range with various doses on the change in texture are presented. A mathematical model of the dependence of the limiting storage capacity for the target indicator of mushrooms on the radiation dose has been built and the optimal processing modes have been established.

Development of Approaches to Monitor the Risks of Not Achieving the National Development Goals of the Russian Federation and Its Regions

The article presents a methodological approach to constructing limits for monitoring the risks of nonachievement of national development goals of the country and its regions. The study’s relevance lies in the fact that the implementation of the suggested approach in public administration will contribute to the implementation of an adequate assessment of the achievement of these goals at the federal level and the level of constituent entities of the Russian Federation. The solution to the problem of building the limit values “corridors” for risk monitoring of non-achievement of the country’s national development goals and regions is carried out on the methodological basis of the scenario approach with the use of indicative analysis. This allows setting the limit values “corridors” as a calculated range of fluctuations of the target indicator within its upper and lower limits. Using the suggested methodological approach, the boundary of the limit values for the indicator of the poverty level, which serves as a target indicator for the assessment of the national development goal “Population preservation, health and well-being of people” achievement is constructed. Based on the calculations obtained, as well as on the estimates of the indicator made for Krasnodar Krai and Astrakhan region, it is shown that the poverty targets defined by the national development goals and the corresponding regional strategies differ significantly from those obtained on the basis of the forecast, which determines the high risk of non-achievement the target values. The methodological approach suggested in the article makes it possible to promptly inform the management agent about the appearance of unfavorable or critical changes in the country’s social and economic development and to develop measures for the elimination of negative tendencies and support of positive trends in the achievement of national development goals.

Protective role of mRNA demethylase FTO on axon guiding molecules of nigro-striatal projection system in manganese-induced Parkinsonism

Background Parkinson's disease (PD) is a neurodegenerative disease caused by environmental and genetic factors. Manganese (Mn) exposure is a major environmental cause of PD. Cellular and molecular mechanism of Parkinsonism caused by Mn has not been explored clearly. In addition, patients with Mn-induced Parkinsonism show poor therapeutic response to levodopa. Therefore, there is need to explore the mechanisms underlying neurotoxicity of Mn exposure. Methods In short, we used SH-SY5Y cells and C57BL/6 mice to characterize Mn-induced Parkinsonism. We measured the behavioral, histological, ultrastructural and nigro-striatal projection system changes, cell viability, axon growth, and other target indicator levels, which led to the discovery of a novel mechanism of Mn-induced neurotoxicity. Results The findings of the current study showed that inhibition of fat mass and obesity-associated protein (FTO)-mediated demethylation of N6-methyladenosine (m6A) mRNA aggravates Mn-induced motor dysfunction. Notably, FTO level is low in Mn exposure model mice and enhances occurrence of dyskinesia in mice. Over-expression of FTO reduces m6A methylation in the key axon guiding molecules of nigro-striatal projection system, including ephrin-A5 and ephrin-B2. It increases ephrin-B2 mRNA decay through the m6A reader YT521-B homology domain family proteins 2 (YTHDF2). Conclusions The findings of this study show that FTO, a m6A demethylase, performs an indispensable function in Mn-induced Parkinsonism. Notably, re-expression of FTO and ephrin-B2 improved motor dysfunction after Mn exposure.

POLICY IMPLEMENTATION TO IMPROVE TOURISM DESTINATION BASED ON LOCAL WISDOM IN GUNUNGKIDUL DISTRICT

Local government in Indonesia adapted to the development legislation of an ideal tourist destination; ethically and aesthetically the local area is known as value-local culture. Gunungkidul Regency is an area that has tourism potential with the number of tourists increasing every year; this can indicate that these tourism objects are well managed. However, Gunungkidul Regency is still one of the areas with underdevelopment, the highest poverty rate indicator in DIY. Community groups have not been thoroughly involved as well as several other tourist objects that have not been managed as tourist destinations. Tourism activities need to be supported by policies that regulate tourism actors in carrying out their activities. This research method is a qualitative method with a literature study model that aims to describe the implementation of policies to increase tourist destinations based on local wisdom which comes from various other types of reading, such as previous research, news articles, and others. Target indicator sets more towards material things. The current policy for increasing tourist destinations in Gunungkidul Regency has not prioritized the value base of local wisdom. Furthermore, it discusses the implementation and obstacles faced in relation to the policies to increase tourist destinations based on local wisdom. The implementation of policies in terms of resources leads to the value of local wisdom in developing human resources which ultimately leads to material benefits. There has been no implementation that leads to local wisdom values of natural resource conservation, social, ethical, and moral meanings. The implementation of policies in terms of communication between the public and the government is good enough, however, among tourism business actors is not optimal.

Shipborne moving target indicator radar versus incoming sea-skimming missile mathematical modeling and simulation

Anti-ship missiles are a primary threat to naval targets because sea-skimming tactics enable the missile to approach the vessel while being obscured by sea clutter. In order to counteract this serious danger, the ship’s radar employs moving target indicator processing in order to detect and subsequently start the tracking of the incoming missile. In this paper, we set up a relevant simulation in order to examine the moving target indicator process for a naval scenario at horizon range which gives the greatest counter-reaction time, which usually is for very small grazing angles in a sea cluttered environment. Finally, the results of the simulator are beneficial to radar designers and educational professionals.

IMPLEMENTASI KEBIJAKAN PEMBAYARAN KAPITASI BERBASIS PEMENUHAN KOMITMEN PELAYANAN (KBKP) DI KABUPATEN JEMBER

Kapitasi berbasis pemenuhan komitmen pelayanan (KBKP) merupakan salah satu sistem pembayaran dalam program jaminan kesehatan nasional pada puskesmas untuk meningkatkan pelayanan yang efektif dan efisien sehingga mutu layanan yang diberikan dapat terjaga. Kabupaten Jember sebagai salah satu kabupaten yang menjalankan kebijakan tersebut, namun diketahui terdapat kendala dalam pelaksanaan kebijakan tersebut. Penilaian terhadap puskesmas melalui KBKP dilihat berdasarkan pencapaian indikator yang meliputi angka contact rate, rasio rujukan rawat jalan non spesialistik, rasio peserta prolanis dan 1 indikator tambahan yaitu kunjungan rumah. Namun pelaksanaan kebijakan ini terdapat beberapa permasalahan yang dapat menghambat pencapaian target. Penelitian ini menggunakan metode Riset Implementasi. Riset ini membahas berbagai masalah implementasi dalam konteks yang beragam dimana pengambilan datanya dilakukan secara kualitatif (indepth interview) dan kuantitatif (analisis data sekunder). Evaluasi pelaksanaan KBKP tahun 2016 menunjukkan masih banyaknya tantangan dan hambatan sehingga BPJS Kesehatan mengeluarkan petunjuk teknis terkait KBKP. Tujuan penyusunan petunjuk teknis tersebut adalah memberikan panduan bersama pelaksanaan pembayaran kapitasi berbasis pemenuhan komitmen pelayanan di FKTP. Pemerintah daerah diketahui kurang terlibat dalam kebijakan KBKP tersebut, tidak terdapat kebijakan yang mendukung kebijakan KBKP di tingkat kabupaten. Pencapaian target indikator yang telah ditetapkan dalam regulasi KBKP masih sulit dicapai oleh puskesmas khususnya pada indikator contact rate, pencapaian target indicator contact rate hanya 15 puskesmas (30%). Pencapaian indikator rujukan non spesialistik yang telah ditetapkan dalam regulasi KBKP selalu dapat dicapai oleh puskesmas (100%), namun indikator prolanis target pencapaiannya hanya 38 puskesmas dari 50 puskesmas yang dapat mencapai (76%). Sulitnya pencapaian target indikator contact rate karena petugas kesehatan di puskesmas tidak sempat meng-entry data kontak sehat dan kontak sakit pada aplikasi P Care. Diketahui KBKP dapat meningkatkan kepuasan peserta karena memaksa puskesmas untuk meningkatkan contact rate dengan peserta JKN dan merasa di ‘spesial’kan dengan program prolanis. Kebijakan KBKP juga dapat meningkatkan mutu pelayanan puskesmas karena puskesmas harus meningkatkan sarana prasarana agar 145 diagnosis tersebut dapat diselesaikan.

About the Possible Mechanisms of the Influence of Optical Intraocular Implants on the Characteristics of Neurosensory Rehabilitation and Adaptation in Patients with Pseudophakia. Literature Review

This literature review analyzed the possible mechanisms of the influence of the design features and optical characteristics of monofocal intraocular lenses (IOLs) on the characteristics of sensorineural adaptation and visual rehabilitation in patients after cataract phacoemulsification. Bibliographic research of scientific publications was carried out in the following databases: Medline, Pubmed, Cochrane, eLibrary. Languages of publications: Russian and English. The literature review reflects research data on the physicochemical properties, optical surface and color of the IOL filter, spatial contrast sensitivity and wavefront aberrations. Analysis of domestic and foreign literature has demonstrated the absence of a systematic approach to the study of sensorineural adaptation in patients after implantation of monofocal IOLs, which would make it possible to reasonably develop requirements for qualitative and constructive characteristics in the production of intraocular lenses to improve the quantitative and qualitative indicators of their visual functions in order to reduce the terms of rehabilitation and improvement of quality of life indicators in patients with pseudophakia. At the same time, there is an obvious need for research on the influence of the design and quality characteristics of optical intraocular implants on the subjective “quality of vision” of patients with pseudophakia, which is, ultimately, the target indicator of cataract surgery at the present stage. Also, the key mechanisms of neurosensory rehabilitation and adaptation of patients who underwent cataract surgery need to be studied and clarified in order to develop recommendations for the production of intraocular implants.