To date there remains much ambiguity in the literature regarding the immunological interplay between SARS-CoV-2 and HIV and the true risk posed to coinfected individuals. There has been little conclusive data regarding the use of CD4 cell count and HIV viral load stratification as predictors of COVID-19 severity in this cohort. We performed a retrospective, observational cohort study on people living with HIV (PLWH) who contracted COVID-19 in central and eastern Europe. We enrolled 536 patients from 16 countries using an online survey. We evaluated patient demographics, HIV characteristics and COVID-19 presentation and outcomes. Statistical analysis was performed using SPSS 20.1. The majority of the study cohort were male (76.4%) and 152 (28.3%) had a significant medical comorbidity. Median CD4 cell count at COVID-19 diagnosis was 605 cells/μL [interquartile range (IQR) 409-824]. The majority of patients on antiretroviral therapy (ART) were virally suppressed (92%). In univariate analysis, CD4 cell count <350 cells/μL was associated with higher rates of hospitalization (p < 0.0001) and respiratory failure (p < 0.0001). Univariate and multivariate analyses found that an undetectable HIV VL was associated with a lower rate of hospitalization (p < 0.0001), respiratory failure (p < 0.0001), ICU admission or death (p < 0.0001), and with a higher chance of full recovery (p < 0.0001). We can conclude that detectable HIV viral load was an independent risk factor for severe COVID-19 illness and can be used as a prognostic indicator in this cohort.

The objective of this study was to characterize fruit and vegetable consumption in 9 selected countries of the World Health Organization (WHO) European Region. We analyzed data on fruit and vegetable intake and participant sociodemographic characteristics for 30,455 adults in 9 Eastern European and Central Asian countries via standardized STEPS survey methodology. Fruit and vegetable consumption across all countries was suboptimal, with a high percentage of populations not meeting the WHO-recommended intake of at least 5 servings (400 g) per day. Strengthened implementation of evidence-based policies to increase intake of fruit and vegetables is needed to reduce the burden of and disparities in NCDs.

Objective. To determine the relationship between violent acts and personality characteristics in alcohol dependent individuals.Materials and methods. The study was conducted in the penitentiary system. It involved 295 men with alcohol dependence syndrome (F10.2) aged from 21 to 60 years, with an average age of 40.7 ± 8.9 years and an average alcohol intake of 13.5 years. During the study, patients with alcohol dependence syndrome were divided into three groups. The following psychodiagnostic methods were used: the technique “Types of aggressiveness” developed by L. G. Pochebut (2012), the questionnaire “Style of self-regulation of behavior” (SSP-98), the test-questionnaire “Study of volitional self-regulation”, the questionnaire for the study of stages of psychotherapy “URICA” and others. Statistical analysis was carried out using the program SPSS 19.0. Spearman’s R-criterion and Mann-Whitney U-criterion were used.Results. The revealed high level of the final HCR-20 score in all three groups under study indicates a significant risk of committing violent acts, low adaptive capabilities and reduced stress tolerance of alcohol-dependent persons. The revealed average level of tolerance showed that personality traits, attitudes and beliefs of alcohol-dependent persons to a great extent determine their ambivalent attitude to the surrounding world with a combination of both tolerant and intolerant traits.The existing dual causal relationship between alcohol intake and stress manifestation shows that excessive stress increases the risk of alcohol-related problems, alcohol abuse in turn causes significant alcohol distress.Conclusions. The risk of violent acts in persons with alcohol dependence syndrome depends on the severity of such personality characteristics as aggressiveness and emotional excitability, low stress resistance, intolerance, and decreased ability to volitional self-regulation.

The article presents a three-dimensional model of the tissues of the human back in the ZBrush and SolidWorks software packages. Modeling of the spinal column with a bend, muscles, adipose tissue and skin was performed. Using the COMSOL Multiphysics environment, the effects of electrical stimulation on biological objects are modeled, and characteristics are determined. When modeling, in the properties of each biological tissue, the values of electrical conductivity and relative permittivity were set, the electrodes were adjusted, a grid was created to divide the models into smaller parts and elements, and the required frequency was adjusted. To verify the simulation results, a study was carried out on the patient, the calculation and analysis of the results obtained. The developed models can be used in clinical medicine to determine the strength of the stimulating current and set the parameters of electrical stimulation. When building a model, one can change the thickness of adipose tissue, skin, muscle and bone sizes, change the size of the electrodes, and thereby select the most optimal parameters for electrical stimulation. Models can be used in the development of the most effective method of electrical stimulation and the scheme for applying electrodes for a certain type of scoliosis.

AbstractFetal meconium peritonitis (FMP) is a rare form of sterile chemical peritonitis occurring in utero due to the perforation of the fetal intestine, sometimes after fetoscopic laser photocoagulation (FLP) in twin-to-twin transfusion syndrome, with the broad spectrum of prenatal ultrasound manifestations including abdominal cyst. We report a unique presentation of FMP following FLP with ascites, pseudocyst formation, and the cyst resolving probably of a fistula formation. This case report highlights unusual FMP development and gives a novel clue to antenatal diagnosis and management.

The purpose of this article is to present methodological tools for strengthening political stability in the Republic of Belarus, which is developed on the basis of the author's integrative model of analysis of the political system and a new approach to identifying the risks of the development of the political system, to determine the possibilities of its application outside the Belarusian context. The basis of the scientific methodology is the integration approach, which is a combination of key provisions of institutional, systemic, neo-institutional approaches to the study of the political system, as well as the concept of the political field by P. Bourdieu and the theories of the autopoietic system by N. Luhmann and structuration by E. Giddens. This research position allows us to verify the heuristic potential of the integrative model of the analysis of the political system to identify the risks of its development at the level of five subsystems: institutional-organizational, institutional-normative, ideological, functional-communicative and subject-actor. Empirical conclusions are formulated on the basis of data from sociological surveys, thought experiment. It is concluded that the degree of threat of one or another identified risk will largely depend on the possibility of localization of the area (point) of risk identification, as well as the efficiency of the deployment of analytical procedures. The theoretical significance of the article lies in the presentation of an approach to risk management, which can be designated as "bearing". It allows you to analyze the risk in dynamics, starting from any point of its detection or fixation. The practical significance is determined by the possibility of adapting the proposed methodology for identifying and assessing the risks of the development of the political system to the national specifics of different states.

This paper examines the status of the development of national digital health information systems (HIS) in Commonwealth of Independent States (CIS) member states. Data for research were collected using a questionnaire adapted from the questionnaire of the WHO’s Third Global Survey on eHealth. The results showed that the digital transformation of HIS was occurring in all seven CIS member states (participating in the study), which were financed by different resources. Laws and regulations on electronic medical records (EMR) use were present in almost all participating CIS member states. Various international standards and classifications were used to support development and the interoperability of digital health information system (d-HIS), including International Classification of Diseases (ICD), Digital Imaging and Communications in Medicine (DICOM), ISO 18308, Logical Observation Identifiers, Names, and Codes (LOINC), Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT), and ISO TC 215. Several CIS member states had adopted a national information security strategy for the safe processing of both personal data and medical confidential information. The digital transformation of healthcare and the Empowerment through Digital Health initiative are taking place in all CIS member states, which are at different stages of introducing electronic medical and health records.

Noncommunicable diseases (NCDs) and maternal newborn and child health (MNCH) are two deeply intertwined health areas that have been artificially separated by global health policies, resource allocations and programming. Optimal MNCH care can provide a unique opportunity to screen for, prevent and manage early signs of NCDs developing in both the woman and the neonate. This paper considers how NCDs, NCD modifiable risk factors, and NCD metabolic risk factors impact MNCH. We argue that integrated management is essential, but this faces challenges that manifest across all levels of domestic health systems. Progress toward Sustainable Development targets requires joined-up action.

In order to identify the role of cellular and humoral immunity, nonspecific resistance, cytokine spec-trum in the development of endothelial dysfunction and apoptosis in the pathogenesis of obstetric complications, 40 women with severe pregnancy complications and critical conditions associated with thrombotic micro angiopathy and 30 patients with physiologically occurring pregnancy were exam-ined. The assessment of cellular elements of peripheral blood, indicators of cellular and humoral im-munity, the level of cytokines, a disintegrin and metalloprotease with thrombospondin-1-like domains, member 13 (ADAMTS – 13), Willebrand factor, apoptosis-inducing factor, CD95, progesterone and the number of endotheliocytes is given.&#x0D; The conducted study indicates the failure of the functional state of both innate and acquired immunity in women with complicated pregnancy. The leading role in the development of endothelial dysfunction and the mechanism of apoptosis in pregnant women with severe complications and criti-cal cases associated with thrombotic microangiopathy belongs to an insufficient reserve of nonspecific resistance, impaired cellular and humoral immunity with low background progesterone level and high cytokine activity