About inefficiency of personnel policy in health care of russia

The shortage of medical personnel, primarily in the district service and rural health care, the insufficient effectiveness of measures taken by the state to solve the personnel problem («presidential» allowance for the district service, the program «Zemsky doctor», etc.) indicate the insolvency of personnel policy in the industry. The state spending huge budgetary funds for training specialists deprived itself of the right to use them where they are urgently needed. The desire to improve the quality of training of medical students on the basis of accession to the Bologna agreement did not give the desired result. The availability of medical care is also limited by the fact that in the general structure of medical specialties, the number of doctors of clinical specialties, i.e. those who directly work with patients is significantly lower than in the EU and their share continues to decline. All of the above suggests that the Ministry of Health has no clear idea about the issue of personnel, is not formed the system able to solve it, which must include: career counseling -training - public distribution trained on a budgetary basis - professional development - career growth. The state and the leadership of the regions should create favorable conditions for work and life, attracting specialists, as well as interesting them in long-term work at the place of distribution. On the basis of the Soviet experience in the organization of personnel work in health care, best practice of other countries, the authors propose measures in the medical personnel training improvement, in attracting and long-term interest in their work in «problem» positions (district service, rural health care, etc.)

Application of reproductive technologies to the improvement of dairy cattle genomic selection

Genomic selection is a direction of breeding in which the value of an animal is predicted from DNA markers evenly covering the entire genome. This review summarizes information on modern trends in the genomic selection of dairy cattle and on application of reproductive technologies to the improvement of breeding process. The main trends in the development of genomic selection include improvement of the accuracy of breeding value estimations by combination of reference populations; use genotyping of cows in breeding programs; imputation of genotypes for absent SNPs with low marker density microarrays, and prediction of animal genotypes from the genotypes of relatives. Genomic selection can be even more profitable in combination with up-to-date reproductive biotechnologies: semen sexing, multiple ovulation and embryo transfer, ovum pick-up followed by in vitro fertilization, embryo genotyping, cloning of best breeders, etc. In programs of dairy cattle genomic selection, biotechnological procedures with gametes and embryos allow improvement of a variety of parameters determining breeding efficacy: selection intensity, accurate breeding value assessment, and generation interval. Successful methods for embryo genotyping for numerous markers after biopsy at the morula or blastocyst stage are based on whole genome amplification of embryo DNA. Eventually, these achievements will provide grounds for new approaches to the reduction of generation interval, selection of elite cows, reduction of inbreeding rate, etc

Rural healthcare of Russia. Status, problems, prospects

The transformations of domestic healthcare carried out in the last three decades have not led to the planned results, and in some areas the consequences have turned out to be negative. Rural healthcare suffered the most significantly. The aim of the study was based on the analysis of the situation in the rural health care of the country to propose measures to improve it. Material and methods. The statistical data of the Ministry of Health of Russia, Rosstat, Central Research Institute of Organization and Informatization of Healthcare, as well as data on the Siberian Federal District for the period from 1990 to 2020 were used. Scientific publications on the problem under consideration have been studied. Results and their discussion. The course taken in the early 90s of the last century towards the commercialization of medicine remains. So for the period from 2005 to 2018 in the structure of the country’s medical personnel, the number of people employed in the public sector decreased from 93.6 to 86.8 % (by 237 000), whereas in private medical organizations it increased by 2.3 times. In 2020, 38.4 % of medical organizations were already private. The most significant changes have occurred in rural healthcare. The number of paramedic and obstetric stations decreased by 21.1 %, the provision of beds in hospitals is 2 times lower than the national average, and doctors are 3 times fewer than in cities. In the age structure, the share of doctors over the age of 60 increased from 13.5 % (2017) to 18.1 % (2020). The implementation of the programs “Zemsky Doctor” and “Zemsky paramedic” did not lead to an increase in the provision of medical workers in rural areas. Today, medical care is geographically available only to 49 % of villagers, for 40 % it is difficult to access, and 9 % is practically inaccessible (2 % of respondents could not answer the question). This has led to the fact that the average life expectancy of the villagers is 1.5 years lower than that of the townspeople, and the total mortality is 1.2 % higher than the national average. Conclusion. The problem of accessibility of medical care to the rural population has worsened in the last three decades. The implemented programs aimed at improving its accessibility and quality, including for rural residents, have not led to a significant positive result

Polymorphism of the LCT gene regulatory region in Turkicspeaking populations of the Altay-Sayan region (southern Siberia)

Retention of lactase activity in adulthood (lactase persistence) is one of the most important adaptive traits for human populations that consume fresh milk from domestic animals. At a molecular-genetic level, lactase persistence is determined by the presence of specific alleles of polymorphic sites in cis-regulatory elements of the LCT gene located on chromosome 2q21. Ascertainment of the molecular-genetic causes of lactase persistence has made this trait one of the most convenient for studying mechanisms of human population adaptation to environmental conditions. But the populations of many regions remain insufficiently investigated in relation to the genetic variability of the LCT loci. This paper presents the results of polymorphism analysis of loci, including the enhancer element for the LCT gene and its flanking regions, in two Turkic-speaking populations from southern Siberia, Altaian Kazakhs and Khakasses. It was found that the “European” allele LCT-13910T is the most characteristic of the Turkic-speaking populations from Altai-Sayan regions among all the polymorphic variants associated with lactase persistence. The expansion of the “European” allele LCT-13910T to the gene pool of the populations in southern Siberia could be related to migration waves of ancient herders form western Eurasia during the Bronze Age (in III – II millennium BC). A decrease of the LCT-13910T allele frequency and the total frequency of its carriers in the Turkic-speaking populations of southern Siberia in comparison with the majority of European populations and the Kazakhs from southern Central Asia can be attributed to: (1) a significant influence on the Altai- Sayan population’s gene pool by Eastern Eurasian populations, for which the LCT-13910T allele is rare; (2) a lesser adaptive significance of lactase persistence for south Siberian populations, compared to the populations of Europe. Rare and unique SNPs in the locus under consideration that were found in the Altaian Kazakhs (LCT-13895G > C and LCT-13927C > G) and Khakasses (LCT-14011C > T) potentially play a role in regulation of LCT gene expression, because they are located within the enhancer, regulating activity of its promoter

Ethnicity-specific distribution of <em>TRPM8</em> gene variants in Eurasian populations: signs of selection

The TRPM8 gene encodes the ion channel, which is a cold receptor in afferent neurons of the mammalian somatosensory system. We studied the frequency of haplotype distribution from six SNPs in the TRPM8 gene in Eurasian human populations, including Russians, Kazakhs and Chukchi. Four of the six SNPs are located in exon 7 (rs13004520, rs28901637, rs11562975, rs17868387), rs7593557 is in exon 11. These exons encode parts of the N-terminus, which is necessary for channel functioning in the plasma membrane of neurons. The rs11563071 is in exon 23 encoding part of the C-terminus. The primary difference in population distribution of haplotypes determines the SNP from exon 11 which leads to Ser419Asn substitution in protein. The most pronounced dif­ferences in the patterns of diversity and frequencies of haplotypes were observed between Chukchi and Russians. The frequency of major H1 haplotype encompassing the 419Ser gene variant differs in examined populations; 0.738 (Russians), 0.507 (Kazakhs) and 0.337 (Chukchi), p &lt; 0.001. The TRPM8 gene variants encoding 419Asn and carrying the minor alleles of rs28901637 (P249P) and rs11562975 (L250L) in exon 7 are characteristic of Asian populations. The frequency of all 419Asn variants in Chukchi is comparable to that in Africans, however, the minor allele frequencies of rs28901637, rs11562975 in Africans is low. Apparently in the process of human colonization of Eurasia, minor alleles of these SNPs diverged depending on rs7593557 structure in exon 11. We analyzed sequences of five TRPM8 mRNA isoforms extracted by researchers from different tissues. Sequence analysis demonstrates that they are transcribed from major H1 variant of the TRPM8 gene but contain different translation start codons, which are generated by alternative splicing from pro-mRNA

Polymorphism of genes associated with infectious lung diseases in Northern Asian populations and in patients with community-acquired pneumonia

The innate Iнн\mmune system is the first to respond to invading pathogens. It is responsible for invader recognition, immune-cell recruitment, adaptive-immunity activation, and regulation of inflammation intensity. Previously, two single-nucleotide polymorphisms of innate-immunity genes – rs5743708 (Arg753Gln) of the TLR2 gene and rs8177374 (Ser180Leu) of the TIRAP gene – have been shown to be associated with both pneumonia and tuberculosis in humans, but the data are contradictory among different ethnic groups. It has also been reported that rs10902158 at the PKP3-SIGGIR-TMEM16J genetic locus belongs to a haplotype race-specifically associated with tuberculosis. Meanwhile, a gradient of its frequency is observed in Asia. The aim of this work was to assess the effect of selection for the genotypes of the above-mentioned SNPs on the gene pools of populations living in harsh climatic conditions that contribute to the development of infectious lung diseases. We estimated the prevalence of these variants in white and Asian (Chukchis and Yakuts) population samples from Northern Asia and among patients with community-acquired pneumonia (CAP). Carriage of the rs5743708 A allele was found to predispose to severe CAP (odds ratio 2.77, p = 0.021), whereas the GG/CT genotype of rs5743708/rs8177374 proved to be protective against it (odds ratio 0.478, p = 0.022) in white patients. No association of rs10902158 with CAP (total or severe) was found among whites. Stratification of CAP by causative pathogen may help eliminate the current discrepancies between different studies. No significant difference in rs5743708 or rs8177374 was found between adolescent and long-lived white samples. Carriage of the alleles studied is probably not associated with predisposition to longevity among whites in Siberia. Both white and Asian populations studied were different from Western European and East Asian populations in the variants’ prevalence. The frequency of the rs8177374 T (Ser180Leu) variant was significantly higher in the Chukchi sample (p = 0, χ2 = 63.22) relative to the East Asian populations. This result may confirm the hypothesis about the selection of this allele in the course of human migration into areas with unfavorable climatic conditions

On the state of public health and healthcare Siberian Federal District during the pandemic (some results of 2020)

Introduction. The COVID-19 pandemic has become a huge challenge for the entire healthcare system, medical institutions and doctors. The results of the industry’s activities turned out to be insufficiently effective, and therefore it is necessary to analyze not only what is directly related to the coronavirus infection, but also the consequences that the pandemic has led to. Goal. To analyze the results and consequences of health care activities and the health status of the population of the Siberian Federal District during the COVID-19 pandemic. Material and methods. The statistical data of the Ministry of Health of the Russian Federation, Rosstat, the Central Research Institute for the Organization and Informatization of Healthcare (TSNIIOIS), the Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, as well as data for the Siberian Federal District were used. Scientific publications on the problem under consideration have been studied. Results and discussion. In connection with the beginning of the COVID-19 pandemic in Russia, as in all countries of the world, serious anti-epidemic measures were carried out, the procedure for providing medical care to the population changed, the consequences of which did not have the best effect on their health, including in the Siberian Federal District. The number of visits per resident of the district as a whole decreased by 16.2 %, in the polyclinic by 19.5 %, at home increased by 44.4 %. The number of visits for preventive purposes decreased by 6 %, and the coverage of dispensary observation by 11.2 %. The proportion of patients with oncological diseases in stages 3-4 increased to 40.6 %. Hospitalization of the SFO declined by 17.2 %, the number of operated patients 17.8 %, and postoperative complications have increased by 43.7 % from 1.07 to 1.54 %. Total mortality amounted to in 2020 for 14.5 per 1,000 population, i.e. increased by 18 % compared to 2019 year, while only 1/3 was due to COVID-19. In 2020, the number of Russians decreased by 510 thousand people. Conclusions. The results of health care activities, a significant deterioration in the health of the population and the complication of the demographic situation in the country during the pandemic, indicate serious shortcomings in the organization of medical care to the population, primarily in extreme situations, and requires a deep analysis and adequate measures to improve the structure and functioning of the industry in any conditions

Development of Education Districts in the Strategy of Strengthening the Axiological Foundations of the Russian Education Space

The article presents an analysis of the specific features of the socio-cultural modernization of education in contemporary Russia and the methodology of the development of the ethno-regional education systems against the background of strengthening the unified education space of Russia. Special attention is paid to the consideration of the strategy of the development of education districts of contemporary Russia as the foundation for building the government vertical of state management in the field of education.As part of the development of organizational and pedagogical resources of risk management of the gap between the scientific and education space of the country, the authors have worked out the idea of setting up scientific and education complexes and developing education districts in the country. This approach meets the objective of improving the quality of higher education in the regions of the country by establishing clear links with regional universities in the most “advanced” areas, organizing scientific and educational activities.Creating education districts serves as the foundation of building up a multicultural education space of the Russian Federation, the resource of lining up control at the federal and regional levels, the formation of a new vector of education policy focused on the preservation and development of a unified, internally differentiated scientific and education space of the country

Features of laboratory parameters in children with multisystem inflammatory syndrome associated with SARS-CoV-2

Multisystem inflammatory syndrome (MIS-C) is a new childhood disease associated with coronavirus SARS-CoV-2 that manifests itself 3–4 weeks after infection. The development of MIS-C is possible, despite the asymptomatic course of coronavirus infection. The pathogenetic features of MIS-C remain unclear. The aim of the study was to investigate the state of peripheral blood parameters in children with multisystem inflammatory syndrome associated with SARS-CoV-2 upon admission to a hospital. Material and methods. We examined 52 children with MIS-C from 1 to 14 years old, hospitalized in Children`s Clinical Hospital No. 3 in Novosibirsk in October–December 2020. Testing for the isolation of SARS-CoV-2 RNA in scrapings from the nasopharynx and oropharynx was carried out using real time PCR (test systems of DNA-Technology, Russia). The presence of specific IgM and IgG antibodies to SARS-CoV-2 in blood serum was determined by ELISA using Vector-Best kits (Russia). Results and discussion. It was noted that SARS-CoV-2 virus RNA was found only in 12.8 % of cases, while specific IgG antibodies in blood serum were detected in 100 % of children. IgM to SARS-CoV-2 antigens were detected in the blood serum only in 53.85 % of children with MIS-C. It has been established that unexpressed leukocytosis was found both in children under the age of 7 and in children of 8–14 years old. However, the leukocytes content in children of the older age group was significantly lower than in children aged 1–7 years. At the same time, in both age groups, some children had extremely low values of the indicator. The causes of severe leukopenia against the background of excessive inflammation remain unclear. Age groups (1–7 and 8–14 years) do not differ statistically significantly in the relative content of lymphocytes and neutrophils. In the study of individual values of the relative content of lymphocytes within the age groups, it was noted that only some children had lymphopenia of varying severity. Conclusions. Against the background of minor leukocytosis in children with MIS-C, upon admission to the hospital, there is a tendency to develop both relative and absolute lymphopenia, regardless of age. The study noted an extremely pronounced variability of individual values of the evaluated peripheral blood parameters, regardless of age, which, with similar clinical symptoms, characterized as MIS-C, requires further study in dynamics, taking into account the initial values of the indicators.There is no pronounced relationship between the leukocytes content and specific IgM antibodies to SARS-CoV-2 antigens in the blood

An association between type A porcine endogenous retrovirus copy number and hematological parameters and gender in miniature pigs

Pig is the most promising species for transplantation of organs and cells into humans, although implementation of xenotransplantation in clinical practice has been hindered by the risk of infecting the recipient with zoonotic infectious diseases. Porcine endogenous retroviruses (PERV) are capable of incorporating copies of DNA into the genome of a host cell. Based on the nucleotide sequence of the envelope gene (env), three main types of pig retrovirus, PERV-A, PERV-B and PERV-C, have been recognized, with PERV-A and PERV-B having the capability of infecting human cell lines in vitro. Selection for animals with low copy number of retroviruses in the genome using simple phenotypic indications is required for the widespread implementation of xenotransplantation. The objective of this study was to evaluate the correlation between PERV-A env gene copy number and hematological parameters, gender and coat  color in miniature pigs of the Institute of Cytology and Genetics (ICG) SB RAS. Reference values for eighteen blood parameters of miniature pigs were determined, including white blood cell count (WBC), red blood cell count (RBC), platelet count (PLT), absolute (LYM#) and relative (LYM%)  lymphocyte counts, absolute (MID#) and relative (MID%) monocyte, basophil and eosinophil counts, absolute (GRA#) and relative (GRA%) granulocyte counts, hematocrit (HCT) and thrombocrit (PCT), mean cell volume (MCV) and mean platelet volume (MPV). Males had significantly higher reference values for WBC, MID#, GRA# and red cell distribution width (RDW-CV) as compared to females. The mean corpuscular hemoglobin  concentration (MCHC) and platelet distribution width (PDW-CV) were significantly higher in female animals. No correlation between PERV-A env gene copy number and the coat color of  animals was detected, suggesting that retroviral insertion sites and genes that determine the coat color of miniature pigs, namely KIT (chromosome 8) and MC1R (chromosome 6), are either located far apart on same chromosome or on different chromosomes. The copy number of PERV-A env gene in males was lower than in females. Presence of multiple copies of PERV-A on the X-chromosome is the most probable cause of such gender-related differences in miniature pigs. Thus, male miniature pigs of ICG SB RAS should be the source of material for xenotransplantation