Introduction: Colorectal cancer occupies leading positions in terms of morbidity and mortality rates among malignant neoplasms and, according to recent research findings, no trend towards a decrease in its prevalence is predicted. Colorectal cancer is one of the tumors for which the effectiveness of population-based screening has been demonstrated. In 2023, the population screening model is used in 10 constituent entities of the Russian Federation.

Objective: To develop a regional model of a system for early diagnosis of colorectal cancer as part of the clinical examination of certain groups of the adult population based on the analysis of colorectal cancer screening organizational patterns.

Materials and methods: We examined the system for early diagnosis of colorectal cancer in primary health care, analyzed statistical reporting data and the contents of fifteen regulations guiding screening within the clinical examination of certain groups of the adult population.

Results: Given the high prevalence of colorectal cancer in the Sverdlovsk Region, a pilot project for colorectal cancer screening to be conducted as part of the clinical examination of certain groups of the regional adult population has been developed. It included creation of the regulatory framework, choice of participating health facilities, approval of an algorithm for examining certain groups of adults aged 40 to 75 years, selection of effectiveness criteria for the screening tests, as well as the planned number of tests, groups of the adult population subject to screening, and the frequency of the latter. Coordination functions were assigned to the intermunicipal medical center entrusted to centralize laboratory testing, provide methodological support for the pilot project implementation, collect and analyze statistics from all project participants.

Conclusion: Introduction of screening programs aimed at early diagnosis of malignancies allows elaboration of new techniques and mechanisms for their implementation by means of pilot studies, enabling replication of successful projects in regional health facilities and, in the long term, obtaining an overall cumulative effect of sustainable positive changes.

Introduction: The article describes a methodological approach to elaborating the public health quality index used to reflect the true size of the medical and social resource of the society. The method of calculation takes into account both social and medical components. The public health quality index is calculated in accordance with the idea that a certain category of people has more opportunities to perform a social function. The proposed approach makes it possible to move from general assessments of public health to true ones.

Objective: To develop a methodological approach to calculating the public health quality index.

Materials and methods: To calculate the public health quality index, age ranges of people were selected, considering their physical fitness to perform social functions. To improve the accuracy of the assessment, each social function was weighted by systematizing expert assessments. The calculated Kendall concordance coefficient (0.7) demonstrated a high degree of expert consistency. The index was calculated considering recommendations of “The Urban Health Index: A Handbook for its Calculation and Use” (2014) by the World Health Organization.

Results: According to expert opinions, the most significant social function is the ability of fertile women to realize their reproductive function while the least significant is the ability of elderly people to continue working in the next 5 years after retirement. The aspect related to the ability of men to reproduce has been also considered of great importance.

Conclusion: During the study, the question was raised about the possibility of clarifying the methodology for calculating the public health index given the goals of public administration. This index should be considered as a monitoring tool available in the current period to counter emerging public health challenges.

Introduction: A rapid development of artificial intelligence software, including that for the analysis of digital fluorography images, has been noted recently. Pre-registered as a medical device, this software can be used for stand-alone analysis and triage of test results, allowing radiologists to focus on pathological findings.

Objective: To substantiate the possibility and efficiency of using artificial intelligence software for stand-alone analysis and triage of digital fluorography images.

Materials and methods: 88,048 digital fluorograms obtained in the first quarter of 2023 were processed using the artificial intelligence software registered in the Russian Federation as a medical device and a ROC analysis of the findings was carried out.

Results: We established that default software settings with the sensitivity of 90.4 % (95 % CI: 88.2–92.7) produced specificity of 75.5 % (95 % CI: 75.2–75.8) and accuracy of 75.6 % (95 % CI: 75.3–75.9). At the maximum sensitivity of 100.0 % (95 % CI: 100–100), specificity was 77.4 % (95 % CI: 74.8–80.0) and accuracy was as high as 77.9 % (95 % CI: 75.3–80.5). We have proposed a model of organizing health care which provides for stand-alone sorting of fluorography images by the software, saving normal results without their verification by a radiologist, and sending images with abnormal findings to a radiologist for diagnosis (in the future, as artificial intelligence improves, the latter will be immediately sent to a physician of the clinical specialty).

Conclusions: The established optimal scenario includes the use of artificial intelligence software to identify normal findings, which examination by a radiologist is optional when the algorithm is set to maximum sensitivity. Only the findings classified as abnormal will be subject to mandatory revision. The annual economic benefit gained by practical implementation of this approach nationwide can reach 5.6 billion rubles.

Introduction: The urgency of the problem of acute chemical poisoning is attributed to the fact that it is the cause of poor health, disability and premature death of the population, as well as a significant medical and socio-economic damage.

Objective: To conduct a retrospective and prospective epidemiological study of acute chemical poisoning based on the results of toxicological monitoring in the city of Taganrog for 2008–2022.

Materials and methods: We carried out a comprehensive analysis of statistical reporting forms and a personalized database of 2,466 cases of acute chemical poisoning registered in the city of Taganrog, Rostov Region, in 2008–2022. To do this, we used software of our own design and professional software packages IBM SPSS Statistics version 19.0 and Matlab R2021a with a set of tools for synthesizing and analyzing neural networks Neural Network Toolbox.

Results: Over the 15-year period under study, trends towards a decrease in the rates of acute chemical poisoning, mortality and lethality had formed, as confirmed by a favorable assessment of the situation based on regional criteria and actual risk indicators. Alcohol surrogates, pharmaceutical drugs, and carbon monoxide remain the priority etiological causes of poisoning. Relatively high rates were observed among children aged 0–6 not attending preschools and schoolchildren aged 7–17, as well as among the unemployed and pensioners, which allowed us to attribute them to risk groups. High accuracy of forecasts generated using artificial neural networks has been confirmed.

Conclusion: The results of toxicological monitoring are the basis for assessing the situation and optimizing toxicological care, both necessary for managerial decision-making and elaboration of targeted chemical safety programs.

Introduction: Nowadays vaccination is the most effective, safe and cost-effective means of preventing infectious diseases. Along with the obvious successes of vaccination, there are problems in its organization, often associated with compliance of both parents and medical workers.

Objective: To establish commitment to vaccination among parents and healthcare professionals at children’s polyclinics and the main barriers to vaccination.

Materials and methods: In February–March 2022, we conducted a questionnaire-based survey of 226 parents and 184 medical workers based on educational institutions and children’s polyclinics of the city of Ivanovo and the region. The sampling was targeted and conducted in gathering places. The collected data were then analyzed using SPSS version 12.0.

Results: The study showed poor parental adherence to vaccination. The main barriers to vaccination among them were disbelief in vaccination efficacy, the opinion that commercial interests of pharmaceutical companies prevail, imaginary concerns about safety of vaccination, distrust of the population in certain vaccines, and poor commitment to vaccination against certain infections. At the same time, the overwhelming majority of the health professionals surveyed supported vaccination and reported such major barriers to vaccination as an increasing number of children with chronic diseases not covered by vaccination, medical advice to refuse vaccination, and the anti-vaccine activism.

Conclusion: It is important to promote adherence to vaccination of both parents and medical workers. The primary task is to eliminate the lack of information about the efficacy and safety of immunization in children using all possible information and educational resources.

Introduction: It is important to assess health impact of the entire set of heterogeneous risk factors and identify the key ones in order to develop personalized measures for prevention of non-occupational diseases in workers.

Objective: To establish the major risk factors for circulatory and musculoskeletal disorders in employees of a metallurgical enterprise.

Materials and methods: We used anonymized data from a special assessment of working conditions and production control of the forging departments of the forging-rod and forging-press shops of a metallurgical enterprise producing titanium alloys for the years 2016–2020. To determine the presence of personal biological and behavioral risk factors for diseases of the circulatory and musculoskeletal systems, we examined anonymized data of the periodic medical check-up conducted in 2020 of 146 male blacksmiths working with hammers and presses. The mean age of the workers was 35.9 ± 8.8 years (range: 21 to 57 years) and their mean length of current employment was 18.9 ± 9.7 years (range: 2 to 41 years). The method of simple and multiple logistic regression was used to build models for predicting the likelihood of a disease; odds ratios were calculated with a 95 % confidence interval. The quality of the models was assessed using the maximum likelihood estimation.

Results: We determined the factors allowing prediction of the disease likelihood. The prevalence of circulatory diseases correlated with age, length of employment, and the body mass index, whole-body and hand-arm vibration, noise exposure, high ambient temperature, thermal radiation, and heavy physical work. The prevalence of musculoskeletal diseases, in its turn, had a somewhat weaker statistically significant association with the same risk factors. Models predicting the likelihood of circulatory and musculoskeletal diseases have been built. The best predictive model for circulatory diseases included the combined effect of the body mass index and heavy physical work while that for musculoskeletal disorders – of the body mass index and hand-arm vibration.

Conclusion: Multiple logistic regression used to analyze statistical relationships between work-related risk factors and disease prevalence in employees in specific occupations allowed identification of the leading factors contributing the most to the disease development and can be recommended for solving practical problems in occupational medicine.

Introduction: Trace elements are involved in brain functioning, ensuring basic neurochemical processes in the central nervous system and neuropsychological functions. Trace element deficiency is a challenge in northern regions, where acclimatization- related lack of many essential elements is aggravated by adverse health effects of a combination geochemical and anthropogenic factors.

Objective: To establish relationships between the elemental profile of the body and some psychophysiological characteristics of young residents of the continental part of the Magadan Region as a model presumably healthy part of the population.

Materials and methods: Fifty-five lyceum students, including 25 girls and 30 boys (mean age = 17.6 ± 0.25 years), living in the town of Susuman, Magadan Region, were examined. Concentrations of 25 trace elements (Al, As, B, Be, Ca, Cd, Co, Cr, Cu, Fe, Hg, I, K, Li, Mg, Mn, Na, Ni, P, Pb, Se, Si, Sn, V, and Zn) were measured in hair samples of the subjects using inductively coupled plasma atomic emission spectrometry (ICP-AES). Psychophysiological indicators were examined using the NS-Psychotest hard & software unit. The I.N. Gurvich questionnaire was applied to study neuropsychic adaptation (NPA) and anxiety levels were determined using the Spielberger-Hanin test.

Results: The correlation analysis showed the highest number of links between lithium and psycho-functional variables in all students, which is consistent with the opinion of experts on the role of this element in reducing neurological manifestations, stress, and depression. The female group demonstrated relationships between the indicator of situational anxiety and those of the functional state of the central nervous system: functionality level (r = –0.56), reaction stability (r = –0.63), and functional ability level (r = –0.61), p < 0.01. Cluster analysis was represented by four clusters, the largest of which included calcium and indicators of velocity of neural responses, the second – indicators of alexithymia, potassium, sodium, magnesium and phosphorus, the third grouped zinc and velocity of a simple visual motor response, and the fourth combined indicators of a simple visual motor response and choice reaction.

Conclusion: The survey revealed a higher risk of neurotic disorders, cognitive impairment, and chronic stress in the adolescents against the background of the region-attributed deficiency in such trace elements as manganese, iodine, cobalt, and selenium and high levels of iron and silicon. Endemic hypothyroidism and diabetes mellitus are likely to develop with age in northerners due to high frequency of thyroid-specific bioelement deficiencies and disorders of chromium and vanadium metabolism.

Introduction: The incidence of respiratory diseases continues to increase annually, causing significant harm to health of the population. Respiratory diseases are induced by a variety of viral and bacterial pathogens and are one of the most common disease categories observed in humans.

Objective: To assess respiratory disease incidence rates in military personnel and to establish contributions of viral and bacterial etiological agents.

Materials and methods: During the epidemic season of 2022–2023, we evaluated the incidence and causes of respiratory diseases in military personnel based on a representative sample of 153 conscripts treated in a military health facility. Respiratory pathogens were detected by real-time polymerase chain reaction.

Results: Viral respiratory infections (63.4 %) and community-acquired pneumonia (26.8 %) were mainly diagnosed in the subjects. Among the causes of single virus respiratory infections (54.2 ± 5.5 %), adenovirus prevailed (84.4 ± 5.4 %) while other respiratory viruses, such as rhinoviruses and influenza B (4.4 ± 3.1 % each), SARS-CoV-2, parainfluenza, and coronaviruses (2.2 ± 2.2 % each) were registered in few cases. The main causative agents of lower respiratory infections (45.8 ± 5.5 %) were S. pneumoniae (63.2 ± 7.8 %), Chlamydophila pneumoniae (21.1 ± 6.6 %), and Mycoplasma pneumoniae (15.8 ± 5.8 %). Among mixed viral-bacterial infections community-acquired pneumonia (34.1 ± 7.4 %) was the most frequent.

Conclusions: Viral pathogens prevailed over bacterial ones in the etiology of diseases of the respiratory system in the servicemen. The main causative agents of respiratory infections were adenovirus and S. pneumoniae.

Introduction: Acute intestinal infections are amongst the most important health concerns worldwide. The majority of them are caused by viruses spread through environmental objects contaminated with feces. A high incidence of intestinal infections is registered annually in the Far Eastern Federal District of the Russian Federation. Over 50 % of cases of established etiology are induced by rota- and noroviruses. Moreover, outbreaks of viral intestinal infections are registered annually in almost all regions of the Far Eastern Federal District, including the Khabarovsk Krai.

Objective: To analyze the incidence of acute intestinal infections and the results of molecular genetics testing of intestinal viruses that caused the outbreaks in the Khabarovsk Krai in the year 2022.

Materials and methods: We used epidemiological and statistical methods to analyze the incidence and conducted molecular genetics testing of samples obtained from patients with acute intestinal infections and their contacts in the foci of the disease in the Khabarovsk Krai.

Results: The acute intestinal infection situation in the Khabarovsk Krai in 2022 was unfavorable. The regional incidence rate was 20.6 % higher than that in the Far Eastern Federal District, with most diseases induced by intestinal viruses and numerous outbreaks registered. Our epidemiological investigation of six outbreaks revealed the fecal-oral transmission route of infection through contaminated food, household contacts and, probably, water. Molecular genetics testing of the causes of outbreaks showed circulation of norovirus genotypes GII.4Sydney[P16], GII.4Sydney[P31], GII.17[P17], and GII.6[P7] as well as rotavirus A genotypes G9P[8], G4P[8] and G3P[8] in the Khabarovsk Krai. Some of the identified norovirus genotypes had already caused outbreaks in the Khabarovsk Krai: GII.17[P17] – back in 2015 among the population of the Mnogovershinny village, GII.6[P7] – in the years 2018 and 2019 in the city of Khabarovsk, thus indicating long-term circulation of these genotypes.

Conclusion: Surveillance over changes in genetic diversity of the viral population is required to evaluate contribution of various gene variants of rota- and noroviruses to the incidence of acute intestinal infections. In this regard, molecular typing of rota- and noroviruses should be performed not only when investigating disease outbreaks, but also when sporadic cases are registered.

Introduction: The review presents the results of a retrospective analysis of the incidence of cholera and the prevalence of Vibrio cholerae in environmental media on the territory of the Donbass Region, Zaporozhye and Kherson Regions.

Objective: To do a retrospective analysis of the cholera epidemiological situation in the Donbass Region, Zaporozhye and Kherson regions, and border areas during the seventh pandemic and to assess risks of importation and spread of the disease.

Materials and methods: We examined topical articles published in peer-reviewed journals and data of the Reference Center for Cholera Monitoring for 1970–2023. The SNP analysis used whole genome sequences of V. cholerae O1 strains, NCBI and ENA databases, UPGMA and ML algorithms, author’s software, and MEGA 5.

Results: We established historic cholera outbreaks in the Donbass Region (Donetsk and Lugansk People’s Republics, former Donetsk and Lugansk regions), Zaporozhye and Kherson regions caused by the infection imported from endemic countries and its spread by water and food. The highest cholera incidence rates were registered in the 1970s and 1990s; the most recent outbreak was documented in the year 2011. In 1989–2022, 490 V. cholerae O1 strains, including 51 toxigenic ones, were isolated from water bodies in the Donetsk People’s Republic (the former Donetsk Region), 8 strains (2) in the Lugansk People’s Republic (the former Lugansk Region), 183 (6) in Zaporozhye, and 66 (51) in the Kherson Region. Toxigenic strains represented a heterogeneous group due to multiple imports of the pathogen. We revealed similarity of genotypes of V. cholerae strains isolated from environmental media in certain areas over several years, which indicates the presence of climatic and social conditions for preservation and development of local populations of cholera vibrios.

Conclusion: The current cholera situation in the Donbass Region, Zaporozhye and Kherson regions is stable. Due to the present-day emergency and infrastructure conditions, high risks of cholera importation from endemic and adjacent territories and spread of this infectious disease through water persist, thus necessitating regular and systematic monitoring of cholera in these regions and strict implementation of all measures envisaged for type I territories in terms of epidemic manifestations of cholera.

Introduction: Cholera lytic phages contribute to the genetic diversity and evolution of Vibrio cholerae. To protect against the phages, the pathogen has acquired various resistance mechanisms.

Objective: To identify antiphage systems located on mobile genetic elements in V. cholerae serogroup O1 El Tor biotype strains.

Materials and methods: Nucleotide sequences of complete genomes of 77 toxigenic V. cholerae O1 El Tor strains imported to the Russian Federation and neighboring countries in 1970–2014 were analyzed using the Blast NCBI GenBank algorithm and REALPHY online tool.

Results: We observed that the examined strains contained two types of anti-phage systems in hotspot 5 of the ICE SXT element: BREX, common for ICE VchBan9, and BREX with Abi typical of ICE VchInd5. We established a direct relationship between the presence of the PLE4 antiphage island and the kappa phage. V. cholerae O1 El Tor strains containing PLE4, except for one isolate, have BREX ICE VchBan9 and are grouped into a separate cluster in phylogenetic analysis. Strains with ICE VchInd5 lacking PLE4 and kappa phage also form a separate group.

Conclusions: The data obtained on the presence of antiphage systems in previously imported strains of V. cholerae O1 biotype El Tor expand knowledge of their genetic organization. The study of the structure of antiphage genes of hotspot 5 of the ICE SXT element makes it possible to reveal genetic differences between closely related strains of V. cholerae O1 biotype El Tor and to determine the type of ICE SXT element.