Universal Criteria Research Articles

Peak VO2 is associated with cardiac functional response and long-term survival in patients with heart failure and atrial fibrillation undergoing catheter ablation

Abstract Background Contemporary guidelines recommend Catheter Ablation (CA) in patients with persistent Atrial Fibrillation (AF) with Heart Failure with reduced ejection fraction (HFrEF). It is challenging to prospectively predict who will respond. We have previously described the long-term survival outcomes of patients in this cohort.(1) However, the clinical characteristics associated with HF response and long-term clinical outcomes have not been reported. Objective To evaluate the association of HF parameters with cardiac functional response to CA and long-term survival after CA. Methods Post-hoc, long-term follow-up of mortality was undertaken in patients enrolled in the CAMTAF and ARC-HF RCTs. Both studies enrolled patients with persistent AF and HFrEF between 2005 and 2012 and randomised to first-time CA or medical therapy alone. Left ventricular ejection fraction (LVEF) and peak VO2 were measured in both studies at baseline and 12-month follow-up. The Universal Definition of HF response (LVEF improves by >10% points or to an LVEF >50%) was used.(2,3) Multi-variate logistic regression was used to determine features associated with HF response and Cox proportional hazards modelling for survival. Results 102 patients underwent randomisation with 52 assigned to CA. The mean age was 60.2 ±10.7 years with 93 (91.2%) male. The mean Baseline LVEF was 31 ±11% and peak VO2 was 1815 ±642mlmin-1. Baseline LVEF did not correlate significantly with Minnesota Living with Heart Failure (MLWHF) score (r=-0.11, p=0.29) whereas baseline peak VO2 did (r=-0.28, p<0.01). In patients randomised to CA, the median (IQR) improvement in LVEF was +8.4% (0, 15%). 22/52 (42.3%) patients were classified as Responders based on the Universal Criteria. Responders were younger (54.7 ±10.6 years vs 61.8 ±11.4, p=0.03) and had a higher mean HR on baseline Holter monitoring (89 ±14bpm vs 79 ±11bpm p<0.01) than non-responders. There was no significant difference in sex, baseline MLWHF scores, BNP levels or LVEF between groups (28±9% vs 31 ±9%, p=0.19). Responders had a significantly higher peak VO2 at baseline than Non-Responders (1972 ±668mlmin-1 vs 1556 ±580mlmin-1, p=0.03). On multivariate analysis, mean heart rate on Holter monitoring and peak VO2 were significantly associated with Responder status post-ablation. (Table 1a) During a median follow-up of 7.8 (3.9 –9.9) years, 34 (33.3%) patients died, including 17 (32.7%) patients in the CA arm. On univariate analysis, baseline peak VO2 was significantly greater of survivors at 5 years (1867 ±624 mlmin-1 vs 1259 ±497 mlmin-1, p<0.01). On multivariate Cox regression analysis, the peak VO2 at baseline was the only significant predictor of survival (Table 1b). Conclusion Peak VO2 at baseline was associated with baseline symptom status, the short-term LVEF response to CA and long-term survival and may be a useful stratification tool to aid patient selection for CA.1a. Regression for 6-month LVEF response1b. Regression for long-term mortality

Diagnosis of heart failure with preserved ejection fraction based on exercise stress echocardiography in real-world practice

Abstract Aims The diagnostic difficulty of heart failure with preserved ejection fraction (HFpEF) is related to the fact that many patients develop abnormal hemodynamics only during exercise. Exercise stress echocardiography is a first-line test to unmask such abnormalities, but exercise protocols and diagnostic criteria have not been established. It remains unclear how cardiologists diagnose HFpEF by exercise echocardiography in real-world practice. Methods and Results An international web-based survey was performed on 87 cardiologists, 59% of whom had ≥ 6 years of experience with exercise echocardiography. A retrospective cohort of 652 dyspneic patients who underwent exercise echocardiography was used to determine the impact of different diagnostic criteria on the proportion of HFpEF diagnosis. The most commonly used exercise echocardiography criterion for the HFpEF diagnosis was the HFA-PEFF algorithm (48%), followed by the ASE/EACVI criteria (24%) and some combinations of multiple parameters (22%). A retrospective study found that the proportion of HFpEF diagnosis varied substantially between the criteria used: 20.1% for the ASE/EACVI criteria and 44.3% for the HFA-PEFF algorithm. A survey demonstrated that 54% of the participating cardiologists would initiate sodium-glucose co-transporter 2 inhibitors based on exercise echocardiography results. Conclusion In real-world practice, exercise echocardiography criteria for HFpEF diagnosis vary among cardiologists. While many cardiologists consider initiating pharmacological treatment on exercise echocardiography results, the frequency of HFpEF diagnosis varies substantially depending on the diagnostic criteria used. The lack of universal diagnostic criteria may limit the delivery of evidence-based treatment to patients with HFpEF.

A Comprehensive Survey on Edge Data Integrity Verification: Fundamentals and Future Trends

Recent advances in edge computing (EC) have pushed cloud-based data caching services to edge; however, such emerging edge storage comes with numerous challenging and unique security issues. One of them is the problem of edge data integrity verification (EDIV), which coordinates multiple participants (e.g., data owners and edge nodes) to inspect whether data cached on edge is authentic. To date, various solutions have been proposed to address the EDIV problem, while there is no systematic review. Thus, we offer a comprehensive survey for the first time, aiming to show current research status, open problems, and potentially promising insights for readers to further investigate this under-explored field. Specifically, we begin by stating the significance of the EDIV problem, the integrity verification difference between data cached on cloud and edge, and three typical system models with corresponding inspection processes. To thoroughly assess prior research efforts, we synthesize a universal criteria framework that an effective verification approach should satisfy. On top of it, a schematic development timeline is developed to reveal the research advance on EDIV in a sequential manner, followed by a detailed review of the existing EDIV solutions. Finally, we highlight intriguing research challenges and possible directions for future work, along with a discussion on how forthcoming technology, e.g., machine learning and context-aware security, can augment security in EC. Given our findings, some major observations are: there is a noticeable trend to equip EDIV solutions with various functions and diversify study scenarios; completing EDIV within two types of participants (i.e., data owner and edge nodes) is garnering escalating interest among researchers; although the majority of existing methods rely on cryptography, emerging technology is being explored to handle the EDIV problem.

INFLUENCE OF DIGITAL TECHNOLOGIES ON THE DEVELOPMENT OF SOME ASPECTS OF THE THEORY OF CONSTITUTIONAL REGULATION OF RELATIONS IN THE REPUBLIC OF KAZAKHSTAN: PROBLEMS AND WAYS FOR IMPROVEMENT

In the article, the author, by analyzing various points of view, proposes theoretical and practical ways to improve such a complex phenomenon of constitutional and legal reality as constitutional regulation of social relations. Considering the dynamics of the development of digitalization products and the deepening of this process, as well as its impact on constitutional matter, the lack of unified universal criteria, the author considers it necessary to invite deputies of the Senate and Mazhilis of the Parliament of the Republic of Kazakhstan, judges of the Constitutional Court of the Republic of Kazakhstan, representatives of executive authorities, scientists to begin work on the popularization of constitutional terms reflecting the influence digitalization, initiate systematic work to include such a comprehensive document as the “Concept of constitutional regulation of the Republic of Kazakhstan”. According to the author, in addition to terms, it should also include a set of practical actions, in particular conducting constitutional monitoring, adding effective constitutional instruments such as constitutional incentives and constitutional permissions, etc. In practical terms, the concept of the development of constitutional regulation will allow us to formulate a holistic view of the directions of regulation of social relations, determine the areas of constitutional regulation, and the role of state bodies in this process. Specifying the goals, objectives, and stages of the sequence of measures that contribute to the development of constitutional regulation will ensure the improvement of constitutional regulation and will also solve several pressing problems - constitutional norms correspond to legal reality, would not allow for their arbitrary interpretation, and would establish uniform standards of behavior for subjects of legal relations. Understanding that this process will take more than one day, we note that in the opinion of the author, the state has all the necessary resources to carry out this work.

The mockery that confounds better treatment of confounding in epidemiology: The change in estimate fallacy

Confounding is one of the most infamous bugbears of epidemiology, used by some to dismiss the field's utility outright. The subject has received considerable attention from epidemiologists and the field boasts a remarkable arsenal for addressing the issue. However, it appears that there are still misconceptions about how to identify variables that cause confounding (a lack of exchangeability) in epidemiologic practice. In this commentary, I examine whether analysis of the properties of change-in-estimate method for identification of confounding, exemplified by two highly cited papers, has been appropriately cited in published reports and whether it was utilized to improve epidemiologic practice. I conclude that the myth that a change-in-estimate criterion of 10 % is legitimate for identifying confounding persists in epidemiological practice, despite having been discredited by several independent research groups decades ago. Speculations on possible solutions to this problem are offered, but my work's main contribution is identification of a problem of how methodological advances in epidemiology may be misapplied. There currently do not exist any universal criteria for identification of confounding! “Citation without representation” or biased presentation of conclusions of methodological research may be pervasive.

Influence of device configuration and noise on a machine learning predictor for the selection of nanoparticle small-angle X-ray scattering models

Small-angle X-ray scattering (SAXS) is a widely used method for nanoparticle characterization. A common approach to analysing nanoparticles in solution by SAXS involves fitting the curve using a parametric model that relates real-space parameters, such as nanoparticle size and electron density, to intensity values in reciprocal space. Selecting the optimal model is a crucial step in terms of analysis quality and can be time-consuming and complex. Several studies have proposed effective methods, based on machine learning, to automate the model selection step. Deploying these methods in software intended for both researchers and industry raises several issues. The diversity of SAXS instrumentation requires assessment of the robustness of these methods on data from various machine configurations, involving significant variations in the q-space ranges and highly variable signal-to-noise ratios (SNR) from one data set to another. In the case of laboratory instrumentation, data acquisition can be time-consuming and there is no universal criterion for defining an optimal acquisition time. This paper presents an approach that revisits the nanoparticle model selection method proposed by Monge et al. [Acta Cryst. (2024), A80, 202–212], evaluating and enhancing its robustness on data from device configurations not seen during training, by expanding the data set used for training. The influence of SNR on predictor robustness is then assessed, improved, and used to propose a stopping criterion for optimizing the trade-off between exposure time and data quality.

Preventive effects of first-generation antihistamine on emergence agitation or delirium: a systematic review.

The effects of first-generation antihistamines in preventing postoperative emergence agitation or delirium are unclear. Determining the postoperative effects of first-generation antihistamines may provide important insights into the management of patient safety. Therefore, we performed a systematic review of randomized controlled trials (RCTs) evaluating the efficacy and safety of postoperative first-generation antihistamines. Patients who used first-generation antihistamines in the intensive care unit or operating room were included. Primary outcomes were assessed postoperative emergence agitation or delirium with binary and continuous variables. The secondary outcome was any adverse event. Nine studies were included. The frequency of postoperative emergence agitation, measured using binary variables, tended to be lower in patients receiving chlorpheniramine or diphenhydramine than those receiving saline. However, evaluation using the Richmond Agitation-Sedation Scale as a continuous variable revealed that only chlorpheniramine was effective at lowering postoperative emergence agitation. Only one study assessed delirium but found no benefit of first-generation antihistamines. Adverse events for first-generation antihistamines did not differ from that of other drugs. Our results provide limited evidence that some first-generation antihistamines may prevent postoperative emergence agitation and are safe. To further verify this possibility, new RCTs with clear and universal assessment criteria for postoperative emergence agitation or delirium should be conducted.

Let the students be heard – student voices on teaching excellence awards

ABSTRACT Globally, academics are encouraged to facilitate teaching excellence. Many business schools use teaching excellence awards to recognize exceptional efforts toward students’ learning, foster pedagogical innovation, and improve faculty motivation. However, prior literature has noted that many business schools lack clear and transparent criteria for TE awards, which can hinder the process and potentially reduce the motivational effects. Research has yet to fully incorporate student voices across a global setting into the evaluation criterion. As a result, this study seeks to identify universal criteria for TE awards based on a large-scale survey of 2,775 business students across eleven countries and five continents intending to capture global student perspectives. First, we reveal whether the possession of a TE award for an educator has any importance from students’ perspectives. Second, we find that students across the globe have a general agreement regarding the criteria for awarding an excellent educator by identifying 30 criteria for TE awards students noted across our global sample. Third, we reveal 15 criteria that are specific to some countries but not globally. Lastly, we explore the differences in TE award criteria across different study levels. Overall, our study makes a significant contribution by identifying global criteria based on student voice to inform the development of teaching excellence award criteria in business education or by higher education providers and professional bodies.

Differences in Success Rate of Two-Stage Revision for Periprosthetic Joint Infection of the Knee Depending on the Applied Definition

BackgroundSuccess rates of two-stage exchange arthroplasty are subject to substantial variance in the literature. An explanation is the lack of a universally accepted definition of what constitutes treatment success for periprosthetic joint infection. Therefore, the main objective of this study was to assess success rates, applying four definitions to identify the one definition that best captures “true” success from both a clinical and patient-centered perspective. MethodsThis was a retrospective study investigating the outcome of a consecutive series of 78 chronic knee periprosthetic joint infections that were treated with a two-stage revision at a single center between 2017 and 2020. Kaplan-Meier survival analyses were conducted to estimate success rates. ResultsAfter a mean follow-up of 36 months (range, 25 to 60), 64 patients (82%) were reimplanted after a mean interim period of 90 days (range, 22 to 201). There was one patient (1%) lost to follow-up, and the overall mortality was 15% (n = 12). Kaplan-Meier survival analyses were used to estimate treatment success at two and three years: implant survival was 93% (95% confidence interval [CI]: 82 to 97) and 87% (95% CI: 73 to 94), infection control was 90% (95% CI: 79 to 95) and 87% (95% CI: 73 to 93), success according to Delphi criteria was 88% (95% CI: 78 to 94), and success according to Musculoskeletal Infection Society criteria was 65% (95% CI: 53 to 74) at both timepoints. ConclusionsSuccess rates were ranging between 65 and 93% depending on the applied definition, highlighting the need for universal success criteria. This variability mainly results from the differing approaches to patients who did not undergo reimplantation or passed away within a year of surgery. These patients exemplify cases of fatal treatment failures. Consequently, the Musculoskeletal Infection Society criteria should be routinely employed to accurately report the “true” success rate.

“To BAL or not to BAL, that is the question”: Variations in smoke inhalation injury guidelines from burn units and centres in England, Scotland and Wales

AimTo evaluate variations in diagnostic criteria and management recommendations for smoke inhalation injury (SII) amongst the burn networks of England, Scotland, and Wales. MethodsA descriptive cross-sectional study examining SII guidelines provided by adult burn units and centres in England, Scotland and Wales. ResultsAll 16 adult burn units and centres responded. Fourteen (87.5 %) had guidelines. Due to sharing of guidelines, ten unique guidelines were assessed. Diagnostic criteria showed variability with no universal criterion shared amongst guidelines. Bronchoscopy was recommended by 90 % of guidelines, but the timing varied. The use of bronchoscopic scoring systems was recommended by four guidelines. Bronchoalveolar lavage (BAL) was recommended by four, with considerable variation in frequency and choice of lavage fluid. All guidelines advised at least one nebulised agent: heparin (n = 8); N-acetyl cysteine (NAC) (n = 8); or salbutamol (n = 8). All guidelines included advice on carbon monoxide poisoning; however, carboxyhaemoglobin (COHb) cut-off levels for treatment varied (5 % [n-4], 10 % [n = 3], 15 % [n = 1]). All recommended high-flow oxygen. Seven (70 %) guidelines offered guidance on cyanide poisoning. Reduced/altered consciousness was the only consistent diagnostic criterion. Five (50 %) guidelines provided intubation guidance, emphasising the role of a ‘senior clinician’ as the intubator. Ventilatory guidance appeared in eight guidelines, focusing on lung protective ventilation (n = 8); oxygenation goals (n = 3); and permissive hypercapnia (n = 3). Within lung-protective ventilation, advice on tidal volume (6, or 6–8 ml/kg) and plateau pressures (>30 cmH2O) were presented most commonly (n = 7). ConclusionThis study has outlined the substantial variations in guidance for the management of SII. The results underscore the need for a national guideline outlining a standardised approach to the diagnosis and management of SII, within the limitations of the current evidence.

Universal testing in endometrial cancer in Sweden

BackgroundThe aim of the study was to test a universal screening strategy on endometrial cancer to evaluate its effectiveness to find Lynch Syndrome (LS) cases to two established clinical criteria: Amsterdam II criteria, and the revised Bethesda criteria to select cases for prescreening with immunohistochemistry (IHC). Cases were subsequently screened for germline disease causing variants regarding the DNA mismatch repair (MMR) genes.MethodsIHC was performed on 221 endometrial cancer (EC) cases, using antibodies against the DNA mismatch repair proteins MLH1, PMS2, MSH2, and MSH6. MMR loss was found in 54 cases, and gene mutation screening was undertaken in 52 of those.ResultsIn this set of patients, the use of Amsterdam II criteria detected two (0.9%), the Bethesda criteria two (0.9%), and universal testing five (2.3%) cases of LS. The combination of universal testing and family history criteria resulted in detection of five patients (2.3%) with LS.ConclusionsBased on our results and other similar studies to date we propose a screening protocol for LS on EC tumors with prescreening using IHC for the four MMR proteins on all new EC cases diagnosed before 70 years of age, followed by mutation screening of all tumors with loss of MSH2 and/or MSH6 or only PMS2, plus consideration for mutation screening of all LS genes in cases fulfilling the clinical Amsterdam II criteria regardless of MMR status on IHC.

Combined Organ Transplantation in Patients with Advanced Liver Disease.

Transplantation of the liver in combination with other organs is an increasingly performed procedure. Over the years, continuous improvement in survival could be realized through careful patient selection and refined organ preservation techniques, in spite of the challenges posed by aging recipients and donors, as well as the increased use of steatotic liver grafts. Herein, we revisit the epidemiology, allocation policies in different transplant zones, indications, and outcomes with regard to simultaneous organ transplants involving the liver, that is combined heart-liver, liver-lung, liver-kidney, and multivisceral transplantation. We address challenges surrounding combined organ transplantation such as equity, utility, and logistics of dual organ implantation, but also advantages that come along with combined transplantation, thereby focusing on molecular mechanisms underlying immunoprotection provided by the liver to the other allografts. In addition, the current standing and knowledge of machine perfusion in combined organ transplantation, mostly based on center experience, will be reviewed. Notwithstanding all the technical advances, shortage of organs, and the lack of universal eligibility criteria for certain multi-organ combinations are hurdles that need to be tackled in the future.

Имущественная обособленность как признак юридического лица: теория и практика (по страницам классики и судебных актов)

The authors consider the essence of the concept of ‘property isolation of a legal entity’, different approaches to the definition of property isolation are given and analysed. The authors conclude that property isolation is characteristic not only of legal entities, but also of individuals and contractual associations, while for legal entities the value of property isolation is high, due to the fact that it allows to participate in turnover and bear property responsibility. Since the degree of property isolation of different types of legal entities differs, the authors propose the respective classification of legal entities. The authors conclude that there are no universal criteria of property isolation for civil, criminal, administrative and other forms of legislation. Thus, direct application of concepts and rules of civil legislation on property isolation to the areas of public law is unreasonable.

Rethinking the Effectiveness of Objective Evaluation Metrics in Multi-Focus Image Fusion: A Statistic-Based Approach.

As an effective technique to extend the depth-of-field (DOF) of optical lenses, multi-focus image fusion has recently become an active topic in image processing community. However, a major problem remaining unsolved in this field is the lack of universal criteria in selecting objective evaluation metrics. Consequently, the metrics utilized in different studies often vary significantly, leading to high difficulties in achieving unbiased evaluation. To address this problem, this paper proposes a statistic-based approach for verifying the effectiveness of objective metrics in multi-focus image fusion. The core idea is to adopt statistical correlation measures to evaluate the performance consistency between a certain fusion metric and some popular full-reference image quality assessment models. In addition, a convolutional neural network (CNN)-based fusion metric is presented to measure the similarity between the source images and the fused image based on the semantic features at multiple abstraction levels. A comparative study is conducted to evaluate 20 existing fusion metrics using the proposed statistic-based approach on a large-scale, realistic and with-ground-truth multi-focus image fusion dataset recently released. Experimental results demonstrate the feasibility of the proposed approach in evaluating the effectiveness of objective metrics and the advantage of our CNN-based metric.

Mid-Flexion Instability in Total Knee Arthroplasty: Insights from Robotic-Assisted Surgery

Despite technological advancements with robotic-assisted surgery, instability remains a challenge in total knee arthroplasty (TKA). Mid-flexion instability (MFI) has been reported to cause patient dissatisfaction. With no universal diagnostic criteria, the MFI concept is still ambiguous, and no specific treatment algorithm is defined. This study aims to analyze the MFI concept and risk factors and investigate how robotic surgery, compared to manual TKA, could impact the MFI concept. A comprehensive investigation of the current literature regarding MIF, focusing especially on its relationship with robotic surgery TKA, was conducted using the PubMed and Scopus databases. The MIF concept remains poorly understood, so it is crucial to prevent it by recognizing risk factors, which are technique-related, implant-related, and patient-related. Since robotics offers optimal balancing in TKA and reduces causes affecting MFI, it could indirectly impact and prevent this complication. This review suggests that robotics utilization improving TKA balancing has the potential to impact and reduce MFI. However, further research in this area is essential to provide insight regarding the role of robotics in mitigating the MFI risk.

Tackling residual tensile stress in AlN-on-Si nucleation layers via the controlled Si(111) surface nitridation

This work is devoted to the study of the influence of controlled Si(111) surface nitridation on the epitaxial growth of AlN-on-Si nucleation layers with reduced tensile stress on ordered crystalline silicon nitride phase. The Si(111) surface nitridation process was performed at low ammonia flux and substrate temperatures in the range of 700–900 °C and was studied using RHEED and STM techniques. A universal criterion, namely the stage of the nitridation process completion is introduced, taking into account the influence of substrate temperature, ammonia flux and nitridation time. The 100 nm AlN nucleation layer on silicon substrates grown by ammonia molecular beam epitaxy is studied using AFM, XRD, HR-TEM and Raman spectroscopy techniques. The Raman data show that reducing the nitridation temperature from 900 °C to 700 °C not only deteriorates the crystalline quality of the subsequent AlN nucleation layers, but also reduces the residual tensile stress by almost 30 %. In the present contribution, micro-Raman spectroscopy is used to determine the nature of the defects formed during the high temperature growth of the AlN nucleation layers and confirms them to be inversion domains. The HR-TEM technique was used to study the AlN/Si interface in AlN-on-Si nucleation layers grown on a nitridated silicon surface at 700 °C and 900 °C at the optimum stage of the nitridation process completion. HR-TEM images of AlN nucleation layers revealed regions with different AlN/Si(111) interfaces: 1) AlN/amorph-Si3N4/Si, 2) AlN/SiN(8 × 8)/Si, and 3) AlN/Si with a sharp interface boundary. Using fast Fourier transform image analysis, it is shown that the presence of amorphous Si3N4 phase inclusions in the AlN/Si interface boundary introduces tensile stresses in the AlN nucleation layer which can be reduced by lowering the nitridation temperature. The results obtained clearly show that one of the causes of cracks in III-nitride layers grown on silicon substrates is the formation of tensile AlN layers with a high content of the amorphous Si3N4 phase at the AlN/Si interface, which is characteristic of silicon nitridation at elevated temperatures (> 700 °C).

How to diagnose heart failure with preserved ejection fraction.

Heart failure with preserved ejection fraction (HFpEF) is a major healthcare problem that is raising in prevalence. There has been a shift in HpEF management towards early diagnosis and phenotype-specific targeted treatment. However, the diagnosis of HFpEF remains a challenge due to the lack of universal criteria and patient heterogeneity. This review aims to provide a comprehensive assessment of the diagnostic workup of HFpEF, highlighting the role of echocardiography in HFpEF phenotyping.

Методические подходы к измерению общественного и индивидуального здоровья как медико-социального ресурса и потенциала общества.

One of the main indicators in healthcare is public and individual health. However, despite a comprehensive, in-depth and long-term study of the theoretical component of «health», there is still a need to define its universal and effective criteria, methodological approaches to measuring public and individual health as a medical and social resource and the potential of society. The purpose to analyze the published data in the scientific literature on methodological approaches to measuring public and individual health as a medical and social resource and the potential of society. Research methods. The collection, study and analysis of available information sources in the scientometric databases WoS, Scopus included in the list approved by the Higher Attestation Commission under the Ministry of Education and Science of the Russian Federation. The search for scientific articles was carried out in the electronic databases PubMed, Google Scholar, eLibrary.RU by keywords. 47 articles were included in the review for analysis. The results of the study. The analysis of the literature data has shown the need to systematize and adapt existing methods of assessing public and individual health into a single multi-level assessment system. Indicators of public and population health should reflect all aspects of the well-being of the population. This is evidenced by the published data on measuring instruments, which have shown their effectiveness, but have a disadvantage – the lack of complexity, or the complexity claimed in the research is not complete. Conclusion. Currently, there is a whole arsenal of methodological approaches to measuring public and individual health. To assess it as a medical and social resource and the potential of society, the use of individual indicators does not allow a comprehensive assessment of public health, in addition, the lack of monitoring of an integrated assessment of public health makes it difficult to apply operational management decisions in the field of healthcare.

DEVELOPMENT STRATEGY FOR THE SCIENTIFIC EDITION “RUSSIAN JOURNAL OF EDUCATION AND PSYCHOLOGY”

Background. Russian scientific journals joined the international market of scientific publications quite late, which actualises the development of a strategy for entering this market and complicates the realisation of the strategy as such in the environment of tough competition on the part of experienced and stable players thereof. Purpose. The purpose is to elaborate a strategy for the development of the “Russian Journal of Education and Psychology” for its introduction to the international market. Materials and methods. The research sources are represented by statutory acts, statistical materials and results of the author’s empirical research. The research is based on the systemic approach; the strategy of the journal is based on the ideas of the positioning school; the main method of business planning is economic analysis. Results. The growth of competition in the domestic market, along with the gradual approximation of the Russian scientific journals evaluation system to the global practice and the universal quality criteria, proved to be the conditions inspiring the change in the strategy of the scientific edition “Russian Journal of Education and Psychology”. The detailed analysis of the internal and external environment of the journal made it possible to form a self-contained range of strategic alternatives among which the entry to the international market was the most appropriate way to meet the objectives of the publishing house and the interests of the proprietor (who is also the project customer). Securing the journal’s work in accordance with the requirements of the international scientometric databases, for its inclusion in the Scopus and (or) Web of Science, became a new strategic goal of the journal. The new goal changed the concept and mission of the journal with regard to the customer’s wish to preserve the edition’s traditional values. Changes in marketing and peer reviewing were identified as the main transformation areas for which new functional strategies were developed. The overall project plan envisages the solution of other targets as well, but it is the tasks connected with the journal distribution and the change in the work of the editorial board and in the business aspects of reviewing that became extremely significant in terms of their timing and involved financial costs. The project team comprising current employees is supposed to cope with possible risks with respect to project completion time, while the financial resources of the publishing house will allow it to overcome the financial risks of the project without any assistance. Even in case of failure to achieve the strategic goal, due to its high risk, the journal’s key performance indicators will be improved through the increased share of high-quality articles; by optimising and tightening the review process, active promotion of the journal in the national and foreign markets; by attracting a numerous audience (authors, readers) and expanding the number and diversity of stakeholders.

Frege on Identity and Identity Statements: 1884/1903

ABSTRACT In this essay, I first solve solve a conundrum and then deal with criteria of identity, Leibniz's definition of identity and Frege's adoption of it in his (failed) attempt to define the cardinality operator contextually in terms of Hume's Principle in Die Grundlagen der Arithmetik. I argue that Frege could have omitted the intermediate step of tentatively defining the cardinality operator in the context of an equation of the form ‘NxF(x) = NxG(x)'. Frege considers Leibniz's definition of identity to be purely logical, although without saying why it is in line with his logicist project. I argue that the universal criterion of identity that Frege takes from Leibniz's definition and the specific criterion of identity for cardinal numbers embodied in Hume’s Principle (namely equinumerosity) work hand in hand in the tentative contextual definition of the cardinality operator. Yet the interplay between the two criteria is powerless to prevent the emergence of the Julius Caesar problem, let alone suggests how it could be solved. The final explicit definition of the cardinality operator that Frege sets up still rests on the identity criterion of equinumerosity since cardinal numbers are defined as equivalence classes of that relation.