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Aim. To evaluate the impact of a decrease in glomerular filtration rate (GFR) on the prognosis of patients with chronic heart failure (CHF), to analyze real clinical practice regarding the frequency of prescribing pathogenetic therapy for CHF, achieving target dosages depending on the gradation of GFR in patients included in the CHF Register of the Tyumen region. Materials and methods. The analysis included medical data of 4077 patients (1662 men and 2415 women) with NYHA class I–IV CHF who underwent examination and treatment in medical organizations of the Tyumen region for the period from January 2020 to May 2023. Criteria for inclusion in the register: proven heart failure. Chronic kidney disease (CKD) was assessed by GFR calculated using the CKD-EPI formula (ml/min/1.73 m2). The primary end point was defined as death from all causes. Results. GFR60 ml/min/1.73 m2 was recorded in 34.6% of patients, more common in women (40.2 and 26.6%, respectively; p0.001). When dividing patients into phenotypes according to LVEF, no statistically significant differences were found in the distribution of patients according to GFR. In patients with HFrEF and HFpEF GFR45 ml/min/1.73 m2 was associated with an increased risk of meeting the endpoint. Analysis of prescribed pathogenetic therapy showed that in patients with HFrEF, the frequency of prescription of ACE inhibitors, â-blockers and MRA decreased (p=0.023, 006 and 0.01, respectively), and ARNI, on the contrary, increased with a decrease in GFR (p=0.026). In patients with HFpEF, a similar trend towards a decrease in the frequency of prescription of ACEIs and MCBs with a decrease in GFR (p0.001) remained, but it was compensated by an inversely proportional increase in the frequency of prescription of ARBs (p0.001). 100% of the target dosage is achieved in more than 90% of patients taking MRA across the entire LVEF range. While for â-blockers and ARNI/ACE/ARB the percentage of patients receiving the full therapeutic dosage of drugs is significantly lower. When analyzing target dosages of pathogenetic drugs, gradations of achieved doses were distributed evenly throughout the entire range of GFR. Conclusion. GFR60 ml/min/1.73 m2 occurs in every 3 patients with CHF across the entire range of LVEF. A decrease in GFR worsens the prognosis of patients with both HFrEF and HFpEF, increasing in direct proportion with the severity of the stage of CKD. Inclusion of patients in the monitoring program within the framework of the CHF service allows the treatment to be significantly brought closer to optimal drug therapy, at the same time, certain efforts are required to overcome difficulties with titration to target dosages.

The annual mortality of patients with clinically pronounced symptoms of chronic heart failure in the Russian Federation reaches 2629%, i.e., from 880 to 986 thousand patients with heart failure die in the country in one year, which is comparable to the population of a large city. Providing care for patients with heart failure places a heavy burden on the country's health care system, making a significant contribution to mortality rates, hospitalization rates, including readmissions, which in turn requires considerable costs. The article presents an overview of registry studies that are devoted to assessing the effectiveness of diagnostics, the completeness of examinations, as well as the adequacy of ongoing drug treatment.

Background. Comorbidity in patients with chronic heart failure (CHF) makes a major impact to the course of both the underlying and concomitant diseases, significantly worsens the prognosis and increases mortality from cardiovascular diseases. Improving specialized treatment within the framework of a three-tier model of providing medical care to patients with CHF is a healthcare priority. Aim. Analysis of the frequency of comorbid conditions in patients with CHF included in the CHF registry in the Tyumen region. Materials and methods. The study was conducted using the CHF register method, which has been operating in the Tyumen region since January 2020. Medical data from outpatient cards and discharge reports were entered by doctors from 9 polyclinics with an attached population, 1 consultative polyclinic, hospitals, on the basis of which there are outpatient CHF rooms in the structure of polyclinics in the city of Tobolsk, Zavodoukovsk, with. Nizhnyaya Tavda, Yalutorovsk, Tyumen Region, Ural Federal District. The study included medical data of 5741 patients with CHF I–IV functional classes (FC). Gender, clinical-instrumental and laboratory data, non-cardiac and cardiac diseases according to the International Classification of Diseases of the 10th revision were entered into a single map of the CHF registry. Results. In the study sample of patients with CHF, whose average age was 70.0±9.7 years, 2331 (40.6%) were men and 3410 (59.4%) were women. The most common cardiovascular diseases were: coronary artery disease – 55.4%, HD – 22.5% and HRT – 13.5% of cases. Among concomitant diseases of non-cardiac reasons, diabetes mellitus was most often noted – in 31.5% of cases, chronic kidney disease – in 31.1% and chronic obstructive pulmonary disease – in 10% of cases. Concomitant diseases were more common in patients with CHF of functional classes III–IV. Conclusion. Maintaining a register of CHF and analyzing register data makes it possible to assess the required volume of medical care, plan the necessary time, material, economic and organizational resources and take into account possible difficulties in diagnosis, treatment and outpatient monitoring.

In the era of digitalization of education and economy and the development of artificial intelligence, adolescents appear highly competitive compared with other generations in understanding digital technologies, acquiring expertise, and mastering modern means of communication, which normally causes intergenerational conflicts and the loss of an adult’s personal and functional authority. The aim of this research was to develop and test a model for developing adolescents’ communicative cultures in an institution of additional education. The research emphasizes the significance of personality-oriented, interactive-communicative, and cultural approaches and conducts a comparative analysis of the sources. Methodologically, the study relies on a quantitative method with primary sources. Besides, the findings of the study contribute to the existing limited stress on the importance of adolescents’ communicative cultures from the perspective of the digitalization of additional education. The study finds that the use of digital options in education has reduced social interaction among students. However, the students prefer to use digital methods of learning as they find them more convenient for communication. Therefore, the digital communication culture has high potential in the educational sector. The findings are novel as this study is one of the few recent studies that examined how communicative culture has transformed due to digital means in education. Doi: 10.28991/ESJ-2022-SIED-019 Full Text: PDF

In the article the peculiarities of human capital is considered as a resource and incomegenerating factor of production. The author also analyzes the mechanism of the analysis of efficiency of investments in human capital. The author substantiates the basic provisions effective management of human capital of business entities, based on the need to ensure continuous learning of staff and improve the quality of working life.

The article discusses the methodology and content of the SWOT-analysis operation of the business environment, the background and the steps of forming competitive strategy based on the analysis results.

In article the analysis of the markets of the liquefied natural gas where the main tendencies of develop- ment of branch of LNG and where the assessment is given are designated is carried out what place in this niche of gas sector of the world market can occupy the Russian Federation.

The purpose of this paper is to identify the current directions and tools of strategic marketing management of retail trade enterprises in modern Russia, as well as to justify the need of and develop recommendations for their expansion (fuller use). research methodology is based on the application of methods of trend and logical analysis. The authors of the article investigate the factors of strategic marketing management of retail trade enterprises in modern Russia, the Russian practice in the application of directions and tools of strategic marketing management of retail trade enterprises is currently studied; in addition, the prospects for further development of strategic marketing management of retail trade enterprises in modern Russia are justified. As a result, we have come to conclusion that strategic marketing management of retail trade enterprises in modern Russia is carried out fragmentarily, i.e. it involves the use of not all potentially sought-after and available directions and tools. These gaps create further problems in ensuring high operating efficiency and competitiveness of the Russian retail trade enterprises, precluding them from fulfilling their marketing potential to the full extent. The innovative recommendations developed by the authors and aimed at developing strategic marketing management of retail trade enterprises in modern Russia are practice-oriented.

In this paper, a method of mathematical modeling for solving the problem of reusing man-made waste from mining and the processing of ores is proposed. The use of intermediate products (man-made waste: tailings of processing plants, rocks from sinking operations and the technical water of mine drainage) in cyclic production presupposes their use as fill material components and placement in the mined-out voids of underground mines. The influence of mining factors on the fill material composition and the parameters of the created fill mass is justified. The results of a practical implementation of the proposed mathematical model are presented, and an algorithm is compiled. Deformation changes and stress concentration are key criteria in the proposed mathematical model. The proposed algorithm allows for the determination of the preferred system of deposit development, and the selection of its parameters and the fill material composition.