Introduction. Cardiovascular diseases (CVD) continue to lead among all causes of death in the world. The CVD incidence in countries continues to rise, despite existing containment strategies applied at various levels, including individual and country-based.

The purpose of the study. To analyze the CVD incidence in populations across the world from 1990 to 2021.

Materials and methods. Data were sourced from the online publication “Our World in Data.” Countries were grouped by disease incidence level using quartile division; hierarchical cluster analysis was performed via the average linkage method, and the average annual growth/decline rate (AR) of disease incidence was calculated.

Results. The CVD incidence in the world from 1990 to 2021 decreased from 0.9 to 0.8 cases per 100 people (AR = –0.46%). In terms of the primary incidence of CVD in 2021, the Russian Federation is in the fourth quarter, in the group of countries with high incidence. Clustering showed the Russian Federation to be grouped with Algeria, Jordan and Mongolia, having similar incidence rates (1.28–1.29 cases per 100 people) and a tendency to decrease the incidence.

Research limitations. For the analysis, age-standardized indices of CVD incidence from 204 countries for the period from 1990 to 2021 were used, constituting a highly representative sample.

Conclusion. From 1990 to 2021, the global CVD incidence declined. As of 2021, the Russian Federation continued to be among the countries with the highest levels of CVD incidence, but at the same time, there was a downward trend in the incidence, which coincided with the trend in most countries of the world. Further research is needed to study the factors determining the revealed variability in the incidence and evaluate the effectiveness of measures aimed at reducing morbidity.

Compliance with ethical standards. This type of research does not require an examination by the local ethics committee.

Contribution of the authors:
Brazhnikov A.Yu. — scientific guidance, concept and design of the research, formulation and development of material, statistical processing of data;
Kuraeva V.M. — collection and processing of material, writing the text, editing, compiling the list of references;
Oynotkinova O.Sh. — material processing, text writing, editing;
Derbenev D.P. — material processing, text writing, editing.
All authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Funding. This article was prepared by the author’s team within the framework of the research “Innovative approaches in the development of the public health system of the city of Moscow” (No. according to EGISU: № 123032100060-2).

Conflict of interest. The authors declare that there is no conflict of interest.

Received: April 4, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025

Introduction. This article presents the Expanded Cost-Benefit Analysis (ECBA) model as an integrative approach to health technology assessment, taking into account clinical, economic, institutional, behavioral, and social factors.

Purpose. To develop and justify a comprehensive model for evaluating health technologies based on ECBA, incorporating the manageability of implementation, behavioral variability, and institutional constraints.

Materials and methods. The ECBA model comprises four blocks: medical outcomes, socio-demographic benefits, implementation costs, and institutional risks. Over a 10-year horizon with an 18.8% discount rate, it integrates real-world data, shadow-cost estimates, national standards (e.g., GOST R 57525–2017), and a case study on preventive ART in a metropolitan setting. Implementation feasibility is assessed via the Technology Manageability Index (TMI).

Results. The ECBA model enables structured comparison of health interventions based on clinical, economic, institutional, behavioral, and social criteria. Though illustrated with the ART case, it is applicable to various preventive, therapeutic, and digital interventions in resource-limited, centralized systems.

Research limitations. The model assumes stable parameters over time and uniformity of institutional and behavioral responses. It does not fully account for partial adoption scenarios, regional disparities in healthcare infrastructure, or variability in institutional implementation practices.

Conclusion. ECBA supports policymakers by integrating multidimensional evidence into a unified framework, improving the assessment of health technologies’ real-world viability under regulatory, fiscal, and institutional constraints. 

Compliance with ethical standards. The study was approved by the local ethics committee of the Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department, Moscow, protocol dated 02.11.2025 No. 02-01/ЭК/2025.

Funding. This article was prepared within the framework of the research work «Development of methodological approaches to value-oriented healthcare (VOH) in the city of Moscow».

Conflict of interest. The authors declare no conflict of interest.

Received: March 28, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025

Introduction. The role of classical methods in assessing the growing number of health technologies remains significant. At the same time, these methods are increasingly implemented by means of specialized, high‑performance hardware‑software platforms.

Purpose. To identify the fundamental approaches to conducting health technology assessment (HTA) that either retain or gain particular importance in the era of digitalization.

This article was prepared in accordance with the SANRA guidelines for narrative reviews. An information search using relevant keywords was conducted in the PubMed/Medline databases and within the Google ecosystem. Priority was given to the most recent and relevant reports from the past 2–3 years.

Cost‑effectiveness and cost‑utility analyses remain widely applied methods of comprehensive assessment. The platforms Trialstreamer and RobotReviewer, designed for analytical extraction of clinical trial data, are reviewed. Core modeling tools are identified: (1) highly‑specific — TreeAge Pro; (2) generic — MS Excel and other spreadsheet applications; (3) statistical — R, Stata, SAS, WinBUGS. Web‑based applications for interactive modeling, such as R Shiny‑based systems and the ICER Interactive Modeler — provide access to a range of health economics models. These tools enable users to modify input variables and visualize the impact of such changes on outcomes in real time. Packages such as R Markdown can facilitate the automation of final report generation and updating.

Additionally, there are provided examples of artificial intelligence (AI) integration into the routine practice of HTA agencies. It is emphasized that, due to the insufficient exploration of AI’s potential, risks, and limitations, there is an urgent need to develop effective mechanisms for oversight and governance of its use.

The limitations of current HTA models are largely associated with the scarcity of refined and context‑appropriate input variables. Human oversight and the involvement of subject‑matter experts remain critically important for ensuring the quality of HTA when implementing AI‑based systems in sensitive areas such as healthcare.

Funding. This article was prepared by the author as part of the research project “Development of methodological approaches to value-based healthcare (VBHC) in the city of Moscow” (USISR No.: 123032100062-6).

Conflict of interest. The author declares the absence of obvious and potential conflicts of interest in connection with the publication of this article.

Received: March 21, 2025 / Accepted: June 24, 2025 / Published: October 31, 202

Introduction. One of the national interests of the Russian Federation is the “conservation” of the population, the “development of human potential” by increasing fertility and “creating motivation to have many children.”

The purpose of the study. A medical and social assessment of the reproduction of the population in the Omsk region based on the study of the conditions and lifestyle of families in modern conditions of family structure formation.

Materials and methods. The data from Rosstat for the Omsk region from 2014 to 2023 were used, as well as survey materials for 1,307 women of the fertile age. Statistical processing was carried out using graphical analysis, calculation of extensive and intensive indicators, and analysis of variance.

Results. According to the respondents, the most important reasons for planning the birth of a child were the desire to have one (54.7–57.5%) and the opportunity to strengthen the family (23.7–24.8%). The responses of surveyed women showed their reproductive attitudes in 2014 to correspond to the level of simple reproduction of the population (2.12–2.46 children), but in 2023 the planned and desired number of children (1.93–2.05) fell below the level required for generational replacement (2.15–2.20). Productive attitudes were found to form under the influence of such independent variables as: the number of children in the family (h² = 16.8–21.9%); housing (h² = 12.2–13.8%) and material (h² = 10.1–13.1%) living conditions of families; marital status of the mother (h² = 10.5–11.5%) and its age (h² = 88.8–9.7%), the presence of abortions (h² = 5.4–9.3%) in the anamnesis of the child’s mother.

Limitations of the study. The study involved women of fertile age living in Omsk and the Omsk region.

Conclusion. By 2024, unfavorable trends in the main indicators of population reproduction have formed in the Omsk region. The analysis of women’s reproductive attitudes revealed a persistent tendency towards a small family, which determines the urgent need for a transition from measures of primarily material support for families with children to the development of areas reflecting social policy.

Compliance with ethical standards. The study was approved by the Biomedical Ethics Committee of the Research Institute for Complex Problems of Hygiene and Occupational Diseases (Protocol No. 4, §1 of November 18, 2021). All participants gave informed voluntary written consent to participate in the study.

Contribution of the authors: The authors contributed equally to the article, including approval of the final version of the article.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: June 21, 2024 / Revised: February 9, 2025 / Accepted: February 19, 2025 / Published: October 31, 2025

Introduction. The introduction of modern technologies into the healthcare system to ensure the quality and accessibility of medical services tailored to the interests and needs of the patient has raised the issue of the effectiveness of the functioning of medical organizations and its measurement to a new level. The most popular tool used to evaluate the effectiveness of medical organizations around the world is the balanced scorecard, which allows you to take into account various aspects of the activities of medical institutions, including financial, clinical, operational and patient-oriented parameters.

The purpose is to study the experience of using a system of balanced application indicators to assess the effectiveness of medical institutions in the world over the past 5 years.

Materials and methods. To write the article, scientific reports were used as research material, the search for which was carried out on the Publish or Perish platform, as well as in the scientific library on the eLibrary website using the keywords: balanced scorecard, BSC, medical institutions. General scientific methods of cognition were used for the analysis: comparison, generalization, system-structural and analytical methods.

Results. The practice of using SSP in various world countries has been studied. The approaches to evaluating the effectiveness of medical institutions based on SSP are analyzed, the main results are identified and the success of using SSP to evaluate the effectiveness of medical institutions is confirmed.

Research limitations. When conducting the study, the following limitations were established for the systematic search for scientific publications on the research topic: time frame (2020–2025), as well as the number of analyzed works selected using the Publish or Perish platform (Google Scholar.

Conclusion. In general, SSP is a powerful tool for improving the effectiveness of medical institutions, but its potential can be fully realized only if it is properly implemented, constantly monitored and adapted to changing conditions.

Compliance with ethical standards. Compliance with ethical standards: the study was approved by the local ethics committee of the Research Institute for Healthcare Institution and Medical Management of Moscow Healthcare Department, Moscow, protocol dated 11.02.2025 No. 02-01/ЭК/2025.

Funding. This article was prepared by the author as part of the research project «Development of methodological approaches to value-oriented healthcare (VOH) in the city of Moscow» (no. according to EGISU: 123032100062-6).

Conflict of interest. The author declares the absence of obvious and potential conflicts of interest in connection with the publication of this article.

Received: April 4, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025

Introduction. Risk management in medical institutions plays a significant role in improving the availability and quality of healthcare. According to their characteristics, risks are divided into financial, such as budget deficit, inefficient use of resources, cost growth, etc., and non-financial, which are directly related to the provision of healthcare and patient safety. The study presents a systematic approach to financial risk management, including their analysis and development of plans for minimization, personnel training and implementation of information systems for monitoring and control. The importance of continuous monitoring and adaptation of risk management strategies in response to external and internal changes is noted.

Purpose. Analysis of the methodological foundations of financial risk management as applied to medical institutions.

Materials and methods. The study used system analysis when studying scientific reports devoted to risk management in medical institutions; comparative analysis when comparing the features of financial and non-financial risks; statistical analysis when processing data on the financing and activities of medical institutions.

Results. The study of risks and their features is an important step towards creating a sustainable healthcare system. Effective risk management allows ensuring financial stability, improve the quality of services provided and ensure long-term development in an unstable external environment in medical institutions.

Research limitations. When conducting research, there were restrictions on access to financial statements of medical institutions, but they did not have a significant impact on the preparation of the article.

Conclusions. Risk management helps to minimize the adverse consequences of both financial and non-financial risks, such as clinical errors, hospital infections, personnel problems, and reputational risks.

Compliance with ethical standards. The conclusion of the biomedical ethics committee is not required.

Funding. This article was prepared by the author within the framework of the research work “Development of methodological approaches to value-oriented healthcare (VOH) in the city of Moscow”.

Conflict of interest. The authors declare no conflict of interest.

Received: March 26, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025

Introduction. The prevalence of tobacco smoking among the population of the Russian Federation remains high, as a result of which the issue of combating tobacco smoking remains relevant.

Purpose. To study the structure of nicotine addiction and the trend that have occurred over twelve years over the process of implementing programs to combat tobacco smoking in the adult population.

Materials and methods. In 2024, 626 smokers (428 men, 198 women) aged of 16 to 79 years (average — 33.3 ± 13.9 years) were surveyed. 511 people (81.6%) were from urban settlements, 115 (18.4%) — from rural areas. The following tests were used: a questionnaire with social indicators, information on tobacco smoking, Fagerström tests to determine nicotine addiction; scale of E.S. Souza et al. — motives for smoking; test of V.F. Levshin — on readiness to quit smoking. Mathematical and statistical processing included descriptive statistics and calculation of the distribution.

Results. During 2024, almost 75% of respondents, more often men, had nicotine addiction. They smoked unfiltered cigarettes much more often. Women, in addition to regular cigarettes, also smoked electronic cigarettes more often. Over the past 12 years, the number of smokers without symptoms of nicotine addiction and with severe nicotine addiction has significantly decreased, but their share with weak nicotine addiction has increased. Men began to smoke fewer cigarettes, while women, on the contrary, significantly increased their number. The proportion of smokers motivated to quit smoking has increased.

Limitations of the study. The study takes into account the no regional characteristics of the smoking population.

Conclusion. The noted circumstances should be taken into account when managing preventive measures, taking into account the regional and gender characteristics of smoking.

Compliance with ethical standards. The study was approved by the Ethics Committee of the Moscow State Technical University named after K.G. Razumovsky (Protocol No. 5 dated of March 20, 2025). All participants gave informed voluntary written consent to participate in the study.

Contribution of the authors:
Golenkov A.V. — concept and design of the study, collection of materials, writing the text;
Bonkalo T.I. — writing the text, statistical data processing, editing;
Shmeleva S.V. — collection of materials, writing the text, editing, compiling the list of references.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Funding. The study had no sponsorship support.

Conflict of interest. The authors declare no obvious or potential conflicts of interest in connection with the publication of this article.

Received: March 21, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025

Introduction. International Statistical Classification of Diseases and Related Health Problems (ICD-10) standardizes approaches to the formation of a pathological diagnosis. It is assumed the principles for forming the final clinical diagnosis to be similar to the pathoanatomical ones, but not in all clinical situations doctors have the opportunity to follow this rule.

The purpose of the study. Assessing the orientation of medical personnel in the rules for forming the final clinical diagnosis; analysis of regulations, accounting documents and methodological recommendations for the formation of a final clinical diagnosis.

Materials and methods. The study used statistical data from the largest oncology clinic in Europe for 2022. An analysis of defects in the final clinical diagnosis was carried out (the second class of diseases — neoplasms, ICD-10). Analytical and statistical methods were used. Additionally, regulations, accounting documents, classifications and methodological recommendations of professional communities were studied — about issues of formalizing the clinical diagnosis in cancer patients.

Results. Analysis of the studied regulations, accounting documents and methodological recommendations showed the presence of a legal gap and different interpretations of the instructions in the second volume of ICD-10 by the professional regarding the formation and coding of the final diagnosis in oncology.

Research limitations. The study has age and nosological restrictions; it concerns the population diagnosed with category C00–D48 aged of 18 years or older.

Conclusion. The described examples of different approaches to coding clinical and pathological diagnoses call into question the statement about uniform rules for forming diagnoses. This issue is very extensive and undoubtedly requires detailed study, both at the level of the expert community and at the legislative level. The development of independent, easy-to-use recommendations for the design and coding of a clinical diagnosis can have a positive impact on reducing the number of diagnostic defects in primary medical documentation.

Compliance with ethical standards. The study was approved by the Ethics Committee National Medical Research Center of Oncology. Protocol No. 14 dated December 16, 2024. All participants gave informed voluntary written consent to participate in the study.

Contribution of the authors:
Voroshilova E.A. — concept and design of the study, collection and processing of material, statistical processing, compilation of a list of references, approval of the final version of the article;
Shekelashvili A.I., Eroshin Yu.V. — critical revision of the draft manuscript with the introduction of valuable comments of intellectual content.
All authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: November 15, 2024 / Revised: January 22, 2025 / Accepted: February 19, 2025 / Published: October 31, 2025

The article provides an overview of domestic and foreign reports on the possibility of implementing self-monitoring and self-control training programs for people suffering from chronic non-communicable diseases (CNCD). There were analyzed at least 1,500 domestic and foreign reports on a given topic, which are available in the databases Scopus, Web of Science, MedLine, The Cochrane Library, CyberLeninka, RSCI and on the WHO website. Data are presented on the possibility of using various patient education options, in particular, such as “patient schools” with CNCD, their effectiveness in terms of improving compliance and the pharmacoeconomic effectiveness of treatment. The difficulties experienced by patients in studying special information related to the disease and determining the search for new solutions in this area are outlined. The relevance of including the teach-back method in working with patients, which is used in various fields of healthcare and allow not only to providing the patient with the most detailed information, but also receiving feedback from him indicating the level of her understanding (based on clarifying questions from the specialist and the patient’s answers, reflecting a sufficient understanding of the essence of the information provided). There are given examples of works demonstrated the relevance of introducing feedback learning when it is included in medical education programs for adult CNCD patients. The reasonable inclusion of systematic educational programs with feedback in the monitoring scheme for this category of patients was shown to make it possible to optimize the treatment process, reduce the labor costs of medical personnel, significantly reduce the time spent by patients in outpatient and inpatient treatment facilities, and reduce the risk of repeated hospitalization.

Contribution of the authors:
Kukshina A.A. — research concept and design, literature analysis, text writing, bibliography, editing;
Kamynina N.N. — research concept and design, text writing, editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Funding. This article was prepared by the author’s team within the framework of the research «Innovative approaches in the development of the public health system of the city of Moscow» (no. according to EGISU: № 123032100060-2).

Conflict of interest. The authors declare no conflict of interest.

Received: March 28, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025

Introduction. The prevalence of obesity has increased significantly over the past four decades worldwide, in all geographical regions, and it is expected that 51% (four billion people) of the global population (over the age of five) will be overweight by 2035, 24% of whom will be obese. Obesity is also one of the main factors of disability and mortality. The causes of obesity are likely to differ at different stages of the life, so research into the prevention and treatment of obesity should cover the period from conception to adulthood.

The purpose of this study. To summarize and analyze foreign practices of the prevention of obesity and overweight in the adult population.

The systematic reviews and meta-analyses (Prisma) reporting method was used to conduct the review. The search was carried out in the bibliographic databases eLibrary, PubMed, MEDLINE, Google Scholar by keywords: “primary health care”, “obesity”, “lipoprotein metabolism disorder”, “prevention”, “review”.

Prevention and support of a healthy lifestyle are new topics in general medical practice. Continuing consultations with general practitioners to discuss ways to normalize a patient’s weight can lead to positive changes in their health behavior, even if they are not related to weight loss. Foreign researchers have identified four main barriers preventing the provision of medical care to obese patients: stigmatization, improper communication, limitations of the medical care system, lack of individual recommendations and socio-cultural influences.

Examples of successful practices from different countries demonstrate that joint efforts by medical organizations, governments, employers and society as a whole can create conditions for improving the quality of life and health of the population.

Contribution of the authors:
Timofeeva A.S. — concept and design of research, collection and processing of material, writing of text, compilation of a list of references, text editing;
Dombaanai B.S. — collecting and processing material, writing text, editing text.
All authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Funding. This article was prepared by the authors’ team within the framework of the research work «Scientific substantiation of approaches to transforming the activities of outpatient and polyclinic institutions subordinate to the Department of Health of the City of Moscow» (no. according to EGISU: 123032100061-9).

Conflict of interest. The authors declare that there is no conflict of interest.

Received: April 1, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025

Introduction. Cognitive biases are persistent thinking errors that influence perception, behavior, and decision-making. Studying them over time is important for understanding the psychological characteristics of perception and the formation of biases.

The purpose of the study. To determine age-specific profiles of cognitive biases in a 16–30 year student sample aged using cluster analysis. The primary objective was to apply cluster analysis to questionnaire results to identify persistent thinking patterns and biases in respondents of different ages.

Materials and methods. A total of three hundred twenty volunteers (71% women, 29% men) participated in the online survey. The average age of the group was 19.8 ± 4.7 years. The author’s CBB-8 questionnaire included 24 statements reflecting eight key biases; the internal consistency of the entire scale was α = 0.83. After standardization of the indices, the profiles were grouped using the k-means++ method (elbow criterion; optimal k = 3; silhouette = 0.41). Intercluster differences were tested by χ² and one-way ANOVA; two-tailed significance level of 0.05.

Results. Three profiles were identified. Cluster 0, “younger”: n = 105; 32.8% (95% CI 27.7–38.3); median age 18 years; low anxiety, high tolerance for uncertainty. Cluster 1, “senior student”: n = 134; 41.9% (95% CI 36.3–47.8); median 23.7 years (IQR 22–25); pronounced pessimism. Cluster 2, “intermediate”: n = 81; 25.3% (95% CI 20.8–30.5); median 21 years.

Research limitations. The study did not account for respondents’ socioeconomic status and was cross-sectional, not accounting for age-related changes.

Conclusion. Cluster analysis demonstrates the existence of three stable age-related profiles of cognitive biases in the youth sample. The resulting typology can be considered when developing educational programs on critical thinking and prejudice prevention.

Compliance with ethical standards. The study was approved by the Ethics Committee of the Research Institute for Healthcare Organization and Medical Management (approval No. 02-01_EC_2025 dated February 11, 2025). All participants provided informed voluntary consent to participate in the study.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare the absence of obvious and potential conflicts of interest in connection with the publication of this article.

Received: March 26, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025

Introduction. The use of artificial intelligence (AI) in medicine is increasingly being applied. Modernization and digitalization processes are taking place in all levels and structures, including in the primary health care sector. The task is to create and ensure the possibility of effective management of work activities, taking into account the acquisition of new knowledge and competencies through the development of a retraining system. The management of this system should take into account the needs of medical professionals and the convenience of obtaining the necessary skills.

The purpose of the article is to study the specifics of the existing work landscape and trends in the development of educational trajectories of medical workers.

Materials and methods. The study includes an analysis of the results of secondary data presented in the monitoring of research agencies for the possibility of using OLAP technology. The author’s research is aimed at analyzing the responses of the survey respondents (n = 1499). Visualization of the landscape of labor activity is implemented using graph theory.

Results. Modern technologies in medicine significantly affect the work of medical workers. Knowledge in the field of AI and IT is becoming more and more in demand. The system of medical retraining, taking into account new work formats, requires significant rethinking. Based on OLAP technologies and graph theory, the authors propose an author’s model of the work landscape of a health worker.

Research limitations. The study has regional (Moscow) limitations. The analysis uses statistical data and the results of a mass questionnaire survey in medical institutions of the Moscow Department of Health.

Conclusions. Taking into account existing trends and changes in work activity (including the introduction of AI), it is advisable in the near future to review both approaches to training medical workers and to provide an opportunity to gain new knowledge for the implementation of innovative personnel strategies corresponding to the "New Moscow Standards" nationwide.

Compliance with ethical standards. The study was approved by the Ethical Committee for the Examination of Research in the field of public health, organization and sociology of healthcare at the Research Institute for Healthcare Organization and Medical Management (Protocol No. 03-01/EC/2023, 14.03.2023).

Contribution of the authors:
Medvedeva E.I. — concept and design of the study, writing the article, editing;
Kroshilin S.V. — collection and processing of material, statistical processing, writing an article.
All authors — approval of the final version of the article, responsibility for the integrity of the article.

Funding. This article was prepared by the author’s team within the framework of the research "Scientific and methodological support of organizational aspects of improving the accessibility and quality of medical care in the public health system of Moscow" (No. according to EGISU: 123032100063-3).

Conflict of interest. The authors declare the absence of obvious and potential conflicts of interest in connection with the publication of this article.

Received: April 4, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025

Introduction. Conditions under which the environment becomes destabilized allow hypothesizing about their modifying effects on the course of the SARS-CoV-2 infection and influenza. This determines the relevance of assessing the effects produced by these viral agents as well as environmental factors (for example, benz(a)pyrene), which use transcripts of candidate genes as a biological substrate, and expected effects in particular include specific expression of mRNA fragments.

Materials and methods. The relative normalized level of gene (protein) expression of the IL6 hs00174131_m1 gene was assessed in incubation of a whole blood cell cultures with benz(a)pyrene, SARS-CoV-2 virus vaccine antigen and influenza virus vaccine antigens the assessment was performed on spontaneous and antigen incubation-induced experimental models in vitro for various polymorphism scenarios of the IL6 C(-174)G (rs1800795) gene.

Results. Effects of bioexposition differed in the expression vector of mRNA fragments depending on polymorphic variants of the IL6 C(-174)G (rs1800795) gene. Thus, the minor variant of the IL6 C(-174)G gene polymorphism, was associated with activation of the expression of the IL6 hs00174131_m1 transcript (by 1.9 times). Exposure to viral antigens and benz(a)pyrene caused inhibition of the mRNA expression of the IL6 transcript hs00174131_m1 (by 1.2–3.7 times) for typical homozygous and heterozygous variants of the IL6 gene (rs1800795), which verifies occurrence of immunosuppression scenarios associated with the cytokine profile under antigenic exposure at the transcriptome level and allows clarifying the mechanism of modification of spontaneous effects by environmental chemical and biological factors depending on a Single Nucleotide Polymorphism (SNP).

Research limitations. Are related to the limited sample.

Conclusion. The hypothesis on modifying (inhibiting) effects of benz(a)pyrene and vaccine antigens (SARS-CoV-2 and influenza virus) on the IL6 C(-174)G (rs1800795) gene expression has been confirmed by using experimental in vitro models. These effects reflect intensity of induction of the scaled values of its IL6 hs00174131_m1 transcript, which makes it possible to clarify some pathways of immune disorders in the “genome-postgenome” system associated with the course of viral infections and to recommend the proposed sensitivity and effect markers as indicators for diagnosing and preventing COVID-19 and influenza in a destabilized environment (using benzo(a)pyrene as an example).

Compliance with ethical standards. The study was approved by the Ethics Committee of the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies (Protocol No. 13 dated of March 14, 2023). All patients were informed about the purpose of the study and gave informed voluntary consent to participate in the study.

Contribution of the authors:
Zaitseva N.V. — study design, editing;
Otavina E.A. — data collection and analysis, statistical analysis, writing and editing the text;
Dolgikh O.V. — study concept and design, editing the text;
Kazakova O.A. — data collection and analysis, statistical analysis, editing the text;
Starkova K.G. — statistical analysis, editing the text.
All authors are responsible for approving the final version of the article and the integrity of its all parts.

Funding. The study had no sponsorship.

Conflict of interests. The authors declare no obvious or potential conflicts of interest in connection with the publication of this article.

Received: March 11, 2025 / Accepted: June 24, 2025 / Published October 31, 2025

Introduction. Effective risk communication is a significant factor in reducing preventable morbidity and mortality associated with anthropogenic environmental pollution in modern cities. The World Health Organization considers active use of digital technologies (risk communications via the Internet or mobile applications) a key trend in the development of up-to-date communication systems.

Purpose. To establish possibilities and ways to integrate digital technologies into risk communications associated with ambient air pollution based on the characteristics on information demands typical for residents of Russian megacities.

Materials and methods. The empirical base for the research was provided by the results of an online quantitative survey conducted among adults in Novosibirsk and Perm, two industrially developed cities in Russia with the population exceeding 1 million people (n = 378, 2020).

Results. We established that people had rather low proactive interest in any information about environmental conditions (ambient air pollution and its impacts on health) since less than a half of the respondents searched for it on their own. Still, 76% of them wanted to be informed about these issues and this means that in general there is a high interest in the topic. Data on health associated with ambient air pollution and possible actions aimed at risk mitigation are the most interesting for public in general. People prefer texts and videos when it comes down to a way to communicate information. Interactive maps have some potential but they are still not very popular among people. There is also a demand for a specialized mobile application, which gives an opportunity to get information about ambient air quality and health risks. Social networks, messengers, and news tickers on websites have the greatest potential for informing people about ambient air pollution and health risks.

Research limitations. The survey was conducted only among residents of large cities in Russia. Therefore, the results do not cover opinions of people who live in medium-sized or small towns or in rural areas.

Conclusion. Emphasis in these risk communications should be made on a) an actual ambient air quality; b) its potential effects on health; c) ways to minimize risks. Overall, it seems necessary to develop a whole system of risk communications on environmental pollution and health in Russia. This should involve active use of digital technologies.

Compliance with ethical standards. The study was conducted in conformity with the International Sociological Association’s (ISA) Code of Ethics; was approved by the Ethics Committee of the Federal Scientific Center for Medical and Preventive Technologies for Population Health Risk Management (protocol No. 6 dated March 12, 2020). All participants gave informed voluntary written consent to participate in the study.

Contribution of the authors:
Lebedeva-Nesevria N.A. — study concept and design, writing and editing the text;
Barg A.O. — sociological data analysis, drawing up the references.
All authors have approved the final version of the article and bear full responsibility for the integrity of all its parts.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: May 14, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025

Introduction. Failures of neuro-immune regulation can be caused by both external exposures and polymorphisms of candidate genes, transcription genes in particular.

The purpose of the study. To estimate effects of exposure to benzene and rs1042522 polymorphism of the TP53 gene on formation of the immune state and phenotype in children suffering from disorders of autonomic nervous system (ANS) (G90.8 and G90.9).

Materials and methods. The study involved eighty-five children (aged 7–12 years) — 46 children exposed to benzene (blood benzene concentration > 0 μg/cm) (observation group), and 39 children not exposed to benzene (reference group) who lived in the Perm region and had disorders of ANS (the observation group was 2.1 times more likely to have a disease (p < 0.05)). CD3⁺CD95⁺, IL-4, IFN-γ and IgG to benzene were determined by immunobiologic methods. The gene polymorphism was evaluated by Real-time polymerase chain reaction.

Results. Benzene contamination in the observation group was established to be equal of 0.0069 ± 0.0014 µg/cm³. The analyzed indices were shown to be different between the groups; thus, absolute CD3⁺CD95⁺ expression was 1.4 times as low and IFN-γ 1.7 times as low in the observation group against the reference one whereas IL-4 and IgG specific to benzene were 2.6 times and 2.5 times as high respectively. We found an authentic direct relationship between the level of IgG specific to benzene and IL-4 (r = 0.21; r = 0.51; p < 0.05 respectively), and an inverse relationship between IFN-γ expression (r = –0.53; p < 0.05) and blood benzene levels. The observation group showed to have significant (p < 0.05) higher frequency of the allele C and CC genotype of the TP53 rs1042522 gene, 1.4 and 1.6 times higher respectively against the reference group (RR = 1.60; CI: 1.21–2.09).

Research limitations. Are related to a small sample size.

Conclusion. The hypothesis regarding participation of by benzene and changed polymorphisms of the candidate gene TP53 (the allele C of the TP53 Pro72Arg gene) in creating relative risks (RR = 1.60) of immune regulation failures. This can be considered a condition for formation of a specific phenotype of ANS diseases (with more frequent manifestations of pathology signs) associated with benzene.

Compliance with ethical standards. The study was approved by the local ethics committee of the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, the meeting protocol No. 5 dated February 28, 2023. All participants and their legal representatives gave informed voluntary written consent to participate in the study.

Contribution of the authors:
Zaitseva N.V., Dolgikh O.V. — concept, interpretation, editing of data;
Yaroma A.V. — concept and design of research, analysis and interpretation of data, writing the text of the article, compiling a list of references, statistical data processing;
Kazakova O.A. — data analysis and interpretation, statistical data processing.
All authors have approved the final version of the manuscript and bear full responsibility for the integrity of all its parts.

Funding. The research was not granted any sponsor support.

Conflict of interest. The authors declare no competing interests.

Received: May 14, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025

Introduction. The most important preventive measure for occupational diseases (OD) is the diagnosis of their early manifestations during periodic medical examinations (PME).

The purpose of the study. To investigate the effectiveness and quality of PME to assess their role in the prevention system of OD among workers in a number of subjects of the Volga Federal District between 2021 and 2023.

Materials and methods. We have analyzed the reporting forms of the centers of occupational pathology (COP) in 4 regions of the Volga Federal District: the Republics of Bashkortostan, Tatarstan, Samara and Orenburg regions between 2021 and 2023. To assess the effectiveness and quality of PME, the following indicators are calculated: the coverage of employees by periodic medical examinations, the detection of diseases, and primary disability. The detection of chronic non-infectious diseases (CNID) using the χ² criterion and its reliability (p) with multiple comparisons of groups and reliability p < 0.05 has been analyzed. Statistical processing was carried out using Microsoft Excel software.

Results. Over the studied period, the PFO revealed an increase in the number of employees covered by PMO. There was a low proportion of employees subject to PME in the COP (2.1–4.2% in Bashkortostan during 2021–2023; 1.7% in the Samara Region in 2023). Low rates of OD detection were identified in Bashkortostan — 17.6%, high ones in Tatarstan — 82.0% and Orenburg Region — 91.2%. An increase in primary disability of workers with OD was recorded — 2.8 — 3.8 — 12.2%. In 2023, the detection of NICD decreased, especially neoplasms (χ² = 153.6; p = 0.001), diseases of the genitourinary system (χ² = 710.2; p = 0.001). The COP reports do not contain information on the number of workers with early signs of OD based on the PME results.

Research limitations. The study is limited to data on examinations of workers in the Volga Federal District.

Conclusions. Obtaining reliable and objective information for the purpose of analyzing the effectiveness and quality of PME based on the reports of the COP is difficult. The qualitative indicators of PME based on the example of several subjects of the Volga Federal District indicate to their low effectiveness in the system of prevention of OD.

Compliance with ethical standards. The study does not require the submission of the conclusion of the biomedical ethics committee or other documents.

Contribution of the authors:
Valeeva E.T., Shaikhlislamova E.R. — research concept and design, writing the text, compilation of the list of literature, statistical data processing;
Shastin A.S., Akhmetshina V.T., Babanov S.A., Galimova R.R., Basyrova A.R. — collection and processing of material;
Distanova A.A. — writing the text, statistical data processing, editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: July 4, 2024 / Revised: February 18, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025