New possibilities and tools for corporate strategic management for supporting its high competitiveness and economic effectiveness

The purpose of the article is to determine new possibilities and tools for corporate strategic management and to substantiate the necessity for their usage for supporting a company’s competitiveness and economic effectiveness in modern Russia. The information and analytical basis of the research consists of the materials of the Report on global competitiveness for 2016-2017, prepared within the World economic forum. For verification of the offered hypothesis, the methods of deduction, induction, synthesis, systemic, problem, and structural & functional analysis, as well as analysis of causal connections, and the methods of modeling and formalization were used. Because of the research, a conclusion is made that imperfection of the process of strategic management is a reason for low competitiveness and economic effectiveness of modern Russian companies. To solve this problem, the authors substantiate the necessity for applying the principle of interactivity, which supposes consideration of new possibilities and usage of leading tools in the process of corporate strategic management and develop the recommendations and offer an interactive model for strategic management of a modern company in modern Russia for the purpose of supporting high competitiveness and economic effectiveness of domestic entrepreneurship.peer-reviewe

Anemia and comorbidity in people over 65: data from the Russian study EUCALYPTUS

Background. Anemia is an essential component of comorbidity, being both a complication of chronic diseases and a factor in their progression. Comorbidity patients with low hemoglobin have a greater number of diseases, worse geriatric status parameters and the lowest survival. Especially negative consequences of a decrease in hemoglobin were noted in people of the older age group. Aim. To investigate the relationship between anemia and comorbidity in patients aged 65 years and older. Materials and methods. The results of a sub-analysis of the multicenter cross-sectional study EUCALYPTUS, which involved 4308 people (30% of men) aged 65 to 107 years (average age – 78 years), are presented. The comorbidity was assessed and the Charlson comorbidity index was calculated, and the complete blood count was studied. Results. The frequency of comorbidity was 89%, anemia – 24%. The value of the Charlson comorbidity index in patients with anemia was greater than in those without anemia – 5 (4; 7) vs. 4 (3; 6) points (p0.001). For every 1-point increase in Charlson index values, the odds of having anemia increase by 21% (odds ratio 1.21; 95% confidence interval 1.17–1.25; p0.001). Multivariate regression analysis identified 9 independent predictors of anemia (age ≥82 years, male, history of myocardial infarction and stroke, peptic ulcer disease, atrial fibrillation, stage 4 and 5 chronic kidney disease, active cancer, no hypertension) with an odds ratio of 1.25 to 3.14. In the presence of 2–4 predictors, the risk of anemia increases 1.3–2.6 times, 5 predictors – almost 5 times, 6 or more – almost 13 times. Conclusion. Comorbidity patients are at risk for the development of anemia, which requires timely treatment, including iron supplements if absolute or functional iron deficiency is confirmed

Dependence in instrumental activities of daily living and its associations with other geriatric syndromes in people over 65 years of age: data from the Russian epidemiological study EUCALYPT

Aim – to assess the frequency of disability in instrumental activities of daily living (IADLs) and to analyze its associations with other geriatric syndromes in persons aged ≥65 years. Material and methods. The study involved 4,308 people (30% male) living in 11 regions of the Russian Federation, aged 65 to 107 years (average age 78 ± 8 years). The majority (60%) of participants were examined in a polyclinic, every fifth – in a hospital (20%) or at home (19%), 1% – in nursing homes. All patients underwent a comprehensive geriatric assessment, including an assessment of instrumental activities of daily living on the Lawton scale. Results. Among the elderly, a high (54%) prevalence of dependence in IADLs was revealed, and with increasing age, this indicator increased significantly, reaching 82% in people over 85 years old. In patients with disability in IADLs, the frequency of all geriatric syndromes, except orthostatic hypotension, was higher, of which the most common were chronic pain syndrome (90%), frailty (80%), dependence in basic activities of daily living (ADLs) (78%), cognitive impairment (75%), probable depression (63%) and urinary incontinence (54%). One-factor regression analysis showed that the presence of disability in IADLs increases the chances of detecting other geriatric syndromes by 1.6–5.9 times. Conclusion. The results of the EUCALYPT epidemiological study demonstrate a high prevalence of dependence in IADLs among the Russian population. The study also gives an idea of the relationship of dependence in IADLs with various geriatric syndromes

RUSS-AGE study: Markers of carbohydrate metabolism and their time course in different age groups of a healthy population of the Russian Federation

Background. One of the important tasks of modern science is to search for key biomarkers of aging of various body systems. Parameters of carbohydrate metabolism play an essential role in maintaining vital activity. The prevalence of carbohydrate metabolism disorders increases with age, but the time course of changes in individual markers remains poorly understood. Therefore, it is important to investigate the patterns of changes in carbohydrate metabolism markers in different age groups among healthy participants, which is the objective of the RUSS-AGE study. Aim. To evaluate changes in carbohydrate status markers (adiponectin, leptin, glucose, glycated hemoglobin, insulin, and carboxymethyllysine – CML) in different age groups of a healthy Russian population. Materials and methods. The study was conducted at the Pirogov Russian National Research Medical University in collaboration with the Moscow City Outpatient Clinic No. 220. The study group included subjects 18 years of age and older who signed an informed consent form; the exclusion criteria were current acute disease, exacerbation of a chronic disease, surgical intervention within the last month, and moderate to severe chronic age-associated diseases. Blood samples were taken to measure aging markers: glucose (enzymatic ultraviolet method), insulin (chemiluminescent enzyme immunoassay), glycated hemoglobin (calorimetric method), CML, adiponectin, and leptin (enzyme immunoassay). The study was approved by the local ethics committee (Minutes No. 59 dated 13.09.2022). Statistical analysis was carried out using the R programming language version 4.4.0. The significance threshold for the p-value values given in the article is 0.05. Results. The study included 711 participants, which were divided into eight age groups. According to the intergroup comparison, a statistically significant direct relationship of age with adiponectin (p0.001), glucose (p0.001), and glycated hemoglobin (p0.001) was found. No significant correlation with age was found for leptin (p=0.116), insulin (p=0.078), and CML (p=0.506). After conducting a statistical analysis using linear regression to assess the dependence of variables on age, it was found that only adiponectin, glucose, and glycated hemoglobin significantly increase with age (p0.001). Conclusion. The study showed a significant increase in adiponectin, glucose, and glycated hemoglobin, while leptin, insulin and CML had no significant correlation with age

Метод полного погружения как наиболее эффективный способ изучения иностранных языков

Данная статья посвящена методу полного погружения в языковую среду как одному из наиболее эффективных способов изучения иностранных языков. Представлено описание этого метода и показаны некоторые доступные способы использования этого метода для людей, у которых нет возможности использовать этот подход традиционным способом.This article is devoted to the method of full immersion in the language environment as one of the most effective ways of learning foreign languages. There is presented the description of this method and shown some accessible ways of using this method for people who do not have an opportunity to use this approach in a traditional way

Real-world experience with netakimab in the treatment of spondyloarthritis

Aim. To study the real-world efficacy and safety of netakimab in the treatment of ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Materials and methods. The retrospective analysis included 23 patients (13 males; 56.5%) aged 23 to 73 years (median 42, interquartile range 28 to 52 years) with AS (n=12) or PsA (n=11) who received netakimab therapy from February 2021 to April 2023. Disease activity was assessed every 3-6 months based on the C-reactive protein (CRP) level for all patients according to the BASDAI and ASDAS-CRP indices for AS, DAPSA and PASI for PsA. These indicators were analyzed before therapy and at the last visit to assess the effectiveness of treatment. The results are presented as median (interquartile range). Results. In all patients treated with netakimab (median duration of treatment 11 months), the CRP level decreased from 10.6 (3.1; 17.3) to 3.1 (1.9; 8.9) mg/L (absolute difference -7.5 mg/L, median relative reduction -60%; p=0.008), and the proportion of patients with elevated CRP decreased from 70 to 41%; p=0.039. In patients with AS (median duration of treatment 9 months), BASDAI score decreased from 5.8 (4.7; 6.5) to 3.0 (1.9; 3.8) points (absolute difference -2.8 points, median relative reduction of -45%; p=0.008) and ASDAS-CRP score decreased from 2.8 (1.9; 3.9) to 1.9 (1.7; 2.6) points (absolute difference -0.9 points, median relative reduction -21%; p=0.007). The proportion of patients with high AS activity (BASDAI≥4) decreased from 90% to 20% (p=0.031); however, there was no significant change in the CRP level (absolute difference -4.9 mg/L, median relative reduction -57%; p=0.110). In patients with PsA (median duration of treatment 18 months), the CRP level decreased from 12.0 (4.5; 17.3) to 3.3 (2.0; 7.8) mg/L (absolute difference -8.7 mg/L, median relative reduction -80%; p=0.041), the DAPSA score decreased from 23.0 (19.0; 30.5) to 6.3 (5.2; 13.5) points (absolute difference -16.7 points, median relative reduction -69%; p=0.018). Three (13%) patients reported mild to moderate adverse events. Conclusion. The obtained data confirm the effectiveness and safety of netakimab in treating AS and PsA in real-world practice

Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study

Background: Multisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments. Methods: The Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370. Findings: We enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2–11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75–1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58–1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91–1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70–1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11–0·20]; p<0·0001) and glucocorticoids alone (0·68 [0·50–0·93]; p=0·014) versus intravenous immunoglobulin alone. Persistent fever (from day 2 onward) was less common with intravenous immunoglobulin plus glucocorticoids compared with either intravenous immunoglobulin alone (OR 0·50 [95% CI 0·38–0·67]; p<0·0001) or glucocorticoids alone (0·63 [0·45–0·88]; p=0·0058). Coronary artery aneurysm occurrence and resolution did not differ significantly between treatment groups. Interpretation: Recovery rates, including occurrence and resolution of coronary artery aneurysms, were similar for primary treatment with intravenous immunoglobulin when compared to glucocorticoids or intravenous immunoglobulin plus glucocorticoids. Initial treatment with glucocorticoids appears to be a safe alternative to immunoglobulin or combined therapy, and might be advantageous in view of the cost and limited availability of intravenous immunoglobulin in many countries. Funding: Imperial College London, the European Union's Horizon 2020, Wellcome Trust, the Medical Research Foundation, UK National Institute for Health and Care Research, and National Institutes of Health

Physiological Reaction of the Cardiovascular System of Men 50-59 Years to Feasible Regular Physical Activity

Changes of the health status of beginners aging men is being closely examined. This caused a sharp increase in males with age of the risk of developing diseases of the cardiovascular system. It is noticed that men older than 50 years often have multiple risk factors cardiovascular disease – coronary heart disease or hypertension, and sometimes combinations thereof. In this regard, it is now very important for men approaching retirement age effective approaches to health improvement, reducing the probability of occurrence of a pathology of heart and vessels. Tested in the study the author's technique, which included regular exercise, have shown the possibility of stimulation of the cardiovascular system, the overall aerobic capacity of the body and enhance the metabolism. The study demonstrated the possibility of achieving after 1 year of muscle loads on the author's technique overall health. Complex loads, which demonstrated high efficiency, included training on simulators "SPIRIT Medical Systems MU100 vertical Ergometer" and "Finnlo EllypsisSX1", with the additional inclusion in the scheme loads the second half of the loads on the simulator "Finnlo MAXIMUM-S". The effect achieved by the author's method exceeded that in the result of a year of physical activity in the gym "Finnlo MAXIMUM elliptical S" when you add in the second half of training on the simulator "SPIRIT Medical Systems MU100 vertical Ergometer". The obtained results are considered as evidence of the decline of the trainees on the author's scheme of men older than 50 years of threats signs of cardiovascular pathology with a significant enhancement of their overall health.</jats:p

Telomere biology and metabolic disorders: the role of insulin resistance and type 2 diabetes

BACKGROUND: Insulin resistance accelerates the aging process, but its speed depends on the individual characteristics of the metabolism. One of the reasons for the different aging rates in individuals with insulin resistance is the initially different “genetic protection” of cells, which many scientists associate with replicative cellular aging.AIMS: to study the relationship between the state of carbohydrate metabolism and markers of replicative cell aging in individuals with different sensitivity to insulin.MATERIALS AND METHODS: The observation study included 305 patients. The parameters of glucose metabolism and telomere biology were studied.RESULTS: The mean age of the patients was 51.5±13.3 years. Patients were divided into three groups depending on presence of insulin resistance: healthy, with insulin resistance and with type 2 diabetes. The mean age of healthy patients was 48.82±13.87 years, in insulin resistance group — 53.04±12.8, in 2 diabetes mellitus — 58.4±7.90. The median telomere length was 9.76. The median telomerase activity was 0.48. Both telomere length and telomerase activity progressively decrease as insulin resistance increases. In patients with diabetes, short telomere lengths and low telomerase activity predominated. The insulin resistance index has the greatest impact on the risk of detecting “short” telomeres. In patients with insulin resistance, an increase in glycated hemoglobin increases the likelihood of detecting short telomeres by 2.4 times, and in diabetes mellitus by 4.26 times, an increase in fasting plasma glucose by 90%, and an increase in HOMA-IR by 35%. An increase in insulin resistance increases the risk of detecting «low» telomerase activity by 53% and the risk of detecting «very low» telomerase activity by 92%. A decrease in synsulin resistance increases the chance of increasing telomerase activity to «very high» by 51%.CONCLUSION: Shorter telomeres are associated with more pronounced disorders of carbohydrate metabolism and a higher degree of insulin resistance. Further studies of metabolic status are necessary to personalize their lifestyle and treatment goals.</jats:p