Перспективы внедрения цифрового рубля в денежный оборот России: атрибуты и принципы формирования доверенной цифровой среды

The rapid nature of the modernization of monetary turnover, accompanied by geopolitical risks against the background of post-pandemic economic recovery and the regionalization process, no longer just arouses the discursive interest of society, but becomes an indispensable condition of the new reality. The process of money turnover transformation by introducing digital currencies into circulation in the wave of digitalization among world powers lagging behind the evolving environment of the cryptocurrency industry is developing into a process of formalization of metaverses and penetrates deeper into the socio-economic reality. The problem of the Russian practice of developing the payment environment consists in its catching-up character, caused by the spontaneous formation of the digital society, resulting in the expansion of the scope of alternative finance outside the legal field. The purpose of the paper is to determine the inherent attributes of the digital trusted environment necessary to ensure digital ruble turnover, based on an empirical study of society’s perceptions about the prospects for using the digital form of the national monetary unit by representatives of various generations. We used systematization, grouping, comparative and content analysis, surveys, and the quota method to achieve the paper’s purpose. The survey involved 35,327 residents from different regions. As a result, the authors revealed the low level of readiness of society for the introduction of the digital ruble as a substitute for cash and cryptocurrency. The paper focuses on the need for an integrated approach to the disclosure of the digital ruble’s value and benefits, which contributes to its successful launch and promotion in the market. The results of the research highlight the importance of correspondence in the digital ruble category “digital currencies”, and also the impossibility of making incorrect decisions in the transformation of money turnover, which leads to the growth of risks of digital inequality, the clash of interests of certain groups of the population in the prevailing behavioral patterns in the form of a cautious attitude to digital finance with insufficient financial literacy.Стремительный характер модернизации денежного оборота, сопровождаемой геополитическими рисками на фоне постпандемийного восстановления экономики и процесса регионализации, не просто вызывает дискурсивный интерес общества, а становится неотъемлемым условием новой реальности. Процесс трансформации денежного оборота путем внедрения цифровых валют на волне гонки цифровизации среди мировых держав, отстающих от эволюционирующей криптовалютной индустрии, перерастает в процесс формализации метавселенных и все глубже проникает в социально- экономическую действительность. Проблема российской практики развития платежной среды заключается в ее догоняющем характере, обусловленном самопроизвольным становлением цифрового общества, приводящем к расширению масштабов альтернативных финансов вне рамок правового поля. Целью исследования стало определение неотъемлемых атрибутов доверенной цифровой среды, необходимой для обеспечения оборота цифрового рубля, и выявление особенностей восприятия перспектив использования цифровой формы национальной денежной единицы представителями различных поколений. Для достижения цели использованы методы систематизации, группировки, компаративного и кон- тент-анализа, анкетирования, метод квот. В опросе приняли участие 35 327 жителей различных регионов страны. Выявлен низкий уровень готовности общества к внедрению цифрового рубля как заместителя наличных денег и альтернативы криптовалюты. Акцентировано внимание на необходимости комплексного подхода к раскрытию ценности и преимуществ цифрового рубля, содействующего его успешному запуску и продвижению. Результаты исследования подчеркивают значимость соответствия цифрового рубля категории «цифровые валюты» и акцентируют внимание на недопустимости принятия неверных решений при трансформации денежного оборота, приводящих к нарастанию рисков цифрового неравенства, столкновению интересов определенных групп населения в условиях сложившихся поведенческих паттернов в виде настороженного отношения к Digital finance при недостаточной финансовой грамотности

Analysis of the health status of patients with type 1 and type 2 diabetes mellitus living in urban and rural areas of the Saratov region (according to the data of the federal register of patients with diabetes mellitus)

BACKGROUND: The World Health Organization considers diabetes mellitus as a significant public health problem, including this disease as one of the four priority noncommunicable diseases. Over the past few decades, the prevalence of diabetes has been steadily increasing and represents a significant threat to the public health of the world’s population. In connection with the territorial features of residence and the availability of medical care to residents of urban and rural areas, studies that include an analysis of the incidence of diabetes mellitus, disability and mortality of the urban and rural population from complications of this disease are one of the important mechanisms for monitoring the health status of the population, which predetermines the improvement and implementation strategies aimed at improving the demographic situation.AIM: To conduct a comparative retrospective analysis of the health indicators of patients with type 1 and type 2 diabetes mellitus living in urban and rural areas of the Saratov region.MATERIALS AND METHODS: Information on life expectancy, morbidity, complications, causes of disability, direct causes of death in patients with type 1 and type 2 diabetes mellitus living in the Saratov region in urban and rural areas was obtained from the Federal Register of Patients with Diabetes; information on the urban and rural population of the Saratov region was obtained from official statistical sources published on the website of the Federal State Statistics Service. Mathematical, statistical and analytical research methods were used. Statistical data processing was carried out using the Microsoft Excel 2019 program. The significance of the difference between the average and relative values was assessed using the Student’s t-test. The presence of a relationship between the signs was determined using the Pearson coefficient. The Mann-Whitney U-test was used to compare populations by quantitative characteristics. The significance level was determined at t>2 and p<005. Data were presented as P ± m, where P is the relative value and m is its standard error, and M ± m, where M is the mean value and m is its standard error.RESULTS: A higher average life expectancy was noted for people with type 2 diabetes, regardless of place of residence, in comparison with the same indicator in the Saratov region. The average life expectancy of patients with type 1 diabetes is 18 years lower than in the Saratov region for those living in urban areas and 17 years for rural residents. There is an excess of the levels of primary and general morbidity in people suffering from type 1 and 2 diabetes and living in rural areas over the same indicators of urban residents. The main causes of death in both urban and rural patients with type 1 and 2 diabetes are: chronic cardiovascular insufficiency, cerebrovascular accident and acute cardiovascular diseases. Disability rates in patients with type 2 diabetes living in urban areas are lower than in rural areas.CONCLUSION: Analysis of data from the Federal Register of Patients with Diabetes Mellitus in the Saratov Region showed high levels of primary and general morbidity, disability and mortality in patients with type 1 and 2 diabetes living in rural areas. Also, frequently occurring complications from the cardiovascular system were identified in all patients with type 1 and type 2 diabetes, regardless of the place of residence. The relationship between the levels of morbidity, mortality, disability, the incidence of complications and the place of residence of patients with type 1 and type 2 diabetes is not statistically significant

A new design for a green calcium indicator with a smaller size and a reduced number of calcium-binding sites

Genetically encoded calcium indicators (GECIs) are mainly represented by two- or one-fluorophore-based sensors. One type of two-fluorophore-based sensor, carrying Opsanus troponin C (TnC) as the Ca2+-binding moiety, has two binding sites for calcium ions, providing a linear response to calcium ions. One-fluorophore-based sensors have four Ca2+-binding sites but are better suited for in vivo experiments. Herein, we describe a novel design for a one-fluorophore-based GECI with two Ca2+-binding sites. The engineered sensor, called NTnC, uses TnC as the Ca2+-binding moiety, inserted in the mNeonGreen fluorescent protein. Monomeric NTnC has higher brightness and pH-stability in vitro compared with the standard GECI GCaMP6s. In addition, NTnC shows an inverted fluorescence response to Ca2+. Using NTnC, we have visualized Ca2+ dynamics during spontaneous activity of neuronal cultures as confirmed by control NTnC and its mutant, in which the affinity to Ca2+ is eliminated. Using whole-cell patch clamp, we have demonstrated that NTnC dynamics in neurons are similar to those of GCaMP6s and allow robust detection of single action potentials. Finally, we have used NTnC to visualize Ca2+ neuronal activity in vivo in the V1 cortical area in awake and freely moving mice using two-photon microscopy or an nVista miniaturized microscope

Efficacy and safety of oral semaglutide in patients with type 2 diabetes and moderate renal impairment (PIONEER 5): a placebo-controlled, randomised, phase 3a trial

Background: Oral semaglutide is the first oral glucagon-like peptide-1 (GLP-1) receptor agonist for glycaemic control in patients with type 2 diabetes. Type 2 diabetes is commonly associated with renal impairment, restricting treatment options. We aimed to investigate the efficacy and safety of oral semaglutide in patients with type 2 diabetes and moderate renal impairment. Methods: This randomised, double-blind, phase 3a trial was undertaken at 88 sites in eight countries. Patients aged 18 years and older, with type 2 diabetes, an estimated glomerular filtration rate of 30–59 mL/min per 1·73 m2, and who had been receiving a stable dose of metformin or sulfonylurea, or both, or basal insulin with or without metformin for the past 90 days were eligible. Participants were randomly assigned (1:1) by use of an interactive web-response system, with stratification by glucose-lowering medication and renal function, to receive oral semaglutide (dose escalated to 14 mg once daily) or matching placebo for 26 weeks, in addition to background medication. Participants and site staff were masked to assignment. Two efficacy-related estimands were defined: treatment policy (regardless of treatment discontinuation or rescue medication) and trial product (on treatment without rescue medication) in all participants randomly assigned. Endpoints were change from baseline to week 26 in HbA1c (primary endpoint) and bodyweight (confirmatory secondary endpoint), assessed in all participants with sufficient data. Safety was assessed in all participants who received at least one dose of study drug. This trial is registered on ClinicalTrials.gov, number NCT02827708, and the European Clinical Trials Registry, number EudraCT 2015-005326-19, and is now complete. Findings: Between Sept 20, 2016, and Sept 29, 2017, of 721 patients screened, 324 were eligible and randomly assigned to oral semaglutide (n=163) or placebo (n=161). Mean age at baseline was 70 years (SD 8), and 168 (52%) of participants were female. 133 (82%) participants in the oral semaglutide group and 141 (88%) in the placebo group completed 26 weeks on treatment. At 26 weeks, oral semaglutide was superior to placebo in decreasing HbA1c (estimated mean change of −1·0 percentage point (SE 0·1; −11 mmol/mol [SE 0·8]) vs −0·2 percentage points (SE 0·1; −2 mmol/mol [SE 0·8]); estimated treatment difference [ETD]: −0·8 percentage points, 95% CI −1·0 to −0·6;

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

A COMPREHENSIVE ANALYSIS DIABETES OF RISK FACTORS IN PATIENTS WITH CHRONIC PANCREATITIS

Aim – to perform comprehensive analysis of the risk factors of diabetes mellitus (DM) in patients with chronic pancreatitis (CP). Materials and methods. All examined patients with chronic pancreatitis (CP) were divided into 2 groups. The first group – 38 patients with the progression of the diabetes in the first 3 years of the CP, the second – 44 people with no diabetes after 10 years of disease. Formation of CP etiologic groups based on the mandatory presence of one of two factors: alcohol abuse, the presence of disease of biliary system. The combination of two etiological factors wasl exclusion criteria. Results and conclusion. Among the examined patients biliary form of CP occurred in 52 patients, alcohol – in 30 patients. It was found that in the first three years of CP risk of diabetes is not associated with family history, obesity, number of exacerbations, but in the form of alcoholic CP DM formed almost two times more often than in the biliary. When combined with CP in patients with diabetes were significantly more common strain of the main flow and structural changes in the tail of the pancreas

QUANTITATIVE APPROACH TO ASSESSMENT OF THERAPEUTIC RESPONSE ON EARLY STAGES OF ULCERATIVE COLITIS TREATMENT

Research is devoted to the design of a quantitative approach to the assessment of therapeutic response to therapy of patients with ulcerative colitis in the first 5 days of treatment. The study included 48 patients with ulcerative colitis with mild and moderate-severe current disease. Quantitative changes in the severity of the condition of the patient were analyzed using a specially designed questionnaire, including laboratory values and clinical symptoms. It was found that the standard qualitative approach to evaluating the effectiveness of the therapy in patients with ulcerative colitis with multidirectional dynamics of individual clinical symptoms and laboratory parameters in the first 5 days of treatment in most cases does not allow to give an integral characteristic of the general condition of the patient changes. Designed quantitative approach to evaluating therapeutic response to the treatment allow not only identify the minimal changes in patient condition in the first 5 days, but also to predict the effect obtained by the treatment of two weeks

North Caucasian Federal District: Conditions and Strategic Reference Points of Development

The authors have carried out the analysis of the North Caucasian Federal District economy in a number of the directions: a general economic situation in the region, investment activity and investment appeal, the diagnostics of the budget stability and budget independence has been performed. They draw the conclusion that the economy of the district has a pronounced non-productive nature, its developed structure and disproportions interfere with forming the stable results and growth of the citizens’ welfare. There are no institutional conditions for the development, a lot of problems with uncoordinated migration flows and logistic disproportions in the region. In order to solve the mentioned problems the concept and the district’s development strategic reference points are offered in the article. One of them is the organization and enhancement of regional clusters. Besides, the forward monotowns dynamics, forming the cross-industry balance, increase in the capacity of the macroregion as a transport (transit) corridor and solving the problems of logistic disproportions through updating and creating the mainstream infrastructure, as well as implementation of a funding mechanism for infrastructure projects are important