Federal Center Research Articles

Comparative analysis of the targets for reducing adult population mortality by 2024

Introduction. Currently, in the Russian Federation there are realized national projects “Healthcare” and “Demography” aimed at reducing the mortality. For implementation at the regional level in Moscow, there have been developed regional programs with appropriate regional indicators. The purpose of the study is to assess the degree of achievement of the targets of national, federal and regional adult mortality rates. Materials and methods. The study is based on a comparative analysis of targets and actual statistical data. Results. In Moscow and in Russia, there is a decrease in mortality from all causes, diseases of the circulatory system, myocardial and cerebral infarction, neoplasms. Despite the increase in the level in 2020–2021 due to the pandemic, in 2022, mortality rates returned to the pre-pandemic period and have a tendency to further decrease. Current trends point to the high achievability of targets in Moscow, while in the country, most indicators have a chance of not being achieved. In Moscow there is noted a higher cancer mortality rate i to which a significant contribution may be made by cancer patients from other Russian regions who receive medical care in federal cancer centers located in Moscow and who died on its territory. Research limitations. Standardized mortality rates of the population were calculated in the FAISS internal use program. Conclusion. The implementation of national, federal and regional projects has had a positive impact on the effectiveness of demographic policy to reduce mortality.

Analysis of the provision of medical care using telemedicine technologies at the endocrinology research centre

In the first months after the pandemic of the COVID-19, the provision of medical care through telemedicine technologies took a leading position, in particular regarding endocrine nosologies. Meanwhile, at present, comprehensive information on telecommunications interaction between doctors of various medical organizations of the regions of the Russian Federation and employees of federal centers is insufficient, which determines the relevance of studying this topic. Analysis of the provision of medical care in remote interaction of medical workers using telemedicine technologies («doctor-doctor») between the Endocrinology Research Centre and the regions of the Russian Federation in 2019-2023. A single-center, observational, single-sample study was conducted, including completed planned and urgent telemedicine consultations in the format of «doctor-doctor « in the fields of «endocrinology» and «pedia-tric endocrinology», conducted through a telemedicine system for remote consultations at federal and regional levels between 2019 and 2023. Data on the referral rate of medical personnel from the regions of the Russian Federation to the Endocrinology Research Centre for telemedicine consultations were analyzed, including annual dynamics of treatment, frequency of referrals from each region, nosological structure of referrals, and number of patients admitted to the center based on the results of these consultations. Analysis of interdepartmental cooperation between the Endocrinology Research Centre and other federal centers was also performed. In the period from 2019-2023, 14,475 telemedicine consultations «doctor-doctor» were conducted. In 2019, medical workers from 78 regions of the Russian Federation applied to the Endocrinology Research Centre. By 2023, this figure has increased to 88 (including newly annexed territories). The Yamalo-Nenets Autonomous Okrug, Tambov Region and Astrakhan Region were the leading regions in terms of the circulation of medicines at the Endocrinology Research Centre. In the nosological structure, the largest number of consultations in adult patients were conducted for acromegaly and primary hyperparathyroidism, in children for stunting and type 1 diabetes mellitus. In the period from 2019-2023, the Endocrinology Research Centre sent a total of 300 «outgoing» requests to 17 medical organizations. Consulting with the use of telemedicine technologies has become a convenient and multifunctional way of providing medical care. Further analysis of the place of telemedicine in practical healthcare will expand its capabilities, including considering the introduction of financing by the territorial fund of compulsory medical insurance for this area of medical activity.

Clinical, functional and neuropsychological status of joint replacement patients

Introduction The number of hip and knee replacement surgeries is increasing annually in Russia and worldwide. The majority of patients receiving joint arthroplasties are elderly women.The objective was to assess the clinical, functional and neuropsychological status of patients undergoing total knee or hip replacement.Material and methods The study included 448 patients admitted for elective surgery of total knee or hip replacement at the Department of Traumatology and Orthopedics of the Federal Center for High Medical Technologies (CHMT, Kaliningrad Region). Anthropometric parameters of the patients were measured, the medical history and concomitant diseases recorded. Common blood count and biochemistry test were evaluated preoperatively. Neuropsychological examination included assessment of cognitive and executive functions, levels of distress, depression, anxiety and somatization.Results Almost all patients studied were found to have varying degrees of obesity. A typical combination of concomitant pathology in volunteers was stage 2 hypertension, risk degree 2–3, and chronic gastritis in remission. Half of the volunteers showed moderate and high levels of distress, depression, anxiety and somatization. A significant number of volunteers showed moderate to high levels of cognitive decline. Age- and sex-related blood counts were slightly different from the normal ranges for a CBC and biochemistry. Changes in leukocyte count were detected.Discussion Leukocyte counts indicated the osteoarthritis induced inflammatory process in most patients. Mitochondrial dysfunction and aging of the immune system contributed to the “proinflammatory status.” The high rate of cognitive impairment in volunteers was associated with age and comorbidity, cardiovascular conditions, in particular. Distress and anxiety were associated with emotional reactions to surgery.Conclusion The factors reported can affect the duration and course of rehabilitation. The “pro-inflammatory status” of patients can complicate the healing of a postoperative wound. Neuropsychological disorders noted during postoperative rehabilitation can have a significant impact on physical recovery, social and professional adaptation.

Identification of Climate-Smart Bread Wheat (Triticum aestivum L.) Germplasm for Optimum Moisture Areas of Ethiopia

Ethiopia's Bread Wheat Breeding Program conducts annual multi-environment yield trials to develop advanced wheat genotypes for Ethiopian wheat cultivation, ensuring a steady supply of new and improved varieties to meet production and marketing challenges. The objective of this research was to assess potential yield and the interactions between genotype and environment in wheat across multiple environments, as every cultivar has a distinct response to soil and climate. The BLUP analysis reveals that the 22AA and 22KU trials in 2022, along with 21KU trials in 2021 yielded high grain production, indicating optimal testing locations for distinguishing bread wheat genotypes and agroecologies. The study found that seven out of sixteen trials exhibited a higher genetic variance for yield, indicating high genotype discriminating power, with estimates ranging from 0.043 to 0.989 for genetic variance, 0.084 to 1.147 for error variance, and 72.7 to 96.4 for heritability. EBW202471 and EBW202473 are stable genotypes with good yield performance across correlated locations, with EBW202471 showing the highest yield (4.98 t/ha) and Deka showing a lower yield (4.07 t/ha). Three wheat genotypes, EBW202471, EBW202472, and EBW202473, were found to be moderately resistant to moderately susceptible to stem and yellow rust among 20 wheat genotypes. Finally, the two genotypes, EBW202471 and EBW202473, were advanced to National Performance Trials to evaluate their performance alongside top genotypes from regional federal research centers and to be released as new varieties.

Методический подход к согласованию стратегических приоритетов государственной региональной политики развития старопромышленных регионов Российской Федерации

The formation of strategic priorities of the state regional policy for the development of old-industrial regions is complicated by the multiplicity of its actors and the need to coordinate spatial and sectoral priorities of regulatory impact. The article presents a methodological approach to coordinating the priorities of spatial and sectoral development of old industrial regions in the format of a scheme reflecting the logic and sequence of actions aimed at achieving strategic goals of regional development in accordance with the strategic national priorities of the Russian Federation. The methodological approach was tested on the example of the Saratov region, one of the old industrial regions of Russia with growth potential within the framework of the industrial development model. The necessity of using two approaches in the coordination process is justified: the first should be used to achieve the strategic priorities of the federal Center in a coordinated manner, on the one hand, and the old industrial regions and enterprises and organizations of the "industrial core", on the other (coordination "vertically"); the second — in order to coordinate the regional priorities of spatial and sectoral development of the old industrial region (horizontal alignment). Proposals are presented for the formation of a list of agreed priorities for the spatial and sectoral development of the Saratov region, the implementation of which will contribute to the transformation of the region into a point of growth of the national economy of Russia.

Comparative analysis of the structure of the heart and blood vessels surgeries, taking into account the clinical and functional status of patients with coronary heart disease in 2015 and 2020

Relevance. In a very short period of time, surgical treatment methods have become widespread due to the expansion of indicators for performing heart surgery in patients with severe complicated forms of coronary heart disease and the use of combined surgical operations.Aim: To study changes in the clinical and functional status of patients depending on the type of surgical intervention for coronary artery disease in different time periods in the gender aspect.Material and Methods. The study was conducted retrospectively. For comparative analysis, patients with an established diagnosis of coronary heart disease who underwent surgical treatment at the Federal Center for Cardiovascular Surgery of the of the Ministry of Healthcare of the Russian Federation (Chelyabinsk) in 2015 (n = 1017) and 2020 (n = 967) were included. Of the total number of patients in 2015, there were 771 (75.8%) men and 246 (24.2%) women, in 2020 718 (74.3%) and 249(25.7%), respectively.Results. In the structure of interventions performed, there is a decrease in the number of almost all types of surgical interventions for complications of myocardial infarction, most pronounced in relation to resection of the left ventricular aneurysm, reconstruction of the left ventricle and operations in combination with mitral valve replacement. In a large percentage of cases, patients with a history of risk factors for cardiovascular diseases are referred for coronary artery bypass surgery, regardless of gender. The majority of patients had angina pectoris of the 3rd–4th functional class. However, there is a trend towards a decrease in the proportion of people with post-infarction cardiosclerosis when referred for surgery.Conclusion. Despite the significant volume and availability of practical information, the number of patients with major cardiovascular risk factors is not decreasing.

Potential of the Arkhangelsk seismic network for European Arctic monitoring

The Arkhangelsk Seismic Network (ASN) of the N. Laverov Federal Center for Integrated Arctic Research of the Ural Branch of the Russian Academy of Sciences, founded in 2003, includes 10 permanent seismic stations located on the coasts of the White, Barents, and Kara Seas and on the Arctic archipelagos of Novaya Zemlya, Franz Josef Land, and Severnaya Zemlya. The network is registered with the International Federation of Digital Seismograph Networks and the International Seismological Center. We used not only ASN data to process earthquakes but also the waveforms of various international seismic stations. The 13,000 seismic events were registered using ASN data for 2012–2022, and for 5,500 of them, we determined the parameters of the earthquake epicenters from the European Arctic. The spatial distribution of epicenters shows that the ASN monitors not only the main seismically active zones but also weak seismicity on the shelf of the Barents and Kara Seas. The representative magnitude of ASN was ML, rep=3.5. The level of microseismic noise has seasonal variations that affect the registration capabilities of each station included in the ASN and the overall sensitivity of the network as a whole. In summer, the sensitivity of the ASN decreased owing to the increasing microseismic and ambient noises, whereas in winter, the sensitivity of the ASN increased significantly because of the decrease.

Was Grand Duchy of Lithuania a Federation?

According to received wisdom in the historiography of the Grand Duchy of Lithuania (GDL), going back to M. Dovnar-Zapolski, M. Liubavski, O. Halecki, the territorial form of government in the GDL was federal in the late XV-early XVI century. The paper critically reviews the arguments advanced in favor of this thesis and argues that the concept of empire describes the territorial organization of GDL in a more accurate way. The criticism of the federalist theory is grounded in the conceptual analysis of the state forms provided by the distinguished Lithuanian historian and law theorist Mykolas Rėimeris (1880-1945). In his analysis, M. Rėimeris draws the distinction between a unitary state and three types of state compounds: federation, confederation, and empire. While federation and empire share the principle of subordination as the mode of organization, in the empire this is the subordination to a privileged metropole territory and cultural-ethnic group, while in federation all territories are subordinated to the federal center on parity grounds, all participating in federal government. Supplementing M. Rėimeris' ideas with those from the contemporary comparative sociological research on empires and imperialism (S. Eisenstadt, M. Doyle, A. Motyl, Ch. Tilly), the author argues that GDL was an empire because relations between Lithuania in the strict sense (including also some Russian lands annexed by the early XV century) and Polotsk, Vitebsk, Smolensk, Volynia, Kiev, Samogitia, etc. were those of subordination of the periphery to the imperial metropole. The proponents of the federalist thesis mistake as federalism what in reality was a system of indirect rule characteristic for premodern empires. The historiographical tradition was blind to imperial features of GDL because it implicitly or explicitly compared GDL with the Moscow state, considering it as a paradigmatic case of empires. However, the Moscow empire represents only one specific type of empire - Westphalian empire, distinguished by the early application of direct rule. While most medieval polities were transformed into sovereign territorial states and Westphalian empires in the early modern time, GDL was unique in following the path of federalization. However, GDL was transformed into a federation only on the eve of the Lublin Union in 1569, while in the XIV-first half of the XVI century it was a traditional empire, including metropolitan military agrarian domains and indirectly ruled peripheral areas shading into areas of mere hegemony.

Profit Tax as a Character of Regional Budget of Our Time

The authors develop approaches to tax decentralization based on the theory of imperfect institutions by T. Eggertsson, in terms of the critically important profit tax for regional budgets of Russia. We see the goal of our research in finding a balance between the action of formal rules and informal, social norms, technologies, and models for distributing the profits of the largest Russian companies as a tax base between the federal center of Russia and the regions depending on the actual location of employees and assets. The article is devoted to the action of a successful and unique formal rule of the tax institution for the Russian Federation – the formation of consolidated groups of taxpayers (CGT). The novelty of the article lies in the study of the phenomenon of transformation of the domestic system of paying profit tax in 2023 as a replacement of one formal rule (action of CGTs) with another formal rule – the introduction of a new excess profit tax for Russia. An empirical study of the regional distribution of payments of legal entities-payers of profit tax according to the formal rules of the CGTs from among the largest Russian companies registered outside Moscow was conducted. Based on the results of the study, a general conclusion was made about the acute contradiction of the current economic policy in Russia in the content of the tax institution: between the new informal social norm on territorial decentralization of the largest Russian companies and the opposite formal rules of tax centralization in terms of profit tax. In this regard, the current policy of coincidence of territorial and tax decentralization in terms of state-owned companies in China deserves attention.

CDC data show some relief in overdose deaths

The most recent data from the federal Centers for Disease Control and Prevention indicate that the death rate from overdoses took a dip, for the first time in years. It's still bad news. But possibly, if the trend continues, good news.

Results of surgical treatment of aortic stenosis in patients with a narrow aortic root after Ozaki surgery and bioprosthetics: A retrospective single-center study

BACKGROUND: Aortic stenosis (AS) itself is a common disease in patients of older populations, and its combination with a narrow aortic root puts the surgeon in front of choosing the most optimal option. The advantages of Ozaki's operation include hemodynamics close to the native aortic valve (AV) and the absence of the need for lifelong anticoagulant therapy. AIM: To evaluate the hospital and long-term results of surgical treatment of patients with AS and a narrow fibrous ring who underwent Ozaki surgery or AV prosthetics with a biological prosthesis. MATERIALS AND METHODS: In total, 836 isolated Ozaki operations or combined interventions of this kind were performed at the Federal Center for Cardiovascular Surgery (Penza). This retrospective single-center study included 150 patients with critical AC (effective opening area ≤1 cm2) in whose surgical treatment tactics Ozaki surgery or prosthetics with a biological prosthesis were used. RESULTS: In the early postoperative period, group 1 patients had significantly lower values of the average and maximum gradients on the aortic valve and a larger area of the effective opening of the aortic valve. Also, in group 1 patients, the postoperative period of stay in intensive care is significantly higher, which is a consequence of the longer duration of the operation, the time of artificial circulation and myocardial ischemia. Long-term mortality is higher in the group with prosthetics of AV (Log Rank=0.006). Freedom from re-operation according to the analysis, there was no significant difference between the groups (Log Rank=0.226). CONCLUSION: Ozaki surgery demonstrates the best hemodynamic characteristics on AV in comparison with a biological prosthesis in patients with a narrow fibrous ring of AV in the early and long-term follow-up periods.

Experience through the Years. Standardized Patient and Accreditation

This study describes the results of a survey conducted among standardized patients of the regional federal accreditation center. The survey revealed the main difficulties in interacting with accredited patients, and also reflected the changes that occurred on the accreditation platform in the period from 2018 to 2024. Analysis of the data obtained will optimize the work of specialists and develop new approaches to training future doctors.

Technology of State Regulation of Regional Economy: A Systematic Approach

The article is dedicated to the examination of the issues pertaining to the development of a framework for the regulation of the regional economy at the state level. The object of the research is the process of state regulation of the regional economy. The focus of this research is an examination of the interrelationships between the state and regional economic development, with a particular emphasis on the role of state regulation in fostering regional economic growth. The purpose of the study is to form the technology of state regulation of the regional economy based on the criterion of synergy arising as a result of the interaction of legislative, executive, and control and supervisory activities by public authorities. The article elucidates the manner in which the technology of state regulation of the regional economy is constituted. It encompasses a number of structural elements, including state institutional policy, state regulatory policy, legislative activity, executive activity, control and supervisory activity, regional economic policy, and the economic environment. These elements function in concert to reconcile interests and enhance social reproduction and sustainable economic development. Such an approach to state regulation of the regional economy will expand the opportunities of the federal center to positively influence economic dynamics at the regional level, which will minimize the amplitude of fluctuations in the level of GRP and smooth out regional differences in economic and social development.

Evaluation of the Effectiveness of Training Using Simulation Equipment and Simulators for Midwives of Maternity Hospitals

For the purpose of professional growth and assignment of qualification categories in the profile "Obstetrics" additional professional education (advanced training programs and professional retraining programs) and training in simulation centers are included. The results of the effectiveness of the training of midwives of maternity hospitals in the specialty "Obstetrics" on the topic "Development of practical skills of the algorithm of actions in the diagnosis of moderate and severe preeclampsia in a pregnant woman and a woman in labor in a maternity hospital" in the federal accreditation center of the Far Eastern State Medical University are presented.

Progress and research trends in lumpy skin disease based on the scientometric assessment – a review

Abstract Background Lumpy skin disease (LSD) has been a significant concern in veterinary medicine since its discovery. Despite decades of research, understanding the full spectrum of this disease remains a challenge. To address this gap, a comprehensive analysis of the existing body of knowledge on LSD is essential. Bibliometric analysis offers a systematic approach towards the mapping of research landscape, identifying key contributors, and uncovering emerging trends in LSD research. Objective This study aims to conduct a thorough bibliometric analysis spanning from 1947 to till the present date in order to map the knowledge domain of LSD. The objective is to gain insights into the global research trends, identify influential contributors, explore collaboration networks, and predict future outlook in LSD research. Method Data extracted from the Scopus database was used to perform a bibliometric analysis. 341 relevant documents were selected for analysis. Bibliometric indicators, including publication numbers, citation counts, and the h-index, were utilized to assess the comprehensive contributions of nations, organizations, authors, and source titles. Additionally, cooperation networks between countries, organizations, and authors were visualized using the VOSviewer tool. Results The analysis revealed a significant increase in research output on LSD, with a notable growth rate of 19.26%. Since its discovery in Zambia in 1929, LSD research has grown steadily, with an average annual growth rate of 5.21%. The University of Pretoria and the Federal Centre for Animal Health emerged as the most active institutions and organizations in LSD research. The Journal of Virology was identified as the most cited journal, reflecting its significant impact on the field, and a strong international collaboration was observed between the United Kingdom and South Africa. Conclusion This study provides valuable insights into the global research landscape of LSD, highlighting key trends, contributors, and collaboration networks. By reviewing decades of research, this analysis enhances our understanding of LSD and serves as a foundation for future research endeavours. The findings of this study will aid researchers in navigating the vast literature on LSD, ultimately contributing to advancements in veterinary medicine and disease management strategies.

Tax potential of municipalities as the basis of regional budgets

In the Russian Federation (hereinafter referred to as RF, Russia), which is a federal state with a three-level budget system, it is assumed that there is tax potential at all levels: federal, regional, and local. With the help of taxes, the financial basis of local governments is formed and the socio-economic development of municipalities is ensured. In developed countries, municipal budgets are formed mainly from the taxes assigned to them. In Russia, they continue to remain the most problematic link in the country’s budget system. The purpose of the article is to study the influence of the taxes assigned to local budgets on the formation of the tax potential of the municipalities. Objectives are the following: analysis and assessment of revenues of the Russian local budgets in dynamics, justification of directions for increasing the tax potential. The methodological basis of the research is founded on a systematic approach, within which the following methods have been used: analysis and synthesis, generalisation, grouping, tabular method, etc. The research has found that over the past years, with the introduction of the Tax Code of the RF, problems of insufficient tax and non-tax revenues remain for most municipalities, low level of the tax potential and predominance of interbudgetary transfers in their budgets are current. Due to the increasing centralisation of the tax revenues, the degree of dependence of the municipalities on the federal centre is high. Without actually enhancing the tax potential of the municipalities, the development of the regional economy is impossible. The re -search results can be used in practice when developing economic policy for municipal development.

Определение селекционной ценности сортов и гибридов подсолнечника с помощью кластерного и факторного анализов

Abstract. The creation of highly productive sunflower varieties and hybrids adapted to the conditions of cultivation regions depends on the use of source material with high genetic diversity. The purpose of the study is to study the variability of agronomic characters in sunflower varieties and hybrids created in various breeding centers, their correlation, and to group genotypes according to a set of economically valuable indicators, using multivariate statistics methods. Methods. The research was carried out on the Right bank of the Saratov region on the experimental field of the Federal Center of Agriculture Research of the South-East Region in 2021–2023. The objects of research were varieties and new experimental hybrids bred by epy Federal Center of Agriculture Research of the South-East Region (31 varieties and hybrids) and V. S. Pustovoyt All-Russian Research Institute of Oil Crops (12 hybrids). To evaluate the breeding material, generally accepted methodological recommendations were used. Results. 43 varieties and hybrids of sunflower were assessed according to 8 agronomic characters. It was established a low degree of variability in yield (V=9.4%); as well as of plant height (V = 7.8 %); anthode diameter (V = 5.2 %); in unit (V = 5.3 %); and of oil content (V = 5.7 %). Average variability was revealed in the weight of 1000 seeds (V = 16.0 %); anthode area (V = 11.1 %); oil crop (V = 15.8 %). Correlation analysis made it possible to identify 8 significant connections at the 5.0 % level. High correlation coefficients were established between oilseed yield and unit (r = 0.7), as well as between anthode diameter and anthode area (r = 0.83). As a result of factor analysis, 8 characteristics were reduced to 5 factors (loading above 5.0 %) with a total variance of 90.95 %. Clustering by minimum Euclidean distances allowed the studied genotypes to be grouped into 10 clusters, including from 1 to 16 genotypes at the 33rd step. The identified clusters can be considered as independent groups for inclusion in the selection process. Scientific novelty. An attempt was made to group varieties and new experimental sunflower hybrids created in various breeding centers according to the similarities and differences of the main agronomic characters in the arid conditions of the Saratov region.

Scientific achievements in Siberian agriculture and their development

A historical review of the formation and development of scientific farming in Siberia is given. The main achievements of the leading research institutes of the region are highlighted. The contribution of Siberian scientists to the development of scientific farming, including its constituent directions, is shown. It presents almost 100 years of development of research on agriculture - from the Omsk experimental farm (XIX century), agricultural experimental stations - to modern federal scientific centers. The evolution of farming from individual crop cultivation techniques to the formation of zonal and then adaptive-landscape farming systems and modern agro-technologies is demonstrated. Examples of completed scientific developments on farming, ready for implementation in production, the number of which runs into thousands, are given. Implementation of knowledge-intensive agro-technologies guarantees grain production in Siberia up to 25-30 million tons, sustainable development of farming, stable food supply and high return on non-renewable resources. The evolution of plant protection from individual methods against the most dangerous pests to the formation of integrated systems that take into account the phytosanitary state of agrocenoses and agro-ecological conditions of agricultural crops cultivation is shown. The most important techniques to optimize the relationship between the crop and pests are the selection of plant species and varieties resistant to their effects, optimization of mineral nutrition of plants and sowing dates. At present, the development of scientific farming is associated with the design of adaptive-landscape farming systems, selection and support of agro-technologies, rational use of land resources, improvement of approaches to the conservation and reproduction of soil fertility, soil treatment systems, fertilizers and integrated plant protection, formation of adaptive crop rotations, research of technological and biological processes in the cultivation of crops, use of GIS-technologies, remote sensing, and the use of remote sensing.

Historical Prerequisites for the Formation of Legal Sovereignty of Russian Regions

The paper examines the theory of federalism in the political, administrative and territorial structure of the country. The collapse of the Soviet Union in the early 1990s caused the inclusion of the principle of national unity in the Constitution of the Russian Federation. The authors trace the dynamics of the division of powers between central and local authorities in Russia. The authors point out the importance of harmonizing the interests of the federal center and the regions, and the equal participation of all constituent entities of the Federation in state building as a guarantee of the unity of Russia. Building a competent balance in the distribution of powers between the federal center and the constituent entities of the Federation makes it possible to mitigate the contradictions that arise, which indicates the desire to ensure a balance of interests between the central government and the regions. The national authorities are working to increase the financial autonomy of the regions, giving them the right to exercise control over their funds. This approach, taking into account the differences in mentality, culture, and needs of the regions, allows for a flexible approach to the management of different constituent entities of the Federation. Increased attention to regional specifics is a vector of the policy of the modern Russian supreme power. The desire for a reasonable balance between the central government and the regions reflects the historical evolution of the Russian state structure towards genuine federalism.

Age-Related Development During Predictors and Clinical Neurodiagnostic Criteria of Cognitive Impairment in the General Medical Network

Background: prevalence, severity and heterogeneity of cognitive impairment in elderlies along with limited therapy options determine the relevance of the problem of timely diagnostics of cognitive disfunction. The purpose of this study is to identify a combination of the most informative patterns that allow a differentiated approach to the diagnosis of age-related cognitive impairment. Patients and methods: 213 patients were examined (99 patients 50–65 years old, 114 patients over 65 years of age) of “Federal Centre for High Medical Technologies” of Russian Ministry of Health (Kaliningrad). All patients complained for impaired mental performance, memory and attention. A neuropsychologic testing was conducted using next scales: Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS), Multidimensional Fatigue Inventory (MFI-20) and additional cognitive impairment tests. For statistical analysis, machine learning algorithms, Python programming language, and Pandas and SciPy libraries were used. Results: for patients in the 50–65 age category, high relevance was found for executive dysfunction, decreased attention span, fatigue, anxiety, and endocrine system disorders. For patients over 65 years of age, significant features were semantic aphasia, perceptual and memory impairment, hyperlipidemia, history of ischemic stroke, and obesity. A significant negative correlation for the age index was found with the parameters of depression and anxiety; a positive correlation was found with the index of physical asthenia, disorders of perception, memory and semantic processing of information. Conclusion: the results demonstrate prevalence of cognitive dysfunctions in elderly patients. The tests assessing visual perception and semantic information processing can be of interest in early degenerative cognitive impairments diagnosis in elderly age. Discriminant analysis of a wide range of age-related variables will allow to make more effective aging trajectories prediction without any time-consuming diagnostic methods.