Specific features of entrepreneurial departments management in Russian companies

The topic is considered to be relevant due to the fact that entrepreneurship is necessary for the businesses survival and development worldwide, including Russia, and today some Russian companies are adapting their economies to the more developed economic standards. The entrepreneurial format adoption is an important stage of development for possible changes and growth in the future. The aim of this research work is to analyze some approaches to the phenomenon of entrepreneurship, to determine some specific features of entrepreneurial departments, including in the context of the Russian business space, and to study specific characteristics of these departments management in Russian companies. The main methods used in the study are the theoretical materials analysis, as well as the analysis of statistical data in the study area, the method of expert judgments, the survey method. The research work included the study of Russian entrepreneurship experience, specific features of entrepreneurial departments. The specific features of the Russian entrepreneurship were identified during the own diagnostic research, as well as some entrepreneurial difficulties caused by the entrepreneurship. Identified due to this research peculiarities of Russian entrepreneurship and difficulties of this phenomenon development in the Russian business space will allow to develop the Russian entrepreneurial business model based on its specific characteristics. On the basis of the obtained data a special mechanism can be created for the support and development of intra-entrepreneurship departments within the overall entrepreneurship management mechanism in Russian companies, where the full range of necessary organizational and economic conditions, as well as the possibilities for entrepreneurial results assessment will be presented, combined with a complete list of tools to facilitate the emergence and development of intrarepreneurship in companies. © 2016 Troshina et al

Functional brain MRI in the setting of drug correction of obesity

AIMS. Study of the dynamics of brain activity using functional MRI (fMRI) in obese patients treated with sibutramine (Reduxine®).MATERIALS AND METHODS. The study enrolled patients with a body mass index (BMI) ≥30 kg/m2 . All participants underwent initial brain fMRI mapping. The obesity cohort was treated with sibutramine at a dose of 10 or 15 mg per day for 3 months. After treatment patients with obesity underwent a second fMRI mapping to assess changes against the initial mapping.RESULTS. The study included: 30 patients (86,7% women) with mean age of 31 [27.25; 36] years, mean body weight (BW)  - 106 [95.75; 121.75] kg, mean BMI 37.4 [33.55; 41.9] kg/m2 , mean waist circumference (WC) - 109 [100; 114.75] cm. The most marked activation volume (via fMRI) was observed in patients with obesity (before treatment) in the visual cortex (occipital lobes). After 3 months of treatment with sibutramine, 80% of patients lose ≥5% of BW. Mean BW decrease was -7.2 [-13.46; -5.37] kg, BMI decrease — -7.2 [-13.49; -5.34] кг/м2 , WC decrease — -6.9 [-11.88; -4.03] см, p <0,05. According to fMRI data, a  decrease in brain activation in the projection of the occipital lobes (35%), left insula (44%), and increase inactivation by 70% in the area of the left DMPF.CONCLUSION. A dynamic study of brain activity using fMRI in obese patients showed that during treatment with sibutramine, a decrease in body weight is accompanied by a decrease in activation in the projection of the occipital lobes and the left insular lobe of the brain, and an increase in activation in the area of the left DMPFC. These data may indicate a decrease in the emotional perception of high-calorie food, a decrease in motivation to eat it, and an increase in cognitive control. In general, the noted dynamics of the functional activity of the brain in obese patients against the background of obesity therapy can be regarded as a change in previously formed patterns of eating behavior

Consensus position of endocrinologists and pathologists on coding causes of death in patients with diabetes mellitus (expert opinion)

Coding of the causes of death of patients with diabetes mellitus (DM) in the Russian Federation is one of the long-discussed problems, due to the comorbidity of diabetes and cardiovascular diseases (CVD) and a number of contradictions in the key regulatory documents regulating the statistics of mortality in this category of patients, which acquires particular relevance in the context of the coronavirus pandemic, due to its negative impact on the outcomes of the course of COVID-19 and mortality risks. In pursuance of the decisions of the Minutes of the meeting of the working group under the project committee of the National Project «Health» on identifying patterns in the formation of mortality rates of the population dated January 20, 2021 No. 1, chaired by Deputy Prime Minister of the Russian Federation T.A. Golikova, experts of two directions - endocrinology and pathological anatomy, prepared a Draft of agreed recommendations on the Rules for coding the causes of death of patients with diabetes, causing the greatest problems in terms of the use of ICD-10 when choosing the initial cause of death, including in the case of death from CVD and COVID-19

Russian clinical practice guidelines «congenital adrenal hyperplasia»

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive diseases characterized by a defect in one of the enzymes or transport proteins involved in the cortisol synthesis in the adrenal cortex. The most common form of CAH, which occurs in more than 90% of cases, is a 21-hydroxylase enzyme deficiency. The latter is subdivided into nonclassical and classic (salt-losing and virilizing) forms. The prevalence of classic forms of 21-hydroxylase deficiency ranges from 1: 14,000 to 1:18,000 live births worldwide. According to the data of neonatal screening in the Russian Federation, the prevalence of the disease in some regions ranges from 1: 5000 to 1: 12000, in the country as a whole - 1: 9638 live newborns. The non-classical form of CAH occurs more often - from 1: 500 to 1: 1000 among the general population. In second place is the hypertensive form of CAH - a deficiency of 11β-hydroxylase, which, according to the literature, occurs in about 1 per 100,000 newborns. These clinical guidelines were compiled by a professional community of narrow specialists, approved by the expert council of the Ministry of Health of the Russian Federation, and updated the previous version published in 2016. The clinical guidelines are based on systematic reviews, meta-analyses and original articles, and scientific work on this issue in the Russian Federation and other countries. The purpose of this document is to provide clinicians with the most up-to-date, evidence-based guidelines for the CAH diagnosis and treatmen

Distribution Analysis of Hydrogenases in Surface Waters of Marine and Freshwater Environments

Background Surface waters of aquatic environments have been shown to both evolve and consume hydrogen and the ocean is estimated to be the principal natural source. In some marine habitats, H2 evolution and uptake are clearly due to biological activity, while contributions of abiotic sources must be considered in others. Until now the only known biological process involved in H2 metabolism in marine environments is nitrogen fixation. Principal Findings We analyzed marine and freshwater environments for the presence and distribution of genes of all known hydrogenases, the enzymes involved in biological hydrogen turnover. The total genomes and the available marine metagenome datasets were searched for hydrogenase sequences. Furthermore, we isolated DNA from samples from the North Atlantic, Mediterranean Sea, North Sea, Baltic Sea, and two fresh water lakes and amplified and sequenced part of the gene encoding the bidirectional NAD(P)-linked hydrogenase. In 21% of all marine heterotrophic bacterial genomes from surface waters, one or several hydrogenase genes were found, with the membrane-bound H2 uptake hydrogenase being the most widespread. A clear bias of hydrogenases to environments with terrestrial influence was found. This is exemplified by the cyanobacterial bidirectional NAD(P)-linked hydrogenase that was found in freshwater and coastal areas but not in the open ocean. Significance This study shows that hydrogenases are surprisingly abundant in marine environments. Due to its ecological distribution the primary function of the bidirectional NAD(P)-linked hydrogenase seems to be fermentative hydrogen evolution. Moreover, our data suggests that marine surface waters could be an interesting source of oxygen-resistant uptake hydrogenases. The respective genes occur in coastal as well as open ocean habitats and we presume that they are used as additional energy scavenging devices in otherwise nutrient limited environments. The membrane-bound H2-evolving hydrogenases might be useful as marker for bacteria living inside of marine snow particles

3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial

Background Liraglutide 3\ub70 mg was shown to reduce bodyweight and improve glucose metabolism after the 56-week period of this trial, one of four trials in the SCALE programme. In the 3-year assessment of the SCALE Obesity and Prediabetes trial we aimed to evaluate the proportion of individuals with prediabetes who were diagnosed with type 2 diabetes. Methods In this randomised, double-blind, placebo-controlled trial, adults with prediabetes and a body-mass index of at least 30 kg/m2, or at least 27 kg/m2 with comorbidities, were randomised 2:1, using a telephone or web-based system, to once-daily subcutaneous liraglutide 3\ub70 mg or matched placebo, as an adjunct to a reduced-calorie diet and increased physical activity. Time to diabetes onset by 160 weeks was the primary outcome, evaluated in all randomised treated individuals with at least one post-baseline assessment. The trial was conducted at 191 clinical research sites in 27 countries and is registered with ClinicalTrials.gov, number NCT01272219. Findings The study ran between June 1, 2011, and March 2, 2015. We randomly assigned 2254 patients to receive liraglutide (n=1505) or placebo (n=749). 1128 (50%) participants completed the study up to week 160, after withdrawal of 714 (47%) participants in the liraglutide group and 412 (55%) participants in the placebo group. By week 160, 26 (2%) of 1472 individuals in the liraglutide group versus 46 (6%) of 738 in the placebo group were diagnosed with diabetes while on treatment. The mean time from randomisation to diagnosis was 99 (SD 47) weeks for the 26 individuals in the liraglutide group versus 87 (47) weeks for the 46 individuals in the placebo group. Taking the different diagnosis frequencies between the treatment groups into account, the time to onset of diabetes over 160 weeks among all randomised individuals was 2\ub77 times longer with liraglutide than with placebo (95% CI 1\ub79 to 3\ub79, p<0\ub70001), corresponding with a hazard ratio of 0\ub721 (95% CI 0\ub713\u20130\ub734). Liraglutide induced greater weight loss than placebo at week 160 (\u20136\ub71 [SD 7\ub73] vs 121\ub79% [6\ub73]; estimated treatment difference 124\ub73%, 95% CI 124\ub79 to 123\ub77, p<0\ub70001). Serious adverse events were reported by 227 (15%) of 1501 randomised treated individuals in the liraglutide group versus 96 (13%) of 747 individuals in the placebo group. Interpretation In this trial, we provide results for 3 years of treatment, with the limitation that withdrawn individuals were not followed up after discontinuation. Liraglutide 3\ub70 mg might provide health benefits in terms of reduced risk of diabetes in individuals with obesity and prediabetes. Funding Novo Nordisk, Denmark

INTERDISCIPLINARY CLINICAL PRACTICE GUIDELINES "MANAGEMENT OF OBESITY AND ITS COMORBIDITIES"

Clinical guidelines have long been one of the working tools of the modern doctor, helping him quickly navigate the most effective proven methods of treatment and prevention of various diseases, and also to adapt these methods to the specific tasks of their patients and to achieve maximum personalization of treatment. Clinical  practice guidelines are drawn up by professional non-profit associations and are approved by the Scientific Council of the Ministry of Health of the Russian Federation, while often one recommendation is prepared by two or even three associations. The peculiarity of the recommendations offered to your attention is that not only endocrinologists, but also therapists, cardiologists, gynecologists, gastroenterologists, and experts of many other specialties are involved in the prevention and treatment of obesity. The Multidisciplinary Working Group presents this a project in a multidisciplinary journal to bring together the efforts of several professional associations that associated with the need to pay attention not only to obesity itself but also to comorbid conditions. We are looking forward to constructive criticism and a comprehensive discussion of the problem on the pages of our journal

A randomized, controlled trial of 3.0 mg of liraglutide in weight management

BACKGROUND Obesity is a chronic disease with serious health consequences, but weight loss is difficult to maintain through lifestyle intervention alone. Liraglutide, a glucagonlike peptide-1 analogue, has been shown to have potential benefit for weight management at a once-daily dose of 3.0 mg, injected subcutaneously. METHODS We conducted a 56-week, double-blind trial involving 3731 patients who did not have type 2 diabetes and who had a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of at least 30 or a BMI of at least 27 if they had treated or untreated dyslipidemia or hypertension. We randomly assigned patients in a 2:1 ratio to receive once-daily subcutaneous injections of liraglutide at a dose of 3.0 mg (2487 patients) or placebo (1244 patients); both groups received counseling on lifestyle modification. The coprimary end points were the change in body weight and the proportions of patients losing at least 5% and more than 10% of their initial body weight. RESULTS At baseline, the mean (±SD) age of the patients was 45.1±12.0 years, the mean weight was 106.2±21.4 kg, and the mean BMI was 38.3±6.4; a total of 78.5% of the patients were women and 61.2% had prediabetes. At week 56, patients in the liraglutide group had lost a mean of 8.4±7.3 kg of body weight, and those in the placebo group had lost a mean of 2.8±6.5 kg (a difference of -5.6 kg; 95% confidence interval, -6.0 to -5.1; P&lt;0.001, with last-observation-carried-forward imputation). A total of 63.2% of the patients in the liraglutide group as compared with 27.1% in the placebo group lost at least 5% of their body weight (P&lt;0.001), and 33.1% and 10.6%, respectively, lost more than 10% of their body weight (P&lt;0.001). The most frequently reported adverse events with liraglutide were mild or moderate nausea and diarrhea. Serious events occurred in 6.2% of the patients in the liraglutide group and in 5.0% of the patients in the placebo group. CONCLUSIONS In this study, 3.0 mg of liraglutide, as an adjunct to diet and exercise, was associated with reduced body weight and improved metabolic control. (Funded by Novo Nordisk; SCALE Obesity and Prediabetes NN8022-1839 ClinicalTrials.gov number, NCT01272219.)

Prevalence of headache disorders in students of medical university according new Classification of Headache Disorders 3rd edition (2013)

The aim of our study was to estimate the prevalence of headache disorders using the newly published third edition International Classification of headache Disorders-3beta and evaluate their previous treatment in students of the Urals State Medical University. Methods: The study population consisted of 1042 students (719 females, 323 males, mean age 20.6, range 17-40). All were interviewed using a semi-structured validated interview conducted by a neurologist or by trained senior medical students. Results: 1-year prevalence of headache in students was 93% (females 95%, males 88%), prevalence of headache during the last month-68% (66% among females, 54% among males), during the last week-46% (48% among females, 32% males) and point prevalence -17% (17% among females, 17% among males). 1-year prevalence of episodic tension type headache was 74.5%, among females -73%, among males- 77%. 1 -year prevalence of migraine without aura was 24%, among females - 28%, among males -14%. 1-year prevalence of migraine with aura was 3.8%, among females — 5.6%, among males - 0.6%. 1-year prevalence of chronic tension type headache-3%, chronic migraine -1% and medication overuse headache-3 %. Only one third of students (35%) had consulted because of headache. Most students (75%) used analgesics or NSAIDs for the acute treatment of headache, only 2% used triptans. Only 0.2% of students received prophylactic treatment. Conclusion: Prophylactic and treatment strategies must be developed to manage the high prevalence of headache disorders in students.Задачей нашего исследования было изучение распространенности головных болей с использованием недавно опубликованной Международной классификации третьего пересмотра - 3 бетта, а также оценка предшествующего лечения головных болей у студентов Уральского государственного медицинского университета. Методы: Исследуемая группа включала 1042 студентов (719 женщин и 323 мужчины средний возраст 20,6 лет, возрастной интервал 17-40). Все студенты были проинтервьюированы с использованием полуструктурированного интервью, проведенного специально обученными студентами, а также врачом неврологом. Результаты: Распространенность головных болей у студентов в течение 1 года до интервью была 93% (95% у женщин, 88% у мужчин), распространенность головных болей в течение последнего месяца была 68% (66% среди женщин, 54% среди мужчин), в течение последней недели головные боли имели 46% студентов (48% среди женщин, 32% среди мужчин) и 17% студентов имели головные боли в день интервью (17% женщин, 17% мужчин). Распространенность эпизодических головных болей напряжения у студентов в течение 1 года до интервью была 74,5% (73% среди женщин и 77% среди мужчин). Распространенность мигрени без ауры у студентов в течение 1 года была 24% (28% среди женщин и 14% среди мужчин). Распространенность мигрени с аурой была 3,8% (5,6% среди женщин и 0,6% среди мужчин). Распространенность хронических головных болей напряжения в течение 1 года была 3%, хронической мигрени -1% и головных болей, связанных с избыточным употреблением анальгетиков 3 %. Только треть студентов (35%) обращались к врачам в связи с головными болями. Большинство студентов (75%) использовали анальгетики или НПВП для купирования головных болей, 2% использовали триптаны. Только 0,2% студентов получали профилактическое лечение по поводу головных болей. Вывод: Необходима разработка профилактических и лечебных мероприятий для снижения высокой частоты головных болей у студентов