Научные публикации


Публикационная активность ППС за 2017-2021 годы (статьи в журналах Q1 и Q2)


Название статьи



Название журнала

Краткая аннотация


2021 год


Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and

child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study



……… Davletov K…………... 


The Lancet, 398 (10303), pp. 870-905. 

(99 процентиль, Q1)

Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods: We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (U5MR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings: Global U5MR decreased from 71·2 deaths per 1000 livebirths (95% uncertainty interval [UI] 68·3–74·0) in 2000 to 37·1 (33·2–41·7) in 2019 while global NMR correspondingly declined more slowly from 28·0 deaths per 1000 live births (26·8–29·5) in 2000 to 17·9 (16·3–19·8) in 2019. In 2019, 136 (67%) of 204 countries had a U5MR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030, 154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9·65 million (95% UI 9·05–10·30) in 2000 and 5·05 million (4·27–6·02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3·76 million [95% UI 3·53–4·02]) in 2000 to 48% (2·42 million; 2·06–2·86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0·80 (95% UI 0·71–0·86) deaths per 1000 livebirths and U5MR to 1·44 (95% UI 1·27–1·58) deaths per 1000 livebirths, and in 2019, there were as many as 1·87 million (95% UI 1·35–2·58; 37% [95% UI 32–43]) of 5·05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation: Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve U5MR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. Funding: Bill & Melinda Gates Foundation.






Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable
disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global
Burden of Disease Study 2019

……… Davletov K…………... 


The Lancet, 397 (10292), pp. 2337-2360. (99 процентиль, Q1)

Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. Methods: We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Findings: Globally in 2019, 1·14 billion (95% uncertainty interval 1·13–1·16) individuals were current smokers, who consumed 7·41 trillion (7·11–7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5% [26·5–28·5] reduction) and females (37·7% [35·4–39·9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98–1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16–8·20) deaths and 200 million (185–214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% [19·3–21·1] of male deaths). 6·68 million [86·9%] of 7·69 million deaths attributable to smoking tobacco use were among current smokers. Interpretation: In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.





Burden of Ischemic Heart Disease in Central Asian Countries, 1990–2017

Lui, M., Safiri, S., Mereke, A., Davletov, K., Mebonia, N., Myrkassymova, A., Aripov, T., Mirrakhimov,
E., Aghayan, S.A., Gamkrelidze, A., Naghavi, M., Kopec, J.A., Sarrafzadegan, N.


IJC Heart and Vasculature, 33, статья No 100726 (47 процентиль, Q3)

The burden of ischemic heart disease (IHD) is high. There is limited information on the burden of IHD in identified high risk areas like Central Asia (CA) which is comprised of Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Turkmenistan, Mongolia, Uzbekistan and Tajikistan. This study addresses the burden of IHD in CA at the regional and country levels. Methods: Using data from the latest iteration of the Global Burden of Disease Study (GBD), this study provides age-adjusted mortality, prevalence, and Disability Adjusted Life Years (DALYs) of IHD by sex in the CA region, and national levels for countries in this region from 1990 to 2017. Results: The CA region has a higher IHD burden than the rest of the world over the studied period. Amongst the countries within this region, age-standardized mortality and DALY rates in Uzbekistan are the highest not only in CA but worldwide, while Armenia consistently has the lowest IHD burden in CA. Unhealthy diet, high systolic blood pressure and LDL-cholesterol are the risk factors with the highest attributable IHD DALYs. Conclusion: Increasing burden of IHD over time in CA can be partially explained by the economic crisis in the 1990s. There is considerable variation in IHD DALY rates among countries in the CA region. The reasons for such differences are likely multifactorial such as differences in risk factors distribution, health care effectiveness, political, social and economic factors.




Alcohol control policies in Former Soviet Union countries: A narrative review of three decades of policy changes and their apparent effects

Neufeld, M., Bobrova, A., Davletov, K., Štelemėkas, M., Stoppel, R., Ferreira-Borges, C., Breda, J.,
Rehm, J.
Alcohol control policies in Former Soviet Union countries: A narrative review of three decades of
policy changes and their apparent effects


Drug and Alcohol Review, 40 (3), pp. 350-367. (89 процентиль, Q1)

The last Soviet anti-alcohol campaign of 1985 resulted in considerably reduced alcohol consumption and saved thousands of lives. But once the campaign's policies were abandoned and the Soviet alcohol monopoly broken up, a steep rise in mortality was observed in many of the newly formed successor countries, although some kept their monopolies. Almost 30 years after the campaign's end, the region faces diverse challenges in relation to alcohol. Approach: The present narrative review sheds light on recent drinking trends and alcohol policy developments in the 15 Former Soviet Union (FSU) countries, highlighting the most important setbacks, achievements and best practices. Vignettes of alcohol control policies in Belarus, Estonia, Kazakhstan, Lithuania and Uzbekistan are presented to illustrate the recent developments. Key Findings: Over the past decade, drinking levels have declined in almost all FSU countries, paralleled by the introduction of various alcohol-control measures. The so-called three ‘best buys’ put forward by the World Health Organization to reduce alcohol-attributable burden (taxation and other measures to increase price, restrictions on alcohol availability and marketing) are relatively well implemented across the countries. Implications: In recent years, evidence-based alcohol policies have been actively implemented as a response to the enormous alcohol-attributable burden in many of the countries, although there is big variance across and within different jurisdictions. Conclusion: Strong declines in alcohol consumption were observed in the 15 FSU countries, which have introduced various alcohol control measures in recent years, resulting in a reduction of alcohol consumption in the World Health Organization European region overall.





Primary prevention efforts are poorly developed in people at high cardiovascular risk: A report from the European Society of Cardiology EURObservational Research Programme EUROASPIRE v survey in 16 European countries

Kotseva, K., De Backer, G., De Bacquer, D., Ryden, L., Hoes, A., Grobbee, D., Maggioni, A.,
Marques-Vidal, P., Jennings, C., Abreu, A., Aguiar, C., Badariene, J., Bruthans, J., Cifkova, R.,
Davletov, K., Dilic, M., Dolzhenko, M., Gaita, D., Gotcheva, N., Hasan-Ali, H., Jankowski, P., Lionis,
C., Mancas, S., Milicic, D., Mirrakhimov, E., Oganov, R., Pogosova, N., Reiner, Z., Vulic, D., Wood,


European Journal of Preventive Cardiology, 28 (4), pp. 370-379. (95 процентиль, Q1)

Background European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V in primary care was carried out by the European Society of Cardiology EURObservational Research Programme in 2016-2018. The main objective was to determine whether the 2016 Joint European Societies' guidelines on cardiovascular disease prevention in people at high cardiovascular risk have been implemented in clinical practice. Methods The method used was a cross-stional survey in 78 centres from 16 European countries. Patients without a history of atherosclerotic cardiovascular disease either started on blood pressure and/or lipid and/or glucose lowering treatments were identified and interviewed ≥ 6 months after the start of medication. Results A total of 3562 medical records were reviewed and 2759 patients (57.6% women; mean age 59.0 ± 11.6 years) interviewed (interview rate 70.0%). The risk factor control was poor with 18.1% of patients being smokers, 43.5% obese (body mass index ≥30 kg/m2) and 63.8% centrally obese (waist circumference ≥88 cm for women, ≥102 cm for men). Of patients on blood pressure lowering medication 47.0% reached the target of <140/90 mm Hg (<140/85 mm Hg in people with diabetes). Among treated dyslipidaemic patients only 46.9% attained low density lipoprotein-cholesterol target of <2.6 mmol/l. Among people treated for type 2 diabetes mellitus, 65.2% achieved the HbA1c target of <7.0%. Conclusion The primary care arm of the EUROASPIRE V survey revealed that large proportions of people at high cardiovascular disease risk have unhealthy lifestyles and inadequate control of blood pressure, lipids and diabetes. Thus, the potential to reduce the risk of future cardiovascular disease throughout Europe by improved preventive cardiology programmes is substantial.






Prognostic value of serum soluble ST2 in professional athletes Valor pronóstico de ST2 soluble en suero en deportistas profesionales

Baurzhan, M., Berkinbayev, S., Abzaliyev, K., Andassova, Z., Anvarbekova, Y., Abzaliyeva, S.,
Absatarova, K.,
Tanabayeva, S., Rakhimbekova, G., Fakhradiyev, I.


Retos, 43, pp. 428-437. (64 процентиль, Q2)

The predictive value of serum soluble ST2 (sST2) biomarker for diagnostics of cardiovascular pathologies is still poorly understood as well as the role of psychological stress on the risk of heart disease. Aim: This study aimed at determining the diagnostic significance of the sST2 level in athletes involved in speed-strength sports. In addition, stress as a risk factor for the development of cardiovascular pathology was assessed and analysed as well. Methods: A prospective study on Greco-Roman wrestlers was carried out at the Centre for Sports Medicine and Rehabilitation (Almaty, Republic of Kazakhstan). All participants (n = 30) were males aged 20 to 34 years. The control group consisted of volunteers (VO) (n = 30). Anthropometric and hemodynamic parameters of athletes were studied along with electrocardiography (ECG) and ECG tests. The sST2 level was determined before (BT) and immediately after (AT) training. The stress level was determined using The Perceived Stress Scale- 10 (PSS-10). Results: The average age of the athletes was 26.57 ± 3.6 years. The total training experience was 14.57 ± 4.02 years. According to the ECG data, minor deviations from the norm (13.3%) and an abnormal ECG (33.3%) were identified. Echo-CG data showed «moderate» and «pronounced changes» in 23.3% and 53.3% of cases, respectively. The sST2 level of VO (337.1 ± 61.8 pg / mL) was lower than that of BT (548.1 ± 32.6 pg / mL) (p d» 0.001). The sST2 level of AT, it was significantly higher (830.01 ± 71.6 pg / mL) than BT (p d» 0.001). The average and high level of stress among athletes was in 43.3% and 56.7% of cases, respectively. Stress increased the likelihood of developing distinctly abnormal ECG (OR = 1.06, 95% CI 1.01-1.08; p = 0.02). The stress level showed a positive correlation with the sST2 level (r = 0.752, p = 0.01). The sST2 concentration and categorical echocardiography data demonstrated a dependent positive correlation (r = 0.6, p = 0.01). Conclusions: Athletes' sST2 levels exceeded thresholds both before and after training. Moreover, the relationship between an increase in sST2 levels and abnormal ECG abnormalities and a high level of stress in athletes was determined. sST2 concentration was associated with cardio-pulmonary stress triggered by the cumulative exercise dose as well as with lifelong psychological stress. Our findings indicate that the elevated sST2 concentrations in athletes could be used as the predictive value. However, clinical relevance and results validity require further intensive studies.





Modern approaches for diagnosing transformations of the heart in qualified athletes

Baurzhan, M., Abzaliyev, K., Anvarbekova, Y., Andassova, Z., Berkinbaev, S., Absatarova, K.,
Murariu, C.


Journal of Physical Education and Sport, 21 (2), статья No 101, pp. 813-818. (54 процентиль, Q2)

The lack of clear standards for medical supervision of athletes considerably limits the ability to diagnose and prevent overstrain of the cardiovascular system. To date, in the Republic of Kazakhstan, an assessment of the significance of early cardiomarkers, reflecting the state of maladjustment of the heart to physical exertion among highly qualified athletes involved in martial arts, has not been performed. Aims: The aim of this study is to determine the level and diagnostic significance of cardiac biomarker IL1RL1 (sST2 - serum-soluble) and the role of psychological stress on the risk of cardiovascular disease in qualified sport veterans engaged in speed-strength sports. Methods: A prospective study on wrestlers was performed at the Centre for Sports Medicine and Rehabilitation (Almaty, Republic of Kazakhstan). All participants (n = 30) were males aged 30 to 44 years s, masters of sports of international class, and honoured masters of sports). The control group consisted of volunteers (VO) (n = 30). The sST2 level was determined before (BT) and immediately after (AT) training. Anthropometric and hemodynamic parameters of athletes were studied along with electrocardiography and echocardiography tests. Results: The average age of 30 athletes was 36.3 ± 0.5 years; the largest proportion of athletes was 35-39 years old (66.7%, n = 20); 6 sports veterans (20%) were 30- 34 years old; the smallest proportion of athletes was under 40-44 years old (13.3%, n = 5). According to the electrocardiography (ECG) data, minor deviations from the norm (16.6 %) and abnormal ECG (30%) were identified. The echo-CG data showed “moderate” and “pronounced changes” in 40.0% and 60.0% of cases, respectively.The sST2 level of VO (337.1 ± 61.8 pg/mL) was lower than that of BT (570.1 ± 32.6 pg/mL) and AT (768.7 ± 71.6 pg/mL) (p [removed] 0.05). Conclusion: Athletes’ sST2 levels exceeded thresholds both before and after training. Our findings indicate that the elevated sST2 concentrations in athletes can be used as the predictive valueshow maladaptation of the cardiovascular. However, it requires further intensive studies.





The efficacy and safety of cryoballoon catheter ablation in patients with paroxysmal atrial fibrillation

Baimbetov, A.K., Abzaliev, K.B., Jukenova, A.M., Bizhanov, K.A., Bairamov, B.A., Ualiyeva, A.Y.


Irish Journal of Medical Science, (66 процентиль, Q2)

Electrical isolation of pulmonary vein ostia is an established therapy for paroxysmal atrial fibrillation. Aims: The purpose of this study is to evaluate the long-term efficacy and safety of cryoballoon catheter ablation in paroxysmal atrial fibrillation with normal anatomy of the left atrium. Methods: Two hundred fifteen consecutive patients were included in the study (from November 2014 to November 2016). All the patients had symptoms of paroxysmal atrial fibrillation resistant to antiarrhythmic drugs and underwent pulmonary vein cryoisolation using second-generation cryoballoons. Standard “single-shot” cryoballoon exposures were used alternately for each of the four pulmonary veins. The endpoint of the ablation procedure was the electrical isolation of each pulmonary vein. Results: Sixty-nine patients had stable atrial fibrillation recurrences and left atrial flutter with 30 of 69 patients having atrial fibrillation paroxysms during the first year after primary ablation. Repeated ablation was performed within 6–12 months after the first ablation. In 39 of 69 cases, arrhythmia recurrences were registered during the second and third year after the first ablation. These patients underwent repeated ablation within 12–36 months after the first ablation. In 98% of the patients, no disease progression with a transition to a persistent form of atrial fibrillation was observed. During the mean 5-year follow-up period, no disease progression with the transition to persistent forms of atrial fibrillation was observed. Conclusions: It was concluded that in patients with paroxysmal atrial fibrillation, with normal left atrium anatomy and no risk factors, it can be controlled with single pulmonary vein isolation without additional atrial substrate modification.







Prediction of arrhythmia recurrence after atrial fibrillation ablation in patients with normal anatomy of the left atrium

Baimbetov, A.K., Bizhanov, K.A., Abzaliyev, K.B., Bairamov, B.A., Yakupova, I.


Journal of Clinical Practice, 75 (6), статья No e14083, (82 процентиль, Q1)

Enlarged left atrium is an established predictor of atrial fibrillation recurrence after pulmonary vein isolation but arrhythmia recurrence is also observed in patients with normal anatomy of the left atrium. The aim of the study is to evaluate arrhythmia recurrence predictors in patients with normal anatomy of the left atrium. Methods: The study included 182 patients with normal anatomy of the left atrium who underwent pulmonary vein isolation using catheter ablation. Various parameters were also compared, including age, gender, history of arrhythmia, arterial hypertension, concomitant coronary pathology, echocardiography findings, such as mitral valve and tricuspid valve regurgitation and procedure parameters, between patients with and without relapses. Statistical analysis was performed using the IBM SPSS Statistics-19 software. Results: Transthoracic echocardiography was performed by independent specialists with extensive experience. Trans-esophageal echocardiography was performed before each ablation procedure. Standard trans-septal puncture was performed under fluoroscopic control. Radiofrequency ablation was performed in the ipsilateral pulmonary vein antrum with a wide capture of nearby lung tissue. Conclusions: It was concluded that the tricuspid valve regurgitation and arterial hypertension correlate with atrial fibrillation recurrence after pulmonary vein isolation in patients with normal left atrial anatomy.






Fractional exhaled NO in a metalworking occupational cohort

Vinnikov, D., Tulekov, Z., Blanc, P.D.


International Archives of Occupational and Environmental Health (75 процентиль, Q1)

Secondary metalworking carries exposure to relatively heavy levels of respirable particulate. We investigated the extent to which metalworking is associated with increased exhaled nitric oxide (FeNO), an established inflammatory biomarker. Methods: We studied 80 metalworking factory employees in Kazakhstan. Informed by industrial hygiene data, we categorized them into three groups: (1) machine operators (41%); (2) welders or assemblers (33%); and (3) all others, including administrative and ancillary staff (26%). Participants completed questionnaires covering occupational history, smoking, home particulate sources, respiratory symptoms, and comorbidities. We measured exhaled carbon monoxide (CO), exhaled fractional nitric oxide (FeNO), and spirometric function. We used mixed-effects modeling to test the associations of occupational group with FeNO, adjusted for covariates. Results: The median age was 51.5 (interquartile range 20.5) years; 7% were women. Occupational group (p < 0.01), daily current cigarette smoking intensity (p < 0.05), and age (p < 0.05), each was statistically associated with FeNO. Welders, or assemblers (Group 2), who had intermediate particulate exposure, manifested significantly higher exhaled FeNO compared to machinists (Group 1, with the highest particulate exposure) and all others (Groups 3, the lowest particulate): adjusted Group 2 mean 44.8 ppb (95% confidence interval (CI) 33.8–55.9) vs. Group 1 24.6 ppb (95% 20.5–28.7) and Group 3, 24.3 ppb (95% CI 17.7–30.9). Secondhand smoking and height were not associated with FeNO. Conclusion: In a metalworking industrial cohort, welders/assemblers manifested significantly higher levels of FeNO. This may reflect respiratory tract inflammation associated with airborne exposures specific to this group.






Occupational Burden of Chronic Obstructive Pulmonary Disease in the Commonwealth of Independent States: Systematic Review and Meta-Analysis

Vinnikov, D., Rybina, T., Strizhakov, L., Babanov, S., Mukatova, I.


Frontiers in Medicine, 7, статья No 614827 (86 процентиль, Q1)

Population-based studies from the Russian Federation and neighboring countries on the occupational burden of chronic obstructive pulmonary disease (COPD) are seldom or not included in the systematic reviews. The aim of this review was to summarize published population-based studies from the Commonwealth of Independent States (CIS) in order to ascertain the occupational burden of COPD. Methods: We systematically searched www.elibrary.ru and PubMed for population-based studies on the epidemiology of COPD in nine countries using PRISMA. Quality of studies was assessed using the original tool. The odds of COPD in the included studies from vapors, gases, dusts, and fumes (VGDF) was pooled using meta-analysis (fixed effects model), whereas the population attributable fraction percent (PAF%) was pooled with meta-proportion using the random effects model in Stata 14.2. Results: Five studies, three from Russia, one from Kazakhstan, and one more from Azerbaijan and Kazakhstan (total N = 18,908) with moderate to high quality and published from 2014 to 2019 (none from Armenia, Belarus, Kyrgyzstan, Moldova, Tajikistan, and Uzbekistan), were included. Spirometry-defined COPD was the outcome in four of them. The pooled odds ratio (OR) of COPD from VGDF was 1.69 [95% confidence interval (CI) 1.34;2.13], greater in Kazakhstan [OR 1.96 (95% CI 1.35;2.85, N = 2 studies)] compared to Russia [OR 1.52 (95% CI 1.13;2.05, N = 2 studies)]. The pooled PAF% was 6% (95% CI 2; 14%) from three studies. Conclusions: Population-based studies in the CIS get little attention with very few studies published. Although the effect was greater in Kazakhstan compared to Russia, the overall effect did not differ from studies published in the rest of the world. Research capacity to study occupational risks of COPD should be strengthened to produce more evidence of higher quality.






Plasma cutting and exposure to PM2.5metal aerosol in metalworking, Almaty, Kazakhstan, 2020

Vinnikov, D., Tulekov, Z. 


Occupational and Environmental Medicine, 78 (3), pp. 218-220. (92 процентиль, Q1)

Objectives Little is known regarding the metal working subprocesses that determine exposures in the workplace primarily because their segregation from the main process is rather difficult in real-life occupational settings. The present study aimed to identify the subprocesses in a metalworks plant with high personal exposure to particulate matter (PM 2.5) metal aerosol in order to plan future risk reduction interventions. Methods A total of eighty 8-hour PM 2.5 metal aerosol samples from the breathing zone of four workers in each of four major operations (plasma cutting, machine operating, assembling and welding) were collected in a metalwork plant in Almaty in January to June 2020. Minimal, maximal, time-weighted average PM 2.5 metal aerosol mass concentrations were recorded with TSI SidePak AM520 personal aerosol and analysed using analysis of variance (ANOVA) after normalisation. Results The overall sampling time was 640 hours. Maximal 1 min and geometric mean PM 2.5 concentrations were 8.551 and 1.7268 mg/m 3 in plasma cutting; 4.844 and 0.9343 mg/m 3 in machine operating; 2.993 and 0.6898 mg/m 3 in assembling; and 2.848 and 0.4903 mg/m 3 in welding. Using a Tukey-Kramer test after a one-way ANOVA, plasma cutting concentrations were significantly higher compared with all other operations (F-ratio 29.6, p<0.001). The fold-range containing 95% of the total variability (R 0.95) from all samples was 12.5. Conclusions The highest PM 2.5 concentrations were found in plasma cutting, potentially elevating the risk of systemic inflammatory effects. © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions.






Air pollution in the workplace: making shish kebab is an overlooked occupational hazard

Vinnikov, D., Romanova, Z., Zhumabayeva, G.



Journal of Exposure Science and Environmental Epidemiology, 31 (4), pp. 777-783. (93 процентиль, Q1)

Meat grilled with wood charcoal is the most popular meal in Central Asia, but little is known about the grillers’ occupational exposure to fine particulate matter (PM) in fumes. Objectives: The aim of this study was to provide a quantitative analysis of occupational exposure to fine PM in grillers in the workplace. Methods: We assessed exposure to PM2.5 from barbecue fumes using SidePak AM520 in six popular cafes in Almaty, Kazakhstan. Grillers wore devices for 8 h of work shift for 7 days in each place. Within- and between-place variances of PM2.5 mass concentrations were calculated using analysis of variance, and we also calculated the fold range of the 95% variance within (wR0.95) and between places (bR0.95), as well as exceedance (γ) and the probability of overexposure (θ). Results: Two modes of exposure were identified, including intermittent and continuous. The median of daily geometric mean PM2.5 concentrations was 0.143 (interquartile range (IQR): 0.213) and 0.404 (IQR: 0.243) mg/m3, accordingly. bR0.95 was very large (20.2), but wR0.95 was even greater (47.8), illustrating extremely high fluctuations in PM2.5 concentrations; γ was 0.116, and θ was 0.095. Significance: Very high occupational exposure to barbecue fumes in grillers is overlooked and likely causes elevated health risks.






Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

..................Davletov K.K., Dushpanova ...............


eLife, 10, статья No e60060 (90 процентиль, Q1)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.







Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

..................Davletov K.K., Dushpanova ...............


The Lancet, 398 (10304), pp. 957-980. (99 процентиль, Q1)

Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods: We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings: The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings.






Health-related quality of life in a general population sample in Kazakhstan and its sociodemographic and occupational determinants

Vinnikov, D., Raushanova, A., Romanova, Z., Tulekov, Z.


Health and Quality of Life Outcomes, 19 (1), статья No 199 (74 процентиль, Q2)

Health-related quality of life (HRQL) in the general population of Kazakhstan has never been characterized. We constructed this population-based study of the largest city in Kazakhstan, Almaty with the aim to quantitatively assess HRQL and ascertain whether occupation and lifestyle are associated with HRQL in this population. Methods: In a random sample (N = 1500) of general population in Almaty (median age 49 (interquartile range 28) years, 50% women), we collected data on demographics, socioeconomic status, lifestyle, lifetime occupational history and general HRQL using SF-8 instrument. The association of demographic and occupational predictors with HRQL was tested in multiple regression models. Results: No occupational associations were found for physical component score in the models adjusted for age, sex, income, cigarette and waterpipe smoking, electronic cigarette use, physical activity, alcohol and exposure to secondhand smoke. Ever being a manager (β − 1.63 (95% confidence interval (CI) − 2.92; − 0.34)), a welder (β − 5.11 (95% CI − 8.77; − 1.46)) and a secretary (β − 5.06 (95% CI − 8.56; − 1.56)) for one year or more was associated with poorer mental component score in the models adjusted for age, sex, income, cigarette smoking, physical activity and each other. Age, income and physical activity were independent predictors of both physical and mental components. Conclusions: Occupational history is associated with HRQL in the general population in Almaty, Kazakhstan, but the mechanism explaining this association should be further elucidated.






Exposure to respirable dust among workers fabricating aluminium trihydroxide-containing synthetic countertops

Vinnikov, D., Blanc, P.D., Raushanova, A., Beisbekova, A., Abraham, J.L., Zlobina, Y.


Scientific Reports, 11 (1), статья No 21219 (93 процентиль, Q1)

The aim of this study is to characterize personal exposure of workers to respirable particulate matter (PM) generated in cutting and other fabrication activities when fabricating acryl polymer/aluminium trihydroxide synthetic countertops. We collected 29 personal full-day samples of respirable PM from three workers in a small private workshop. We tested differences between- and within-worker variances of mass concentrations using the Kruskall-Wallis test. We used segmented regression to test the means and medians 15-min interval concentrations changes over time and to identify a breakpoint. Respirable PM concentrations ranged nearly 100-fold, from 0.280 to 25.4 mg/m3 with a median of 2.0 mg/m3 (1-min concentrations from 13,920 data points). There were no statistical difference in daily median or geometric mean concentrations among workers, whereas the concentrations were significantly higher on days with three versus two workers present. The 15-min median concentrations (n = 974 measures) increased until 2.35 h (beta 0.177; p < 0.05), representing a 0.70 mg increase in exposure per hour. This was followed by a plateau in concentrations. The high levels of respirable PM we observed among workers fabricating aluminium trihydroxide-containing synthetic countertops highlight an unmet early prevention need.






Testosterone and occupational burnout in professional male firefighters

Vinnikov, D., Romanova, Z., Kapanova, G., Raushanova, A., Kalmakhanov, S., Zhigalin, A.


BMC Public Health, 21 (1), статья No 397 (77 процентиль, Q1)

Very little is known about the biologic predictors of the occupational burnout in firefighters. The aim of this study was to characterize testosterone profile of active firefighters and quantify its association with three domains of the occupational burnout. Methods: We enrolled 100 firefighters (median age 28 (interquartile range (IQR) 9.8) years with 5 (IQR 9) years in service) of three fire departments in Almaty, Kazakhstan. Demographics, smoking status, health-related quality of life (HRQL) and burnout scores of Maslach Burnout Inventory were assessed using a questionnaire, while total blood testosterone was measured in venous blood. Logistic regression models were used to quantify the association of blood testosterone with each burnout domain in the adjusted for confounders models. Results: The median blood testosterone level was 14 (IQR 3.5) nmol/l and was only predicted by age (beta − 0.14, p < 0.01, 79% power). There were no differences in blood testosterone levels between occupational groups (Group 1 (firefighters), 14.6 (IQR 3.4); Group 2 (fire truck drivers), 14.7 (IQR 5.6); Group 3 (shift commanders, division heads, department managers and engineers), 14 (IQR 4.1) nmol/l, Kruskal-Wallis p = 0.32) or departments. Testosterone could not predict EX or CY, but had a negative association with PE score reflecting more burnout (odds ratio 1.18 (95% confidence interval 1.01;1.38)), adjusted for age, mental component of HRQL and education. Conclusions: Firefighters with higher testosterone may develop burnout in PE earlier, and this should be considered for proper work placement within the rescue system.

DOI: 10.1186/s12889-021-10446-z





Effects of air temperature on the number of ambulance calls for asthma during cold season in Nur-Sultan– the second coldest capital in the world

Grjibovski, A.M., Adilbekova, B., Omralina, E., Imangazinova, S., Akhmetova, Z., Ainabai, A.,
Kalmakhanov, S., Aituganova, A., Kosbayeva, A., Menne, B., Odland, J.Ø.



International Journal of Circumpolar Health, 80 (1), статья No 1978228 (55 процентиль, Q2)

Deleterious effect of cold on overall mortality is well-established. We studied associations between the air temperature and the number f ambulance calls for asthma in Nur-Sultan, Kazakhstan–the second coldest capital in the world. Daily counts of ambulance calls for asthma in Nur-Sultan for the cold seasons (October-March) 2006–2010 were obtained from the Municipal Ambulance Station. Associations between the number of calls and mean and minimum apparent temperatures (average for lags 0–15) were studied using first-order Poisson auto-regression models controlling for wind speed and effects of month, year, weekends and holidays. Altogether, there were 7373 ambulance calls for asthma during the study period. An inverse association between minimum apparent temperature and the number of calls was observed for the age-group 60 years and older. A decrease of the minimum apparent temperature by 1°C was associated with an increase in the number of calls by 1.7% (95% CI: 0.1%-3.3%) across the whole temperature spectrum. No associations in other age groups were found. Our results suggest an inverse association between the average 15-day lag minimum apparent temperature and the number of ambulance calls during the cold season in Nur-Sultan, but this is limited to the oldest age-group.

DOI: 10.1080/22423982.2021.1978228





Concentrations of persistent organic pollutants in women’s serum in the European arctic Russia

Varakina, Y., Lahmanov, D., Aksenov, A., Trofimova, A., Korobitsyna, R., Belova, N., Sobolev, N.,
Kotsur, D., Sorokina, T., Grjibovski, A.M., Chashchin, V., Thomassen, Y.


Toxics, 9 (1), статья No 6, pp. 1-12. (86 процентиль, Q1)

Persistent organic pollutants (POPs) are heterogeneous carbon-based compounds that can seriously affect human health. The aim of this study was to measure serum concentrations of POPs in women residing in the Euro-Arctic Region of Russia. A total of 204 women from seven rural settlements of the Nenets Autonomous Okrug (NAO) took part in the study. We measured serum concentrations of 11 polychlorinated biphenyls (PCBs) and 17 organochlorine pesticides (OCPs) across the study sites and among Nenets and non-Nenets residents. Measurement of POPs was performed using an Agilent 7890A gas chromatograph equipped with an Agilent 7000 series MS/MS triple quadrupole system. The concentrations of all POPs were low and similar to findings from other Arctic countries. However, significant geographic differences between the settlements were observed with exceptionally high concentrations of PCBs in Varnek located on Vaygach Island. Both ΣDDT (p = 0.011) and ΣPCB (p = 0.038) concentrations were significantly lower in Nenets. Our main findings suggest that the serum concentrations of the legacy POPs in women in the Euro-Arctic Region of Russia are low and similar to those in other Arctic countries. Significant variations between settlements, and between Nenets and non-Nenets residents, were found. Arctic biomonitoring research in Russia should include studies on the associations between nutrition and concentrations of POPs.

DOI: 10.3390/toxics9010006





Essential and non-essential elements in biological samples of inhabitants residing in Nenets Autonomous Okrug of the Russian Arctic

Sobolev, N., Ellingsen, D.G., Belova, N., Aksenov, A., Sorokina, T., Trofimova, A., Varakina, Y.,
Kotsur, D., Grjibovski, A.M., Chashchin, V., Bogolitsyn, K., Thomassen, Y.


Environment International, 152, статья No 106510 (96 процентиль, Q1)

Exposure of Arctic residents to environmental pollutants is an emerging public health problem receiving little global attention. The objective of this study was to assess whole blood concentrations of nine selected essential (Co, Cu, Mn, Se, Zn) and non-essential (As, Cd, Hg, Pb) elements among Nenets and non-Nenets adult residents of the Nenets Autonomous Okrug (NAO) living in seven coastal and inland settlements. Urine was collected in two settlements for assessment of iodine status. Altogether 297 whole blood and 68 urine samples were analysed by inductively coupled mass spectrometry and the accuracy of the measurements was assessed by use of human whole blood and urine quality control materials. Several essential and non-essential showed significant variations in whole blood concentrations characterized by gender, population group and locality. Cd levels among non-Nenets non-smokers (0.19 µg/L) indicated a dietary intake at a natural global background level. Hg concentrations in whole blood show that not more than 10% of women in the fertile age had a Hg intake above the EFAS's recommendation. The Pb concentrations were in the range of, or partly exceeding reference values for increased risk of nephrotoxicity, and there is a need for a continued effort to reduce Pb exposure among the population groups in NAO. With high prevalence of obesity among the Nenets and non-Nenets population, a high prevalence of Fe-deficiency among menstruating women (<50 years) (37.2%) and a lower I status than recommended by WHO, these nutritional dependent components deserve further attention.

DOI: 10.1016/j.envint.2021.106510





Molecular genetic tests in survival factors in patients with NSCLC in the clinical practice of Kazakhstan

Yessentayeva, S.Y., Makarov, V.A., Kalmatayeva, Z.A., Zhakenova, Z.K., Arybzhanov, D.T.


Medical Journal of the Islamic Republic of Iran, 35 (1), pp. 1-11. (56 процентиль, Q2)

Recent changes in understanding of the nature of cancer allow us, in some cases, to consider it a chronic process that requires constant or periodic treatment. The purpose of this study was to assess the efficacy of the methods for diagnosis and treatment of non-small cell lung cancer (NSCLC) in the Republic of Kazakhstan and present scientifically proven methods for the improvement of existing diagnostic algorithms and treatment programs. Methods: This work was a retrospective study. A retrospective study using descriptive and analytical statistics was used as the main method. Reported data and medical records of the patients with NSCLC who were treated from 2015 to 2017 in 6 oncology clinics in the Republic of Kazakhstan were used as study materials. The methods used for histological studies and influence of the patient's sex on the frequency of various histological forms of NSCLC were studied. Polymerase chain reaction (PCR) studies to determine the epidermal growth factor receptor (EGFR) gene status as well as surgical methods were also studied. Results: A comparative analysis of the compliance of oncologists from various regions of the republic with molecular genetic testing as an essential component of the diagnosis of NSCLC showed that the coverage of patients with immunohistochemical (IHC) and PCR studies in this country is low, 50.9% and 21.2%, respectively. The study included data on 423 patients. At the same time, the majority of studies, 64.2% (IHC) and 100% (PCR), were performed in patients in Almaty and only 35.8% of IHC studies were performed in other 5 regions included in this study. Conclusion: The morphological verification of malignant neoplasms in the lungs was based on histological studies. IHC and PCR coverage of the patients in the country was low. Most of the patients received pharmacotherapy. Surgical interventions were rarely performed. Also, the lack of IHC status data were a risk factor for the patients with NSCLC






Medicine storage, wastage, and associated determinants among urban households: a systematic review and meta-analysis of household surveys

Jafarzadeh, A., Mahboub-Ahari, A., Najafi, M., Yousefi, M., Dalal, K.


BMC Public Health, 21 (1), статья No 1127, (77 процентиль, Q1)

Irrational household storage of medicines is a world-wide problem, which triggers medicine wastage as well as its associated harms. This study aimed to include all available evidences from literature to perform a focused examination of the prevalence and factors associated with medicine storage and wastage among urban households. This systematic review and meta-analysis mapped the existing literature on the burden, outcomes, and affective socio-economic factors of medicine storage among urban households. In addition, this study estimated pooled effect sizes for storage and wastage rates. Methods: Household surveys evaluating modality, size, costs, and affective factors of medicines storage at home were searched in PubMed, EMBASE, OVID, SCOPUS, ProQuest, and Google scholar databases in 2019. Random effect meta-analysis and subgroup analysis were used to pool effect sizes for medicine storage and wastage prevalence among different geographical regions. Results: From the 2604 initial records, 20 studies were selected for systematic review and 16 articles were selected for meta-analysis. An overall pooled-prevalence of medicine storage and real wastage rate was 77 and 15%, respectively. In this regard, some significant differences were observed between geographical regions. Southwest Asia region had the highest storage and wastage rates. The most common classes of medicines found in households belonged to the Infective agents for systemic (17.4%) and the Nervous system (16.4%). Moreover, income, education, age, the presence of chronic illness, female gender, and insurance coverage were found to be associated with higher home storage. The most commonly used method of disposal was throwing them in the garbage. Conclusions: Factors beyond medical needs were also found to be associated with medicine storage, which urges effective strategies in the supply and demand side of the medicine consumption chain. The first necessary step to mitigate home storage is establishing an adequate legislation and strict enforcement of regulations on dispensing, prescription, and marketing of medicines. Patient’s pressure on excessive prescription, irrational storage, and use of medicines deserve efficient community-centered programs, in order to increase awareness on these issues. So, hazardous consequences of inappropriate disposal should be mitigated by different take back programs, particularly in low and middle income countries.







Assessing service availability and readiness to manage cervical cancer in Bangladesh

Rakhshanda, S., Dalal, K., Chowdhury, H.A., Mayaboti, C.A., Paromita, P., Rahman, A.K.M.F.,
Hussain, A.H.M.E., Mashreky, S.R.


BMC Cancer, 21 (1), статья No 670 (68 процентиль, Q2)

The second most common cancer among females in Bangladesh is cervical cancer. The national strategy for cervical cancer needs monitoring to ensure that patients have access to care. In order to provide accurate information to policymakers in Bangladesh and other low and middle income countries, it is vital to assess current service availability and readiness to manage cervical cancer at health facilities in Bangladesh. Methods: An interviewer-administered questionnaire adapted from the World Health Organization Service Availability and Readiness Assessment Standard Tool was used to collect cross-sectional data from health administrators of 323 health facilities in Bangladesh. Services provided were categorized into domains and service readiness was determined by mean readiness index (RI) scores. Data analysis was conducted using STATA version 13. Results: There were seven tertiary and specialized hospitals, 118 secondary level health facilities, 124 primary level health facilities, and 74 NGO/private hospitals included in the study. Twenty-six per cent of the health facilities provided services to cancer patients. Among the 34 tracer items used to assess cancer management capacity of health facilities, four cervical cancer-specific tracer items were used to determine service readiness for cervical cancer. On average, tertiary and specialized hospitals surpassed the readiness index cutoff of 70% with adequate staff and training (100%), equipment (100%), and diagnostic facilities (85.7%), indicating that they were ready to manage cervical cancer. The mean RI scores for the rest of the health facilities were below the cutoff value, meaning that they were not prepared to provide adequate cervical cancer services. Conclusion: The health facilities in Bangladesh (except for some tertiary hospitals) lack readiness in cervical cancer management in terms of guidelines on diagnosis and treatment, training of staff, and shortage of equipment. Given that cervical cancer accounts for more than one-fourth of all female cancers in Bangladesh, management of cervical cancer needs to be available at all levels of health facilities, with primary level facilities focusing on early diagnosis. It is recommended that appropriate standard operating procedures on cervical cancer be developed for each level of health facilities to contribute towards attaining sustainable developmental goals.






Assessment of medical equipment maintenance management: proposed checklist using Iranian experience

Arab-Zozani, M., Imani, A., Doshmangir, L., Dalal, K., Bahreini, R.


BioMedical Engineering Online, 20 (1), статья No 49, (81 процентиль, Q1)

Effective maintenance management of medical equipment is one of the major issues for quality of care, for providing cost-effective health services and for saving scarce resources. This study aimed to develop a comprehensive checklist for assessing the medical equipment maintenance management (MEMM) in the Iranian hospitals. Methods: This is a multi-methods study. First, data related to factors which affect the assessment of MEMM were collected through a systematic review in PubMed, ProQuest, Scopus, Embase, and web of science without any time limitation until October 2015, updated in June 2017. Then, we investigated these factors affecting using document review and interviews with experts in the Iranian hospitals. In the end, the results of the first and second stages were combined using content analysis and the final checklist was developed in a two-round Delphi. Results: Using a combination of factors extracted from the systematic and qualitative studies, the primary checklist was developed in the form of assessment checklists in seven dimensions. The final checklist includes 7 dimensions and 19 sub-categories: “resources = 3,” “quality control = 3,” “information bank = 4,” “education = 1,” “service = 3,” “inspection and preventive maintenance = 2” and “design and implementation = 3.” Conclusions: Developing an assessment checklist for MEMM provide a comprehensive framework for the proper implementation of accurate assessment of medical equipment maintenance. This checklist can be used to improve the profitability of health facilities and the reliability of medical equipment. In addition, it is implicated in the decision-making in support of selection, purchase, repair and maintenance of medical equipment, especially for capital equipment managers and medical engineers in hospitals and also for the assessment of this process.







Perceptions and practices on newborn care and managing complications at rural communities in Bangladesh: a qualitative study

Abdullah, A.S.M., Dalal, K., Yasmin, M., Ussatayeva, G., Halim, A., Biswas, A.


BMC Pediatrics, 21 (1), статья No 168 (63 процентиль, Q2)

Community misperception on newborn care and poor treatment of sick newborn attributes to neonatal death and illness severity. Misperceptions and malpractices regarding neonatal care and neonatal complications are the leading causes of neonatal deaths in Bangladesh. The study was conducted to explore neonatal care’s perceptions and practices and manage complications among Bangladesh’s rural communities. Methods: A qualitative study was conducted in Netrakona district of Bangladesh from April to June 2015. Three sub-districts (Upazilas) including Purbadhala, Durgapur and Atpara of Netrakona district were selected purposively. Five focus group discussions (FGDs) and twenty in-depth interviews (IDIs) were conducted in the rural community. Themes were identified through reading and re-reading the qualitative data and thematic analysis was performed. Results: Community people were far behind, regarding the knowledge of neonatal complications. Most of them felt that the complications occurred due to lack of care by the parents. Some believed that mothers did not follow the religious customs after delivery, which affected the newborns. Many of them followed the practice of bathing the newborns and cutting their hair immediately after birth. The community still preferred to receive traditional treatment from their community, usually from Kabiraj (traditional healer), village doctor, or traditional birth attendant. Families also refrained from seeking treatment from the health facilities during neonatal complications. Instead, they preferred to wait until the traditional healers or village doctors recommended transferring the newborn. Conclusions: Poor knowledge, beliefs and practices are the key barriers to ensure the quality of care for the newborns during complications. The communities still depend on traditional practices and the level of demand for facility care is low. Appropriate interventions focusing on these issues might improve the overall neonatal mortality in Bangladesh.






The catastrophic out-of-pocket health expenditure of multiple sclerosis patients in Iran

Gharibi, F., Imani, A., Dalal, K.


BMC Health Services Research, 21 (1), статья No 257 (72 процентиль, Q3)

The present study was designed and conducted to evaluate multiple sclerosis (MS) treatment costs and the resulting economic impact imposed on MS patients in Iran. Methods: This was a cross-sectional study, among randomly selected 300 MS patients, registered in the MS Association of East Azerbaijan Province, Iran (1 year after their treatment began). The regression analysis, ANOVA, T-test, and chi-square were used. Results: The average amount of out-of-pocket payments (OOPs) by MS patients during the previous year was 1669.20 USD, most of which was spent on medication, rehabilitation care, and physician visits. Their mean annual income was 5182.84 USD. Fifty four percent of families with an MS patient suffer from catastrophic health expenditure (CHE) and 44% experience poverty caused by the OOPs. Occupational status, having supplemental health insurance, and being residents of Tabriz significantly affect OOPs, CHE, and the resulting poverty (P < 0.05). Conclusion: The catastrophic financial burden of health care costs on MS patients and their families justifies health policymakers to promote pre-payment systems and provide subsidies to less well-off patients to protect them from the unfairness of OOPs and its resulting CHE and poverty.






COVID-19 Transmission due to Mass Mobility Before and After the Largest Festival in Bangladesh: An Epidemiologic Study

Rahman, F.N., Rahman, A.K.M.F., Iwuagwu, A.O., Dalal, K.


Inquiry (United States), 58 (50 процентиль, Q2)

Festivals traditionally result in mass public mobility from large cities to rural or semi-urban areas in low- and middle-Income Countries (LMIC), which are inadequately prepared for tackling the consequences of the COVID-19 pandemic. This study aimed to explore the trend of COVID-19 infection in a peripheral region of Bangladesh during one of the largest festivals to develop an evidence-based hypothesis for its influence on the transmission rate of COVID-19. This study conducted a quantitative analysis of secondary data on COVID-19 collected from the Directorate General of Health Services Bangladesh (DGHS) and divisional director’s office in the Mymensingh division. To explore the influence of one of the biggest festivals (Eid-ul-Adha) on the trend of COVID-19 infection, we analyzed data from a week before the festival to 2 weeks following the festival. The infection rate (positive cases per million of the population) and the test positivity rate (positive cases among the total number of conducted diagnostic tests) of each day during this period were calculated both for the Mymensingh region and national level. Both the test positivity rate (TPR) and infection rates in the Mymensingh region demonstrated an increasing trend. The mean test positivity rate of the Mymensingh region on the week before the festival was 9.5%. It increased to a mean test positivity rate of 13% in the following week and further rose to a rate of 17% in the next week. The infection rate of Mymensingh also increased more than 2 folds from the day of the festival (2.0-5.3 cases per million) within the next 2 weeks. The TPR and infection rate on the national level remained similar throughout the study period. Mass mobility during Eid-ul-Adha influences the increased transmission of COVID-19 among the peripheral regions of Bangladesh from the central capital city Dhaka. The findings will help policymakers plan and implement travel restrictions during festivals during the pandemic in LMICs.





Lifestyle risk factor assessment through who step approach in Tabriz, Iran

Golestani, M., Sadeghi-Bazargani, H., Saadati, M., Farahbakhsh, M., Dalal, K.


ClinicoEconomics and Outcomes Research, 13, pp. 487-492. (78 процентиль, Q1)

The aim of this study was to assess the lifestyle behaviour and risk factors for lifestyle-related diseases in East Azerbaijan province, Iran. Methods: A household study using a two-stage cluster sampling method was performed. Tabriz city was randomly selected for data collection among five geographic regions in the East-Azerbaijan province. Short WHO-STEP and Ultra-short version of Socio-Economic Status assessment questionnaire were used. Six hundred households were asked to respond to the STEP questionnaire. Results: A total of 1196 people have participated in the study. People with higher socioeconomic status consumed more fruits, vegetables and fish than the people with lower socioeconomic status. People with academic education less likely to be hypertensive com-pared to people with non-academic education. People with a medium socioeconomic status are less likely to be hypertensive than people with high socioeconomic status. The majority of participants had poor dietary habits. In this study, 17.22%, 7.53% and 4.35% of respon-dents had hypertension, diabetes and depression, respectively. Conclusion: Considering that lifestyle-related risk factors are common among people. Due to the direct link between lifestyle and the occurrence of many chronic diseases, campaigns for and training programs to implement healthy lifestyle habits are recommended.






Maternal Delivery at Home: Issues in India

Ou, C.-Y., Yasmin, M., Ussatayeva, G., Lee, M.-S., Dalal, K.


Advances in Therapy, 38 (1), pp. 386-398. (76 процентиль, Q1)

Maternal delivery at home without skilled care at birth is a major public health issue. The current study aimed to assess the various contributing and eliminating factors of maternal delivery at home in India. The reasons for not delivering at healthcare facilities were also explored. Methods: The study used the National Family Health Surveys (NFHS)-4 (2015–2016) data from states and union territories of India for analysis. A national representative sample of 699,686 women of reproductive age group (15–49 years) was used. Cross-tabulation and multivariate logistic regression analyses were performed. Results: The prevalence of home delivery in India was 22%, among which 34% of women believed that institutional delivery was not a necessity. Financial constraints, lack of proper transportation facilities, non-accessibility of healthcare institutions and not getting permission from family members were the main reasons cited by the women for delivering at home. The proportion of home deliveries was much higher among women from more disadvantaged socioeconomic areas than women from less disadvantaged socioeconomic areas. Domestic violence and partner control were essential factors contributing to the prevalence of home delivery. However, the women who owned mobile phones and used a short message service (SMS) facility delivered at home less often. Conclusion: Policymakers should focus more on the women living in disadvantaged socioeconomic areas and other marginalised populations with less education and low economic levels to provide them with optimum delivery care utilisation. Strengthening of public healthcare facilities and more effective use of skilled birth attendents and their networking are essential steps. Electronic and economic empowerment of women should be emphasised to bring about a significant reduction in the proportion of home deliveries in India.






Predicting associations of mirnas and candidate gastric cancer genes for nanomedicine

Akimniyazova, A., Pyrkova, A., Uversky, V., Ivashchenko, A.

Predicting associations of mirnas and candidate gastric cancer genes for nanomedicine



Nanomaterials, 11 (3), статья № 691, pp. 1-16.

(79 процентиль, Q1)

Nanoscale miRNAs regulate the synthesis of most human proteins involved in differentiation, proliferation, cell cycle, apoptosis, and other processes associated with the growth and the development of an organism. miRNAs also play a number of important roles in the development of gastric cancer. In this work, we studied the quantitative characteristics of miRNA interactions with 69 candidate gastric cancer genes using bioinformatics approaches. To this end, the MirTarget program was used, which determines the characteristics of miRNA binding to mRNA in the 5′UTR, CDS, and 3’UTR. Associations of miRNAs with alternative target genes and associations of genes with alternative miRNAs were established. The cluster organization of miRNA binding sites (BSs) in mRNA was revealed, leading to the emergence of miRNA competition for binding to the mRNA of a target gene. Groups of target genes with clusters of overlapping BSs include miR‐5095,miR‐619‐5p, miR‐1273 family, miR‐466, ID01030.3p‐miR, ID00436.3p‐miR, miR‐574‐5p, and ID00470.5p‐miR. In the defined associations of target genes and miRNAs, miRNA BSs are organized into clusters of multiple BSs, which facilitate the design and the development of a system of chips that can be used to control the state of miRNA and target genes associations in gastric cancer.







Systematic analysis of combined antioxidant and membrane-stabilizing properties of several

lamiaceae family Kazakhstani plants for potential production of tea beverages


Ydyrys, A., Zhaparkulova, N., Aralbaeva, A., Mamataeva, A., Seilkhan, A., Syraiyl, S.,

Murzakhmetova, M.



Plants, 10 (4), статья № 666

(56 процентиль, Q2)

One of the most important compounds that exhibit a wide range of biological activities with especially strong antioxidant action are plant polyphenols. In the course of the experiment, the dose-dependent effects of polyphenols-rich extracts isolated from the Lamiaceae family Ka-zakhstani plants were studied on the processes of lipid peroxidation and on the degree of erythrocytes hemolysis. The activity of aqueous-ethanolic extracts from dried parts of plants, such as Origanum vulgare, Ziziphora bungeana, Dracocephalum integrifolium, Mentha piperita, Leonurus turke-stanicus, Thymus serpyllum, and Salvia officinalis, was studied in a Wistar rat model. Lipid peroxi-dation (LPO) in liver microsomes was assessed by measuring malondialdehyde content in the form of thiobarbituric acid-reacting substances (TBARS). Estimation of osmotic resistance of isolated erythrocytes was evaluated based on hemoglobin absorbance. The amount of total phenolics in the extracts was measured using the Folin-Ciocalteu reagent method. Based on the results, Thymus serpyllum extract exhibited a significantly higher antioxidant activity (IC50 = 3.3 ± 0.7) compared to other plant extracts. Accordingly, among the extracts studied, those from Salvia officinalis, Thymus serpyllum, and Origanum vulgare show the most pronounced membrane-stabilizing activity. Anti-oxidant and antihemolytic properties of green tea and Origanum vulgare extract mixtures were similar to that of each individual plant extract. Similar results were obtained when the green tea extract was mixed with Mentha piperita, Ziziphora bungeana, and Dracocephalum integrifolium ex-tracts, indicating no discernible synergistic interaction.







Lignite biosolubilization and bioconversion by Bacillus sp.: the collation of analytical data


Akimbekov, N., Digel, I., Abdieva, G., Ualieva, P., Tastambek, K.



Biofuels, 12 (3), pp. 247-258

(63 процентиль, Q2)

The vast metabolic potential of microbes in brown coal (lignite) processing and utilization can greatly contribute to innovative approaches to sustainable production of high-value products from coal. In this study, the multi-faceted and complex coal biosolubilization process by Bacillus sp. RKB 7 isolate from the Kazakhstan coal-mining soil is reported, and the derived products are characterized. Lignite solubilization tests performed for surface and suspension cultures testify to the formation of numerous soluble lignite-derived substances. Almost 24% of crude lignite (5% w/v) was solubilized within 14 days under slightly alkaline conditions (pH 8.2). FTIR analysis revealed various functional groups in the obtained biosolubilization products. Analyses of the lignite-derived humic products by UV-Vis and fluorescence spectrometry as well as elemental analysis yielded compatible results indicating the emerging products had a lower molecular weight and degree of aromaticity. Furthermore, XRD and SEM analyses were used to evaluate the biosolubilization processes from mineralogical and microscopic points of view. The findings not only contribute to a deeper understanding of microbe–mineral interactions in coal environments, but also contribute to knowledge of coal biosolubilization and bioconversion with regard to sustainable production of humic substances. The detailed and comprehensive analyses demonstrate the huge biotechnological potential of Bacillus sp. for agricultural productivity and environmental health.







Mass gap for a monopole interacting with a nonlinear spinor field


Dzhunushaliev, V., Burtebayev, N., Folomeev, V., Kunz, J., Serikbolova, A., Tlemisov, A.


Physical Review D, 104 (5), статья № 056010,

(95 процентиль, Q1)

Within SU(2) Yang-Mills theory with a source of the non-Abelian gauge field in the form of a classical spinor field, we study the dependence of the mass gap on the coupling constant between the gauge and nonlinear spinor fields. It is shown that the total dimensionless energy of the monopole interacting with the nonlinear spinor fields depends only on the dimensionless coupling constant.







Effect of sulfur-containing agrochemicals on growth, yield, and protein content of soybeans (Glycine

max (L.) Merr)


Burkitbayev, M., Bachilova, N., Kurmanbayeva, M., Tolenova, K., Yerezhepova, N., Zhumagul, M.,

Mamurova, A., Turysbek, B., Demeu, G.



Saudi Journal of Biological Sciences, 28 (1), pp. 891-900

(90 процентиль, Q1)

In this study, effect of different forms of sulfur-containing agrochemicals on growth, yield, and protein content of soybean grains have been evaluated. Three forms were used, such as powdery, solute, and pasty, in which elemental sulfur is contained in a nanostructured state. Plants treated with powdered and solute sulfur-containing agrochemicals had the highest growth and grain yield values, and the effect of applying pasty sulfur-containing agrochemicals did not differ from the control, in which there was low yield on all variants. The use of powdered and solute sulfur-containing agrochemicals increased all protein fractions in soybeans. The results show that the use of powdered and solute sulfur-containing agrochemicals is necessary to boost the yield of soy and increase the supply of proteins in the grains. A key factor in the availability of sulfur for soybean plants is the conversion of sulfur to a nanodisperse state. This study provides relevant information about sulfur-containing agrochemicals, which can promote higher seed yields and increase the content of protein in soybeans.







The Contribution of Genetic Variants to the Risk of Papillary Thyroid Carcinoma in the Kazakh

Population: Study of Common Single Nucleotide Polymorphisms and Their Clinicopathological



Mussazhanova, Z., Rogounovitch, T.I., Saenko, V.A., Krykpayeva, A., Espenbetova, M., Azizov, B.,

Kondo, H., Matsuda, K., Kalmatayeva, Z., Issayeva, R., Yeleubayeva, Z., Madiyeva, M., Mukanova,

A., Sandybayev, M., Bolsynbekova, S., Kozykenova, Z., Yamashita, S., Nakashima, M. 


Frontiers in Endocrinology, 11, статья № 543500,

(67 процентиль, Q2)

Risk for developing papillary thyroid carcinoma (PTC), the most common endocrine malignancy, is thought to be mediated by lifestyle, environmental exposures and genetic factors. Recent progress in the genome-wide association studies of thyroid cancer leads to the identification of several genetic variants conferring risk to this malignancy across different ethnicities. We set out to elucidate the impact of selected single nucleotide polymorphisms (SNPs) on PTC risk and to evaluate clinicopathological correlations of these genetic variants in the Kazakh population for the first time. Methods: Eight SNPs were genotyped in 485 patients with PTC and 1,008 healthy control Kazakh subjects. The association analysis and multivariable modeling of PTC risk by the genetic factors, supplemented with rigorous statistical validation, were performed. Result: Five of the eight SNPs: rs965513 (FOXE1/PTCSC2, P = 1.3E-16), rs1867277 (FOXE1 5’UTR, P = 7.5E-06), rs2439302 (NRG1 intron 1, P = 4.0E-05), rs944289 (PTCSC3/NKX2-1, P = 4.5E-06) and rs10136427 (BATF upstream, P = 9.8E-03) were significantly associated with PTC. rs966423 (DIRC3, P = 0.07) showed a suggestive association. rs7267944 (DHX35) was associated with PTC risk in males (P = 0.02), rs1867277 (FOXE1) conferred the higher risk in subjects older than 55 years (P = 7.0E-05), and rs6983267 (POU5F1B/CCAT2) was associated with pT3–T4 tumors (P = 0.01). The contribution of genetic component (unidirectional independent effects of rs965513, rs944289, rs2439302 and rs10136427 adjusted for age and sex) to PTC risk in the analyzed series was estimated to be 30–40%. Conclusion: Genetic factors analyzed in the present work display significant association signals with PTC either on the whole group analysis or in particular clinicopathological groups and account for about one-third of the risk for PTC in the Kazakh population







53bp1 expression as a biomarker to differentiate thyroid follicular tumors


Sato, A., Matsuda, K., Motoyama, T., Mussazhanova, Z., Otsubo, R., Kondo, H., Akazawa, Y.,

Higuchi, M., Suzuki, A., Hirokawa, M., Miyauchi, A., Nagayasu, T., Nakashima, M.



Endocrine Connections, 10 (3), pp. 309-315.

(64 процентиль, Q2)

We have previously reported that the expression of p53-binding protein 1 (53BP1) in nuclear foci (NF), a marker reflecting DNA damage response (DDR), detected using immunofluorescence (IF) is useful to estimate the malignant potency of diverse cancers. In this prospective study, we clarified the impact of 53BP1 expression via IF as a biomarker to differentiate thyroid follicular tumors (FTs) with liquid-based cytology (LBC). A total of 183 consecutively obtained-LBC samples, which were preoperatively suspected as FTs, were analyzed. Before histological diagnosis, the type of 53BP1 immunoreactivity in LBC was classified as follows: low DDR type, one or two NF; high DDR type, three or more NF; large foci type, larger than 1.0 μm; abnormal type, intense nuclear staining. Among the 183 cases, 136 cases were postoperatively diagnosed as FTs, including adenomatous goiter (AG, n = 30), follicular adenoma (FA, n = 60), FT-uncertain malignant potency (FT-UMP, n = 18), and follicular carcinoma (FC, n = 28), and 47 cases were diagnosed as tumors other than FTs or technically inadequate materials. Total 136 FT cases were collated with the type of 53BP1 immunoreactivity in LBC. The mean incidence expressing abnormal 53BP1 expression was significantly higher in FC than FA (9.5% vs 2.6%, P-value < 0.001). When adopting 4.3% as a cut-off value to distinguish FC from FA, the sensitivity, specificity, positive predictive value, and negative predictive value were 89.3, 83.3, 71.4, and 94.3%, respectively. Therefore, IF analysis of 53BP1 expression can be employed as a novel technique to diagnose FTs and to distinguish between different types of FTs using LBC







The state of stroke services across the globe: Report of World Stroke Organization–World Health Organization surveys

Owolabi M.O.,Thrift A.G.b,Martins S.c,Johnson W.d,Pandian J.e,Abd-Allah F.f,Varghese C.g,Mahal A.h,Yaria J.i,Phan H.T.j,Roth G.k,Gall S.L.j,Beare R.l,Phan T.G.m,Mikulik R.n,Norrving B.o,Feigin V.L.p,on behalf of the Stroke Experts Collaboration Group

Kondybayeva, А., A., Kamenova, S.,



International Journal of StrokeОткрытый доступТом 16, Выпуск 8, Страницы 889 - 901October 2021

(88 процентиль, Q1)

Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization–World Health Organization–Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. Methods: Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019. Results: Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p < 0.001). Acute stroke treatments were offered in ∼ 60% of high-income countries compared to 26% of low-income countries (p = 0.009). Compared to high-income countries, LMICs provided less rehabilitation services including in-patient rehabilitation, home assessment, community rehabilitation, education, early hospital discharge program, and presence of rehabilitation protocol. Conclusions: There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.







SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

……Almabayev, Y…….


British Journal of Surgery

Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year.

Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.



Genistein as a regulator of signaling pathways and microRNAs in different types of cancers


Javed, Z., Khan, K., Herrera-Bravo, J., Naeem, S., Iqbal, M.J., Sadia, H., Qadri, Q.R., Raza, S.,

Irshad, A., Akbar, A., Reiner, Ž., Al-Harrasi, A., Al-Rawahi, A., Satmbekova, D., Butnariu, M., Bagiu,

I.C., Bagiu, R.V., Sharifi-Rad, J.



Cancer Cell International, 21 (1), статья No 388

(63 процентиль, Q2)

Cancers are complex diseases orchestrated by a plethora of extrinsic and intrinsic factors. Research spanning over several decades has provided better understanding of complex molecular interactions responsible for the multifaceted nature of cancer. Recent advances in the field of next generation sequencing and functional genomics have brought us closer towards unravelling the complexities of tumor microenvironment (tumor heterogeneity) and deregulated signaling cascades responsible for proliferation and survival of tumor cells. Phytochemicals have begun to emerge as potent beneficial substances aimed to target deregulated signaling pathways. Isoflavonoid genistein is an essential phytochemical involved in regulation of key biological processes including those in different types of cancer. Emerging preclinical evidence have shown its anti-cancer, anti-inflammatory and anti-oxidant properties. Testing of this substance is in various phases of clinical trials. Comprehensive preclinical and clinical trials data is providing insight on genistein as a modulator of various signaling pathways both at transcription and translation levels. In this review we have explained the mechanistic regulation of several key cellular pathways by genistein. We have also addressed in detail various microRNAs regulated by genistein in different types of cancer. Moreover, application of nano-formulations to increase the efficiency of genistein is also discussed. Understanding the pleiotropic potential of genistein to regulate key cellular pathways and development of efficient drug delivery system will bring us a step towards designing better chemotherapeutics







Premature mortality attributable to COVID-19: potential years of life lost in 17 countries around the

world, January–August 2020


Ugarte, M.P., Achilleos, S., Quattrocchi, A., Gabel, J., Kolokotroni, O., Constantinou, C., Nicolaou, N.,

Rodriguez-Llanes, J.M., Huang, Q., Verstiuk, O., Pidmurniak, N., Tao, J.W., Burström, B., Klepac, P.,

Erzen, I., Chong, M., Barron, M., Hagen, T.P., Kalmatayeva, Z., Davletov, K., Zucker, I., Kaufman, Z.,

Kereselidze, M., Kandelaki, L., Le Meur, N., Goldsmith, L., Critchley, J.A., Pinilla, M.A., Jaramillo,

G.I., Teixeira, D., Goméz, L.F., Lobato, J., Araújo, C., Cuthbertson, J., Bennett, C.M., Polemitis, A.,

Charalambous, A., Demetriou, C.A., On behalf of the C-MOR consortium 


BMC Public Health, 22 (1), статья No 54

(77 процентиль, Q1)

Understanding the impact of the burden of COVID-19 is key to successfully navigating the COVID-19 pandemic. As part of a larger investigation on COVID-19 mortality impact, this study aims to estimate the Potential Years of Life Lost (PYLL) in 17 countries and territories across the world (Australia, Brazil, Cape Verde, Colombia, Cyprus, France, Georgia, Israel, Kazakhstan, Peru, Norway, England & Wales, Scotland, Slovenia, Sweden, Ukraine, and the United States [USA]). Methods: Age- and sex-specific COVID-19 death numbers from primary national sources were collected by an international research consortium. The study period was established based on the availability of data from the inception of the pandemic to the end of August 2020. The PYLL for each country were computed using 80 years as the maximum life expectancy. Results: As of August 2020, 442,677 (range: 18–185,083) deaths attributed to COVID-19 were recorded in 17 countries which translated to 4,210,654 (range: 112–1,554,225) PYLL. The average PYLL per death was 8.7 years, with substantial variation ranging from 2.7 years in Australia to 19.3 PYLL in Ukraine. North and South American countries as well as England & Wales, Scotland and Sweden experienced the highest PYLL per 100,000 population; whereas Australia, Slovenia and Georgia experienced the lowest. Overall, males experienced higher PYLL rate and higher PYLL per death than females. In most countries, most of the PYLL were observed for people aged over 60 or 65 years, irrespective of sex. Yet, Brazil, Cape Verde, Colombia, Israel, Peru, Scotland, Ukraine, and the USA concentrated most PYLL in younger age groups. Conclusions: Our results highlight the role of PYLL as a tool to understand the impact of COVID-19 on demographic groups within and across countries, guiding preventive measures to protect these groups under the ongoing pandemic. Continuous monitoring of PYLL is therefore needed to better understand the burden of COVID-19 in terms of premature mortality.








Global, regional, and national mortality among young people aged 10–24 years, 1950–2019: a systematic analysis for the Global Burden of Disease Study 2019

……… Davletov K…………... 


The Lancet, 398 (10303), pp. 870-905.

(99 процентиль, Q1)

Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods: We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (U5MR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings: Global U5MR decreased from 71·2 deaths per 1000 livebirths (95% uncertainty interval [UI] 68·3–74·0) in 2000 to 37·1 (33·2–41·7) in 2019 while global NMR correspondingly declined more slowly from 28·0 deaths per 1000 live births (26·8–29·5) in 2000 to 17·9 (16·3–19·8) in 2019. In 2019, 136 (67%) of 204 countries had a U5MR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030, 154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9·65 million (95% UI 9·05–10·30) in 2000 and 5·05 million (4·27–6·02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3·76 million [95% UI 3·53–4·02]) in 2000 to 48% (2·42 million; 2·06–2·86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0·80 (95% UI 0·71–0·86) deaths per 1000 livebirths and U5MR to 1·44 (95% UI 1·27–1·58) deaths per 1000 livebirths, and in 2019, there were as many as 1·87 million (95% UI 1·35–2·58; 37% [95% UI 32–43]) of 5·05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation: Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve U5MR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. Funding: Bill & Melinda Gates Foundation







Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000

and 2018


……… Davletov K…………... 


Nature Medicine, 27 (10), pp. 1761-1782.

(99 процентиль, Q1)

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations







Alcohol abuse and insomnia disorder: Focus on a group of night and day workers


Plescia, F., Cirrincione, L., Martorana, D., Ledda, C., Rapisarda, V., Castelli, V., Martines, F.,

Vinnikov, D., Cannizzaro, E.



International Journal of Environmental Research and Public Health, 18 (24), статья № 13196,

(66 процентиль, Q2)

The sleep-wake cycle plays a fundamental role in maintaining the physiological balance of our body. Its alteration favours the genesis of several organic alterations and diseases including sleep disorders and the consumption of several substances of abuse. It has been reported that the work activity, especially that carried out during the night, is able to influence the sleep-wake cycle, promoting the development of insomnia, which, in turn, would subject the worker to a stressful condition such as to encourage adverse behaviour such as the use/abuse of psychotropic substances. Based on the above premises, the aim of our research was to evaluate, in night workers: (i) the pattern of consumption of alcoholic beverages; (ii) the presence of insomnia; and (iii) the possible correlation between alcohol consumption and insomnia disorder. We used the AUDIT-C test (the abbreviated version of the Alcohol Use Disorders Identification Test) and the Insomnia Severity Index to assess alcohol consumption and insomnia disorder, respectively. All questionnaires were completed by workers of both sexes belonging to different types of work activities, exclusively day or night. The results of our research show a higher propensity of night workers to consume alcoholic beverages than those who work during daytime hours, often in binge-drinking mode. In addition, an increase in the amount of alcohol consumed was found to be related to insomnia disorder, especially in night workers. This study provides further awareness of the importance of the negative impact of alcohol consumption on sleep quality in night workers







Global Impact of COVID-19 on Stroke Care and IV Thrombolysis


…….Kondybayeva, A., . Kamenova, S…….


Neurology, 96 (23), pp. e2824-e2838. (96 процентиль, Q1)

To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. METHODS: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. RESULTS: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] -11.7 to -11.3, p < 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI -13.8 to -12.7, p < 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI -13.7 to -10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2-9.8, p < 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. CONCLUSIONS: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months.







Repositioning of the global epicentre of non-optimal cholesterol

……………………….Davletov K., Mereke A………………………….


Nature, 582 (7810), pp. 73-77. (99 процентиль, Q1)

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.





The INVICTUS rheumatic heart disease research program: Rationale, design and baseline characteristics of a randomized trial of rivaroxaban compared to vitamin K antagonists in rheumatic valvular disease and atrial fibrillation

Karthikeyan, G., Connolly, S.J., Ntsekhe, M., Benz, A., Rangarajan, S., Lewis, G., Yun, Y., Sharma,
S.K., Maklady, F., Elghamrawy, A.E., Kazmi, K., Cabral, T.T.J., Dayi, H., Changsheng, M., Gitura,
B.M., Avezum, A., Zuhlke, L., Lwabi, P., Haileamlak, A., Ogah, O., Chillo, P., Paniagua, M., ElSayed,
A., Dans, A., Gondwe-Chunda, L., Molefe-Baikai, O.J., Gonzalez-Hermosillo, J.A., Hakim, J.,
Damasceno, A., Kamanzi, E.R., Musuku, J., Davletov, K., Connolly, K., Mayosi, B.M., Yusuf, S.,


American Heart Journal, 225, pp. 69-77. (85 процентиль, Q1)

Rheumatic heart disease (RHD) is a neglected disease affecting 33 million people, mainly in low and middle income countries. Yet very few large trials or registries have been conducted in this population. The INVICTUS program of research in RHD consists of a randomized-controlled trial (RCT) of 4500 patients comparing rivaroxaban with vitamin K antagonists (VKA) in patients with RHD and atrial fibrillation (AF), a registry of 17,000 patients to document the contemporary clinical course of patients with RHD, including a focused sub-study on pregnant women with RHD within the registry. This paper describes the rationale, design, organization and baseline characteristics of the RCT and a summary of the design of the registry and its sub-study. Patients with RHD and AF are considered to be at high risk of embolic strokes, and oral anticoagulation with VKAs is recommended for stroke prevention. But the quality of anticoagulation with VKA is poor in developing countries. A drug which does not require monitoring, and which is safe and effective for preventing stroke in patients with valvular AF, would fulfill a major unmet need. Methods: The INVestIgation of rheumatiC AF Treatment Using VKAs, rivaroxaban or aspirin Studies (INVICTUS-VKA) trial is an international, multicentre, randomized, open-label, parallel group trial, testing whether rivaroxaban 20 mg given once daily is non-inferior (or superior) to VKA in patients with RHD, AF, and an elevated risk of stroke (mitral stenosis with valve area ≤2 cm2, left atrial spontaneous echo-contrast or thrombus, or a CHA2DS2VASc score ≥2). The primary efficacy outcome is a composite of stroke or systemic embolism and the primary safety outcome is the occurrence of major bleeding. The trial has enrolled 4565 patients from 138 sites in 23 countries from Africa, Asia and South America. The Registry plans to enroll an additional 17,000 patients with RHD and document their treatments, and their clinical course for at least 2 years. The pregnancy sub-study will document the clinical course of pregnant women with RHD. Conclusion: INVICTUS is the largest program of clinical research focused on a neglected cardiovascular disease and will provide new information on the clinical course of patients with RHD, and approaches to anticoagulation in those with concomitant AF.





Variations between women and men in risk factors, treatments, cardiovascular disease incidence, and death in 27 high-income, middle-income, and low-income countries (PURE): a prospective cohort study

Walli-Attaei, M., Joseph, P., Rosengren, A., Chow, C.K., Rangarajan, S., Lear, S.A., AlHabib, K.F.,
Davletov, K., Dans, A., Lanas, F., Yeates, K., Poirier, P., Teo, K.K., Bahonar, A., Camilo, F.,
Chifamba, J., Diaz, R., Didkowska, J.A., Irazola, V., Ismail, R., Kaur, M., Khatib, R., Liu, X., Mańczuk,
M., Miranda, J.J., Oguz, A., Perez-Mayorga, M., Szuba, A., Tsolekile, L.P., Prasad Varma, R.,
Yusufali, A., Yusuf, R., Wei, L., Anand, S.S., Yusuf, S.


The Lancet, 396 (10244), pp. 97-109. (99 процентиль, Q1)

Some studies, mainly from high-income countries (HICs), report that women receive less care (investigations and treatments) for cardiovascular disease than do men and might have a higher risk of death. However, very few studies systematically report risk factors, use of primary or secondary prevention medications, incidence of cardiovascular disease, or death in populations drawn from the community. Given that most cardiovascular disease occurs in low-income and middle-income countries (LMICs), there is a need for comprehensive information comparing treatments and outcomes between women and men in HICs, middle-income countries, and low-income countries from community-based population studies. Methods: In the Prospective Urban Rural Epidemiological study (PURE), individuals aged 35–70 years from urban and rural communities in 27 countries were considered for inclusion. We recorded information on participants' sociodemographic characteristics, risk factors, medication use, cardiac investigations, and interventions. 168 490 participants who enrolled in the first two of the three phases of PURE were followed up prospectively for incident cardiovascular disease and death. Findings: From Jan 6, 2005 to May 6, 2019, 202 072 individuals were recruited to the study. The mean age of women included in the study was 50•8 (SD 9•9) years compared with 51•7 (10) years for men. Participants were followed up for a median of 9•5 (IQR 8•5–10•9) years. Women had a lower cardiovascular disease risk factor burden using two different risk scores (INTERHEART and Framingham). Primary prevention strategies, such as adoption of several healthy lifestyle behaviours and use of proven medicines, were more frequent in women than men. Incidence of cardiovascular disease (4•1 [95% CI 4•0–4•2] for women vs 6•4 [6•2–6•6] for men per 1000 person-years; adjusted hazard ratio [aHR] 0•75 [95% CI 0•72–0•79]) and all-cause death (4•5 [95% CI 4•4–4•7] for women vs 7•4 [7•2–7•7] for men per 1000 person-years; aHR 0•62 [95% CI 0•60–0•65]) were also lower in women. By contrast, secondary prevention treatments, cardiac investigations, and coronary revascularisation were less frequent in women than men with coronary artery disease in all groups of countries. Despite this, women had lower risk of recurrent cardiovascular disease events (20•0 [95% CI 18•2–21•7] versus 27•7 [95% CI 25•6–29•8] per 1000 person-years in men, adjusted hazard ratio 0•73 [95% CI 0•64-0•83]) and women had lower 30-day mortality after a new cardiovascular disease event compared with men (22% in women versus 28% in men; p<0•0001). Differences between women and men in treatments and outcomes were more marked in LMICs with little differences in HICs in those with or without previous cardiovascular disease. Interpretation: Treatments for cardiovascular disease are more common in women than men in primary prevention, but the reverse is seen in secondary prevention. However, consistently better outcomes are observed in women than in men, both in those with and without previous cardiovascular disease. Improving cardiovascular disease prevention and treatment, especially in LMICs, should be vigorously pursued in both women and men. Funding: Full funding sources are listed at the end of the paper (see Acknowledgments).





Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

...........................Davletov K...................................



The Lancet, 396 (10258), pp. 1250-1284. (99 процентиль, Q1)

Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2•5th and 97•5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings: Globally, performance on the UHC effective coverage index improved from 45•8 (95% uncertainty interval 44•2–47•5) in 1990 to 60•3 (58•7–61•9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2•6% [1•9–3•3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0•79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388•9 million (358•6–421•3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3•1 billion (3•0–3•2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968•1 million [903•5–1040•3]) residing in south Asia. Interpretation: The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC. Funding: Bill & Melinda Gates Foundation.





Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019

.................Davletov K., Mereke A.....................................




The Lancet, 396 (10258), pp. 1160-1203. (99 процентиль, Q1)

Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2•72 (95% uncertainty interval [UI] 2•66–2•79) in 2000 to 2•31 (2•17–2•46) in 2019. Global annual livebirths increased from 134•5 million (131•5–137•8) in 2000 to a peak of 139•6 million (133•0–146•9) in 2016. Global livebirths then declined to 135•3 million (127•2–144•1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2•1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27•1% (95% UI 26•4–27•8) of global livebirths. Global life expectancy at birth increased from 67•2 years (95% UI 66•8–67•6) in 2000 to 73•5 years (72•8–74•3) in 2019. The total number of deaths increased from 50•7 million (49•5–51•9) in 2000 to 56•5 million (53•7–59•2) in 2019. Under-5 deaths declined from 9•6 million (9•1–10•3) in 2000 to 5•0 million (4•3–6•0) in 2019. Global population increased by 25•7%, from 6•2 billion (6•0–6•3) in 2000 to 7•7 billion (7•5–8•0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58•6 years (56•1–60•8) in 2000 to 63•5 years (60•8–66•1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Interpretation: Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Funding: Bill & Melinda Gates Foundation.





Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

……………………….Mereke A., Davletov K…................................


The Lancet, 396 (10258), pp. 1204-1222. (99 процентиль, Q1)

In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation.





Five insights from the Global Burden of Disease Study 2019

…………….Davletov K., Mereke A…………………………..


The Lancet, 396 (10258), pp. 1135-1159. (99 процентиль, Q1)

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3·5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.






Alcohol consumption patterns across Europe and adherence to the European guidelines in coronary patients: Findings from the ESC-EORP EUROASPIRE V survey

van de Luitgaarden, I.A.T., Schrieks, I.C., De Bacquer, D., van Oort, S., Mirrakhimov, E.M.,
Pogosova, N., Davletov, K., Dolzhenko, M., van Ballegooijen, A.J., Kotseva, K., Grobbee, D.E.,
Beulens, J.W.J., On behalf of the EUROASPIRE V investigators group


Atherosclerosis, 313, pp. 35-42. (86 процентиль, Q1)

Alcohol consumption is an important risk factor for cardiovascular morbidity and mortality worldwide. The highest levels of alcohol consumption are observed in Europe, where alcohol as contributing cause of coronary heart disease (CHD) is also most significant. We aimed to describe alcohol consumption patterns across European regions and adherence to the current guidelines in patients with a recent CHD event. Methods: The ESC-EORP survey (EUROASPIRE V) has been conducted in 2016–2017 at 131 centers in 27 European countries in 7350 patients with a recent CHD. Median alcohol consumption, as well as the proportion of abstainers and excessive drinkers (i.e. >70 g/week for women and >140 for men, as recommended by the European guidelines on cardiovascular prevention), was calculated for each region. To assess adherence to guidelines, proportions of participants who were advised to reduce excessive alcohol consumption and participants who were incorrectly not advised were calculated per region. Results: Mean age was 64 years (SD: 9.5), 75% were male. Abstention rates were 53% in males and 77% in females, whereas excessive drinking was reported by 9% and 5% of them, respectively. Overall, 57% of the participants were advised to reduce alcohol consumption. In the total population, 3% were incorrectly not advised, however, this percentage differed per region (range: 1%–9%). In regions where alcohol consumption was highest, participants were less often advised to reduce their consumption. Conclusion: In this EUROASPIRE V survey, the majority of CHD patients adhere to the current drinking guidelines, but substantial heterogeneity exists between European regions.





Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study

……………Davletov K……………………...


Journal of the American College of Cardiology, 76 (25), pp. 2982-3021. (99 процентиль, Q1)

Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases.





Update in chronic obstructive pulmonary disease 2019

Alter, P., Baker, J.R., Dauletbaev, N., Donnelly, L.E., Pistenmaa, C., Schmeck, B., Washko, G.,
Vogelmeier, C.F.


American Journal of Respiratory and Critical Care Medicine, 202 (3), pp. 348-355. (99 процентиль, Q1)

Chronic obstructive pulmonary disease (COPD) is believed to be associated with both intrinsic and exogenous disease determinants. The former comprise genetic (1, 2) and epigenetic (2–4) factors. The latter involve various nonhost disease determinants (5–7), such as pathogens or air pollution. Advancing our understanding, several studies interrogated genetic and epigenetic factors as contributors to clinical manifestations. The studies focused either on a single candidate gene (8–11) or a group of genes (12, 13) with or without previously demonstrated associations with COPD. In line with previous studies (14), several reports converged on the SERPINA1 gene (9, 12, 13). The SERPINA1 (serpin family A member 1) gene encodes the inhibitor of neutrophil elastase, alpha-1 antitrypsin, the genetic deficiency of which causes a monogenic disease with respiratory manifestations similar to those in COPD (15). These observations highlight the prominence of the intrinsic disease component in COPD (14).





The phosphodiesterase inhibitor ensifentrine reduces production of proinflammatory mediators in well differentiated bronchial epithelial cells by inhibiting PDE4

Turner, M.J., Dauletbaev, N., Lands, L.C., Hanrahan, J.W.


Journal of Pharmacology and Experimental Therapeutics, 375 (3), pp. 414-429 (77 процентиль, Q1)

Cystic fibrosis (CF) is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) anion channel that impair airway salt and fluid secretion. Excessive release of proinflammatory cytokines and chemokines by CF bronchial epithelium during airway infection leads to chronic inflammation and a slow decline in lung function; thus, there is much interest in finding safe and effective treatments that reduce inflammation in CF. We showed previously that the cyclic nucleotide phosphodiesterase (PDE) inhibitor ensifentrine (RPL554; Verona Pharma) stimulates the channel function of CFTR mutants with abnormal gating and also those with defective trafficking that are partially rescued using a clinically approved corrector drug. PDE inhibitors also have known anti-inflammatory effects; therefore, we examined whether ensifentrine alters the production of proinflammatory cytokines in CF bronchial epithelial cells. Ensifentrine reduced the production of monocyte chemoattractant protein-1 and granulocyte monocyte colony-stimulating factor (GM-CSF) during challenge with interleukin-1b. Comparing the effect of ensifentrine with milrinone and roflumilast, selective PDE3 and PDE4 inhibitors, respectively, demonstrated that the anti-inflammatory effect of ensifentrine was mainly due to inhibition of PDE4. Beneficial modulation of GM-CSF was further enhanced when ensifentrine was combined with low concentrations of the b2-adrenergic agonist isoproterenol or the corticosteroid dexamethasone. The results indicate that ensifentrine may have beneficial anti-inflammatory effects in CF airways particularly when used in combination with b2adrenergic agonists or corticosteroids. SIGNIFICANCE STATEMENT Airway inflammation that is disproportionate to the burden of chronic airway infection causes much of the pathology in the cystic fibrosis (CF) lung. We show here that ensifentrine beneficially modulates the release of proinflammatory factors in well differentiated CF bronchial epithelial cells that is further enhanced when combined with b2-adrenergic agonists or low-concentration corticosteroids. The results encourage further clinical testing of ensifentrine, alone and in combination with b2-adrenergic agonists or low-concentration corticosteroids, as a novel anti-inflammatory therapy for CF. Copyright





Gene-to-gene interactions and the association of TP53, XRCC1, TNFα, HMMR, MDM2 and PALB2 with breast cancer in Kyrgyz females

Isakova, J.T., Vinnikov, D., Kipen, V.N., Talaibekova, E.T., Aldashev, A.A., Aldasheva, N.M.,
Makieva, K.B., Semetei kyzy, A., Bukuev, N.M., Tilekov, E.A., Shaimbetov, B.O., Kudaibergenova,


Breast Cancer, 27 (5), pp. 938-946. (81 процентиль, Q1)

At present, little is known about the genetic background of breast cancer (BC) in Kyrgyz. Therefore, the aim of this study was to assess gene-to-gene interactions and the contribution of p.Arg72Pro (TP53 gene), p.Gln399Arg (XRCC1 gene), p.Arg194Trp (XRCC1 gene), g.4682G > A (TNFα gene), p.Val353Ala (HMMR gene), c.14 + 309 T > G (MDM2 gene) and g.38444 T > G (PALB2 gene) polymorphic loci in breast cancer (BC) risk in females of Kyrgyz ethnicity. Methods: The case–control study comprised 103 females with histologically verified BC and 102 controls with no cancer. We used polymerase chain reaction-based restriction fragment length polymorphism to genotype polymorphic loci. Results: Gln/Arg heterozygous variant of XRCC1 gene’s p.Gln399Arg locus, as well as combined carriage of Arg/Gln//Arg/Pro of XRCC1/TP53; Arg/Gln//T/T of XRCC1/MDM2; Arg/Gln//G/G and Arg/Gln//G/A of XRCC1/TNFα, Arg/Gln//T/T of XRCC1/PALB2; Arg/Gln//Arg/Arg and Arg/Gln//Arg/Trp for p.Gln399Arg and p.Arg194Trp polymorphic loci of XRCC1 were associated with BC in Kyrgyz females. Conclusion: TP53, XRCC1, TNFα, HMMR, MDM2 and PALB2 genes’ polymorphic site combinations appear to be candidate markers of genetic predisposition to BC in Kyrgyz population and prompt targeted personalized care.





Assessment of comfort variation among different types of driving agricultural tractors: Traditional, satellite-assisted and semi-automatic

Romano, E., Bisaglia, C., Calcante, A., Oberti, R., Zani, A., Vinnikov, D., Marconi, A., Vitale, E.,
Bracci, M., Rapisarda, V.


International Journal of Environmental Research and Public Health, 17 (23), статья No 8836 (66 процентиль, Q2)

Over the past years, in the agricultural field, geo-localization has been introduced in order to develop specific farming processes, optimize resources, and reduce environmental pollution. Researchers have found alternative driving methods to traditional ones, such as assisted and semi-automatic driving. The aim of this study was to monitor the musculoskeletal efforts necessary to carry out different kinds of driving. The muscular strain was assessed using surface electromyographic devices, the distribution of the pressure exerted by the operator’s body on the seat was observed by using two barometric pads applied on the seat back and on the seat, respectively, while the body movements and postures were analyzed through a Microsoft Kinect Camera 3D acquisition system. Results showed a significantly greater muscular activation during manual and assisted driving conditions. The pressure exerted by the operator on the barometric pads was significantly higher in manual and semi-automatic driving modes than in the assisted one. A remarkable increase in the average swinging speed of examined joints was also detected, as well as the distances run by the joints in semi-automatic driving. From our study, assisted driving seems to be the best driving mode both in terms of joint economy and from the efficiency of agricultural processes.





Smoking practices in relation to exhaled carbon monoxide in an occupational cohort

Vinnikov, D., Tulekov, Z., Romanova, Z., Krugovykh, I., Blanc, P.D.


BMC Public Health, 20 (1), статья No 1894 (77 процентиль, Q1)

Exposure to carbon monoxide (CO) remains a leading occupational hazard in firefighters, but cigarette and waterpipe smoking likely contributes to the other sources of CO in such workers. The aim of this study was to estimate the contribution of self-reported active cigarette smoking, waterpipe use, and potential job-related sources of CO to the level of exhaled CO in firefighters. Methods: We surveyed the personnel of 18 fire stations (N = 842), median age 28 years, who participated at an annual screening not timed to coincide with recent firefighting. We surveyed smoking and waterpipe history, exposure to secondhand smoke (SHS), use of coal for health and biomass for cooking and time since last exposure to firefighting in the workplace. We measured exhaled CO with an instantaneous reading device (piCO Smokerlyzer). We used multivariable regression models to test the association of time since last smoked cigarette (≤12 h) and waterpipe (≤12 h) and time since last fire (≤6 h) with exhaled CO. Results: In analysis limited to men (93.5% of all surveyed), 42% were daily cigarette; 1% were waterpipe smokers; 94% were exposed to SHS, 29% used coal for heating and 4% used biomass for cooking. The median CO was 4 (interquartile range 3;8) ppm. Age (beta 0.74 per 10 years, p < 0.001), use of biomass fuel for cooking (beta 1.38, p = 0.05), cigarette smoked in the last 12 h (beta 8.22, p < 0.001), waterpipe smoked in the last 12 h (beta 23.10, p < 0.001) were statistically associated with CO, but not time since last fire (≤6 h) (beta 4.12, p = 0.12). There was a significant interaction between older age and firefighting for exhaled CO (p = 0.03). Conclusions: Cigarette and recent waterpipe smoking are associated with increased exhaled CO in firefighters. Firefighting itself was a less potent contributor to exhaled CO when measured at an annual screening, but an age interaction was manifested.





Prevalence and patient awareness of inflammatory bowel disease in Kazakhstan: a cross-sectional study

Kaibullayeva, J., Ualiyeva, A., Oshibayeva, A., Dushpanova, A., Marshall, J.K.


Intestinal Research, 18 (4), pp. 430-437. (67 процентиль, Q2)

There has been a paucity of published data on the epidemiology of inflammatory bowel disease (IBD) in Central Asia and Kazakhstan. Therefore, we aimed to study IBD prevalence and patient awareness among adults in Kazakhstan.
The cross-sectional study was carried out among subjects of both sexes aged 18 years and older using IBD Alert Questionnaire (CalproQuest), single fecal calprotectin test, and endoscopy with biopsy to verify IBD from January to December 2017, across regions of Kazakhstan. All participants were included in the study after providing informed consent.
Out of 115,556 subjects, there were 128 confirmed IBD cases, in which 36 Crohn’s disease (CD) and 92 ulcerative colitis (UC) cases identified. The age and sex-adjusted IBD prevalence were 113.9 (95% confidence interval [CI], 69.0–158.9) per 100,000 population. The age- and sex-adjusted prevalence for UC were 84.4 (95% CI, 44.8–123.9) and for CD were 29.5 (95% CI, 8.2–50.9) per 100,000 population.
This is the first report on the prevalence of IBD with a verified diagnosis in the Central Asia and could be used to better plan and allocate healthcare resources for IBD management program.





Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

..............Davletov K., Dushpanova A., Mereke A., Kalmatayeva Zh..................................  


The Lancet, 396 (10261), pp. 1511-1524. (99 процентиль, Q1)

Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods: For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings: We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation: The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks.





Occupational exposure to particulate matter from air pollution in the outdoor workplaces in Almaty during the cold season

Vinnikov, D., Tulekov, Z., Raushanova, A.



PLoS ONE, 15 (1), статья № e0227447

(92 процентиль, Q1)

Background A large fraction of population in Almaty and other Kazakhstan cities is employed in the outdoor jobs and likely exposed to high levels of particulate matter (PM) during the cold season. The magnitude of such occupational exposure remains unknown; therefore, the aim was to quantify the levels of exposure to PM10 in the outdoor workplaces in Almaty in order to guide future interventions of primary prevention. Methods Outdoor security non-smoking guards (N = 12) wore TSI DustTrack AM520 aerosol monitors with a 10-μm impactor for 8 hours of outdoor shift. Ten samples (k = 10) from each worker were obtained for the cold season (November-March) from various locations across Almaty. Total sampling time was 57600 minutes. We compared normalized time-weighted average (TWA) concentrations for 8-hour shifts within and between workers using analysis of variance (ANOVA) and assessed compliance with environmental exposure limit (EEL) (0.060 mg/m3) via exceedance (γ) and probability of overexposure (θ). Results PM10 TWA ranged from 0.050 to 2.075 mg/m3 with the geometric mean 0.366 and median 0.352 mg/m3. PM10 TWA distribution was left-skewed with large variation. The fold-range of within-person variability, containing 95% of the exposure concentration (wR0.95) was 13, whereas between-person fold-range (bR0.95) was 3. However, between-person variance exceeded the one within with F-ratio 2.797 (p = 0.003) with statistical power 97% at α = 0.05. Only two of 120 samples had TWA below EEL, yielding γ = 0.995 and θ = 1. Conclusions Outdoor workers in polluted cities like Almaty are exposed to very high levels of PM10 during the cold season. Urgent action should be taken to regulate such occupational exposure and to raise awareness of workers and employers on hazards associated with it.





Rethinking priorities in hospital management: a case from Central Asia


Kosherbayeva, L., Kalmakhanov, S., Hailey, D., Pazilov, S., Seiduanova, L., Kozhamkul, R.,

Jaworzynska, M., Bazhanova, A.E., Juraeva, N., Jarylkasynova, G.



Health Policy and Technology, 9 (3), pp. 391-396.

(60 процентиль, Q2)


To evaluate post-Soviet aspects of hospital management in Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan, considering indicators of health care and information on planning processes and factors that affect strategy in their hospitals. Methods: Data on indicators of health care were obtained from government agencies, the WHO and the World Bank. A survey of hospital managers in each of the countries was undertaken to obtain opinions on matters influencing the operation of their organizations. Results: There was some increase in health expenditure for three countries and a recent decline for Kyrgyzstan. All countries had levels of out of pocket expenditure that were higher than recommended by WHO. Hospital bed occupancy was relatively constant. Average length of stay was higher than in European health systems. Managers in all countries reported greater motivation of staff in their work as a planning benefit. Difficulties with the implementation of plans were greater for Kyrgyzstan than the other countries. Inappropriate assessment during planning seemed important for two countries and changes in environment during implementation for two others. Issues with health policy and regulation, new health technologies, and changes in health behaviour and morbidity were considered significant by managers from all countries. Conclusions: The health care indicator data and survey findings may reflect differences between the countries in the rate of reorganization of hospital sectors, available resources and political circumstances. They point to areas in need of attention for future hospital planning and challenges for managers in maintaining essential health services.

DOI: 10.1016/j.hlpt.2020.06.002




Regulation of RUNX proteins by long non-coding RNAs and circular RNAs in different cancers

Farooqi, A.A., Gulnara, K., Mukhanbetzhanovna, A.A., Datkhayev, U., Kussainov, A.Z., Adylova, A.



Non-coding RNA Research, 6 (2), pp. 100-106. (80 процентиль, Q1)

RUNX proteins have been shown to behave as “double-edge sword” in wide variety of cancers. Discovery of non-coding RNAs has played linchpin role in improving our understanding about the post-transcriptional regulation of different cell signaling pathways. Several new mechanistic insights and distinct modes of cross-regulation of RUNX proteins and non-coding RNAs have been highlighted by recent research. In this review we have attempted to provide an intricate interplay between non-coding RNAs and RUNX proteins in different cancers. Better conceptual and mechanistic understanding of layered regulation of RUNX proteins by non-coding RNAs will be helpful in effective translation of the laboratory findings to clinically effective therapeutics.

DOI: 10.1016/j.ncrna.2021.05.001




Iodine status of women and infants in russia: A systematic review

Korobitsyna, R., Aksenov, A., Sorokina, T., Trofimova, A., Sobolev, N., Grjibovski, A.M., Chashchin,
V., Thomassen, Y.


International Journal of Environmental Research and Public Health, 17 (22), статья No 8346,
pp. 1-15. (66
процентиль, Q2)

This systematic review presents a critical synthesis of the available information on the iodine status among women and infants in Russia. Literature search was performed in accordance with PRISMA guidelines using PubMed, Scopus Web of Science databases as well as eLIBRARY— the Russian national source. Altogether, 277 papers were identified and 19 of them were eligible for the review. The data on median urinary iodine concentration (UIC) in women and infants from 25 Russian regions were presented. A substantial variability in UIC across the country with no clear geographical pattern was observed. Despite substantial heterogeneity in research methodology and data presentation the results suggest that the iodine status among pregnant women and infants in Russia is below the recommended levels. Our findings demonstrate that iodine deficiency is a re-emerging public health problem in Russia. Urgent public health measures on national, regional and individual levels are warranted.

DOI: 10.3390/ijerph17228346




Weather conditions and outdoor fall injuries in Northwestern Russia

Unguryanu, T.N., Grjibovski, A.M., Trovik, T.A., Ytterstad, B., Kudryavtsev, A.V.


International Journal of Environmental Research and Public Health, 17 (17), статья No 6096,
pp. 1-16. (66
процентиль, Q2)

This study aimed to investigate associations between the weather conditions and the frequency of medically-treated, non-fatal accidental outdoor fall injuries (AOFIs) in a provincial region of Northwestern Russia. Data on all non-fatal AOFIs that occurred from January 2015 through June 2018 (N = 1125) were extracted from the population-based Shenkursk Injury Registry (SHIR). Associations between the weather conditions and AOFIs were investigated separately for the cold (15 October–14 April) and the warm (15 April–14 October) seasons. Negative binomial regression was used to investigate daily numbers of AOFIs in the cold season, while zero-inflated Poisson regression was used for the warm season. The mean daily number of AOFIs was 1.7 times higher in the cold season compared to the warm season (1.10 vs. 0.65, respectively). The most typical accident mechanism in the cold season was slipping (83%), whereas stepping wrong or stumbling over something was most common (49%) in the warm season. The highest mean daily incidence of AOFIs in the cold season (20.2 per 100,000 population) was observed on days when the ground surface was covered by compact or wet snow, air temperature ranged from −7.0◦ C to −0.7◦ C, and the amount of precipitation was above 0.4 mm. In the warm season, the highest mean daily incidence (7.0 per 100,000 population) was observed when the air temperature and atmospheric pressure were between 9.0◦ C and 15.1◦ C and 1003.6 to 1010.9 hPa, respectively. Along with local weather forecasts, broadcasting warnings about the increased risks of outdoor falls may serve as an effective AOFI prevention tool.

DOI: 10.3390/ijerph17176096




Mechanisms of accidental fall injuries and involved injury factors: A registry-based study

Unguryanu, T.N., Grjibovski, A.M., Trovik, T.A., Ytterstad, B., Kudryavtsev, A.V.


Injury Epidemiology, 7 (1), статья No 8 (77 процентиль, Q1)

Falls are the leading cause of injury-related morbidity and mortality worldwide, but fall injury circumstances differ by age. We studied the circumstances of accidental fall injuries by age in Shenkursk District, Northwest Russia, using the data from the population-based Shenkursk Injury Registry. Methods: Data on accidental fall injuries (hereafter: fall injuries) occurring in January 2015-June 2018 were extracted from the Shenkursk Injury Registry (N = 1551) and categorized by age group (0-6, 7-17, 18-59, and 60+ years). The chi-square test and ANOVA were used to compare descriptive injury variables across age groups, and a two-step cluster analysis was performed to identify homogeneous groups of fall injuries by preceding circumstances. Results: Half of recorded fall injuries in the 0-6 year age group occurred inside dwellings (49%). The largest cluster of falls (64%) mainly included climbing up or down on home furnishings. In the 7-17 year age group, public outdoor residential areas were the most common fall injury site (29%), and the largest cluster of falls (37%) involved physical exercise and sport or play equipment. Homestead lands or areas near a dwelling were the most typical fall injury sites in the age groups 18-59 and 60+ years (31 and 33%, respectively). Most frequently, fall injury circumstances in these groups involved slipping on ice-covered surfaces (32% in 18-59 years, 37% in 60+ years). Conclusion: The circumstances of fall injuries in the Shenkursk District varied across age groups. This knowledge can be used to guide age-specific preventive strategies in the study area and similar settings.

DOI: 10.1186/s40621-020-0234-7




Ethnic variations in nutritional status among preschool children in northern Vietnam: A cross-sectional study

Le, T.T., Le, T.T.D., Do, N.K., Savvina Nadezhda, V., Andrej, M.G., Nguyen, T.T.T., Nguyen, T.T.M.,
Vu, T.T., Le, T.H., Nguyen, T.T.L., Duong, T.A.D.


International Journal of Environmental Research and Public Health, 16 (21), статья No 4060 (66 процентиль, Q2)

Vietnam is a multiethnic country undergoing rapid economic development, the improvement in nutritional status in preschool children is not equally shared by all ethnic groups; (2) Methods: A cross-sectional study was performed from September–December 2018 on 16,177 children aged 24–60 months representing Kinh (n = 14421), Muong (n = 1307) and Tay (n = 449) ethnic groups. Prevalence of malnutrition, overweight, obesity and anthropometric indices were compared across ethnic groups, using WHO 2006 child growth standards; (3) Results: The prevalence of malnutrition among children of Kinh, Muong and Tay origins was 14.7%, 34.3% and 43.2%, respectively. The corresponding data for overweight was 5.5%, 2.7%, 2.2% and for obesity 2.8%, 0.8% and 0.4%, respectively. The prevalence of stunting remained the highest in three subtypes of malnutrition in all ethnic groups. Kinh children were heavier and taller than the other groups, while Muong children were taller than Tay children (p-value < 0.001); and (4) Conclusions: Malnutrition remains a major public health issue among children of minor ethnicities while overweight and obesity is an emerging challenge for the Kinh ethnic group. The results imply that a community-based intervention should be specific to ethnicity to reduce the gap in nutritional status between ethnic groups in Vietnam.

DOI: 10.3390/ijerph16214060




Barriers to managing and delivery of care to war-injured survivors or patients with non-communicable disease: A qualitative study of Palestinian patients' and policy-makers' perspectives

Mosleh, M., Al Jeesh, Y., Dalal, K., Eriksson, C., Carlerby, H., Viitasara, E.


BMC Health Services Research, 20 (1), статья No 406 (72 процентиль, Q2)

Improving access to optimal quality of care is a core priority and ambitious health policy goal in spite of impediments, threats and challenges in Palestine. Understanding the factors that may impede quality of care is essential in developing an effective healthcare intervention for patient with non-communicable disease (NCD) or war-injured survivors. Methods: Qualitative interviews were performed using a purposive sampling strategy of 18 political-key informants, 10 patients with NCD and 7 war-injured survivors from different health facilities in Gaza Strip. A semi-structured interview guide was developed for data collection. The interviews were audio recorded and transcribed verbatim. Important field notes of the individual interviews were also reported. Thematic-driven analytic approach was used to identify key themes and patterns. Results: From the policy maker's perspective, the following important barriers to accessing optimal healthcare for patients with NCD or war-injured survivors' treatment were identified; 1) organizational/structural 2) availability 3) communication 4) personnel/lack of staff 5) financial and political barriers. Patient with NCD or war-injury had similar experiences of barriers as the policy makers. In addition, they also identified socioeconomic, physical and psychological barriers for accessing optimal healthcare and treatment. Conclusions: The main perceived barriers explored through this study will be very interesting and useful if they are considered seriously and handled carefully, in order to ensure efficient, productive, cost-effective intervention and delivery of a high-standard quality of care and better disease management.





Perceptions of non-communicable disease and war injury management in the palestinian health system: A qualitative study of healthcare providers perspectives

Mosleh, M., Aljeesh, Y., Dalal, K., Eriksson, C., Carlerby, H., Viitasara, E.


Journal of Multidisciplinary Healthcare, 13, pp. 593-605. (69 процентиль, Q2)

Palestine, like other low-income countries, is confronting an increasing epidemic of non-communicable disease (NCD) and trend of war injury. The management of health problems often presents a critical challenge to the Palestinian health system (PHS). Understanding the perceptions of healthcare providers is essential in exploring the gaps in the health system to develop an effective healthcare intervention. Unfortunately, health research on management of NCD and war injury has largely been neglected and received little attention. Therefore, the study aimed to explore the perspectives of healthcare providers regarding NCD and war injury management in the PHS in the Gaza Strip. Methods: A qualitative study approach was used, based on four focus group discussions (FGDs) involving a purposive sampling strategy of 30 healthcare providers from three main public hospitals in Gaza Strip. A semi-structured topic guide was used, and the focus group interviews data were analyzed using manifest content analysis. The study was approved by the Palestinian Health Research Council (PHRC) for ethics approval. Results: From the healthcare providers perspective, four main themes and several subthemes have emerged from the descriptive manifest content analysis: functioning of healthcare system; system-related challenges; patients-related challenges; strategies and actions to navigating the challenges and improving care. Informants frequently discussed that despite some positive aspects in the system, fundamental changes and significant improvements are needed. Some expressed serious concerns that the healthcare system needs complete rebuilding to facilitate the management of NCD and war-related injury. They perceived important barriers to effective management of NCD and war injury such as poor hospital infrastructure and logistics, shortage of micro and sub-specialities and essential resources. Participants also expressed a dilemma and troubles in communication and interactions, especially during emergencies or crises. The informants stressed the unused of updated clinical management guidelines. There was a consensus regarding poor shared-care/task sharing, partnership, and cooperation among healthcare facilities. Conclusion: Our findings suggest that fundamental changes and significant reforms are needed in the health system to make healthcare services more effective, timely, and efficient. The study disclosed the non-use of clinical guidelines as well as suboptimal sectorial tasksharing among different stakeholders and healthcare providers. A clear and comprehensive healthcare policy considering the gaps in the system must be adopted for the improvement and development of care in the PHS.





Evaluation of Kazakhstan Students’Views on Health, Lifestyle, and Physical Activity

Otaraly, S., Alikey, A., Sabyrbek, Z., Zhumanova, A., Martynenko, I., Poteliuniene, S.


Sport Mont, 18 (2), pp. 67-72. (56 процентиль, Q2)

The purpose of this research was to investigate students' perception of their health, the development of their healthy lifestyle habits, and the role and place of physical activity in their daily lives. The research subjects were freshmen of one of the largest universities in the country, Al-Faraby Kazakh National University (n=100), at the age of 17.77±0.12 years, 64 of whom were female, and 36 were male. Respondents were asked to reply to a questionnaire consisting of 39 questions at the initial stage of adaptation to academic and physical activity at the university. The questionnaire included research on students' perception of their health, the development of healthy lifestyle habits, such as the quality of food, water consumption, the amount of time dedicated to sleep and its quality, the presence of bad habits, as well as the research on the role and place of working out in shaping the students’ lifestyle, volume and intensity of physical activity. It was revealed that students, even those having an understanding of the role and place of a healthy lifestyle, the significance of health in life, including their future professional career, were still distinguished by the insufficiently formed habits of healthy lifestyles, and did not work out to preserve and strengthen their health. The physical activity of most of the surveyed students did not even meet the recommended minimum. This research showed that the problem of a healthy lifestyle for young people studying in different socio-cultural contexts remains relevant and requires further more extensive research.





Lignite Biosolubilization by Bacillus sp. RKB 2 and Characterization of its Products


Akimbekov, N., Digel, I., Qiao, X., Tastambek, K., Zhubanova, A.



Geomicrobiology Journal, 37 (3), pp. 255-261.

(75 процентиль, Q1)

Nowadays, the advancements of coal microbiology and biotechnology have been highly emphasized, providing leading-edge approaches in sustainable development of agriculture and the protection of the environment. The biosolubilization of low-rank coals, such as lignite and leonardite is a promising technology for converting these sedimentary rocks into valuable products. In this study, the process involved in lignite biosolubilization by Bacillus sp. RKB 2 was investigated. The biotransformed lignite and the produced humic substances were determined in vitro in a liquid medium and on a solid matrix. The bacterial strain was isolated from untreated Kazakhstani lignite and was shown to be capable of effectively solubilizing and transforming lignite (5% w/v). Fourier Transform Infrared (FTIR) and UHPLC-QqQ-MS/MS analyses were performed to examine the solubilization products and lignite humic substances processed by bacteria. The absorption peaks of FTIR showed the diverse nature of the bacteria-induced humic substances, and the vast majority of intense peaks detected are mainly below an m/z of 1000 Da (liquid chromatography-mass spectrometry [LC-MS] (QqQ)). Data analysis concluded that our isolate could depolymerize lignite and form bio-humic substances. Due to its ability to solubilize lignite Bacillus sp. RKB 2 may be useful in the coal-bed for in situ bioutilization of low-rank coal.







Causative role for defective expression of mitochondria-eating protein in accumulation of

mitochondria in thyroid oncocytic cell tumors


Mussazhanova, Z., Shimamura, M., Kurashige, T., Ito, M., Nakashima, M., Nagayama, Y.



Cancer Science, 111 (8), pp. 2814-2823 (85 процентиль, Q1)

Oncocytic cell tumor of the thyroid is composed of large polygonal cells with eosinophilic cytoplasm that is rich in mitochondria. These tumors frequently have the mutations in mitochondrial DNA encoding the mitochondrial electron transport system complex I. However, the mechanism for accumulation of abnormal mitochondria is unknown. A noncanonical mitophagy system has recently been identified, and mitochondria-eating protein (MIEAP) plays a key role in this system. We therefore hypothesized that accumulation of abnormal mitochondria could be attributed to defective MIEAP expression in these tumors. We first show that MIEAP was expressed in all the conventional thyroid follicular adenomas (FAs)/adenomatous goiters (AGs) but not in oncocytic FAs/AGs; its expression was defective not only in oncocytic thyroid cancers but also in the majority of conventional thyroid cancers. expression of MIEAP was not correlated with methylation status of the 5′-UTR of the gene. Our functional analysis showed that exogenously induced MIEAP, but not PARK2, reduced the amounts of abnormal mitochondria, as indicated by decreased reactive oxygen species levels, mitochondrial DNA / nuclear DNA ratios, and cytoplasmic acidification. Therefore, together with previous studies showing that impaired mitochondrial function triggers compensatory mitochondrial biogenesis that causes an increase in the amounts of mitochondria, we conclude that, in oncocytic cell tumors of the thyroid, increased abnormal mitochondria cannot be efficiently eliminated because of a loss of MIEAP expression, ie impaired MIEAP-mediated noncanonical mitophagy.







Vitamin d and the host-gut microbiome: A brief overview


Akimbekov, N.S., Digel, I., Sherelkhan, D.K., Lutfor, A.B., Razzaque, M.S.



Acta Histochemica et Cytochemica, 53 (3), pp. 33-42. (85 процентиль, Q1)

There is a growing body of evidence for the effects of vitamin D on intestinal host-microbiome interactions related to gut dysbiosis and bowel inflammation. This brief review highlights the potential links between vitamin D and gut health, emphasizing the role of vitamin D in microbiological and immunological mechanisms of inflammatory bowel diseases. A comprehensive literature search was carried out in PubMed and Google Scholar using combinations of keywords “vitamin D,” “intestines,” “gut microflora,” “bowel inflammation”. Only articles published in English and related to the study topic are included in the review. We discuss how vitamin D (a) modulates intestinal microbiome function, (b) controls antimicrobial peptide expression, and (c) has a protective effect on epithelial barriers in the gut mucosa. Vitamin D and its nuclear receptor (VDR) regulate intestinal barrier integrity, and control innate and adaptive immunity in the gut. Metabolites from the gut microbiota may also regulate expression of VDR, while vitamin D may influence the gut microbiota and exert anti-inflammatory and immune-modulating effects. The underlying mechanism of vitamin D in the pathogenesis of bowel diseases is not fully understood, but maintaining an optimal vitamin D status appears to be beneficial for gut health. Future studies will shed light on the molecular mechanisms through which vitamin D and VDR interactions affect intestinal mucosal immunity, pathogen invasion, symbiont colonization, and antimicrobial peptide expression.







Lignite Biosolubilization by Bacillus sp. RKB 2 and Characterization of its Products


Akimbekov, N., Digel, I., Qiao, X., Tastambek, K., Zhubanova, A.



Geomicrobiology Journal, 37 (3), pp. 255-261

(75 процентиль, Q1)

Nowadays, the advancements of coal microbiology and biotechnology have been highly emphasized, providing leading-edge approaches in sustainable development of agriculture and the protection of the environment. The biosolubilization of low-rank coals, such as lignite and leonardite is a promising technology for converting these sedimentary rocks into valuable products. In this study, the process involved in lignite biosolubilization by Bacillus sp. RKB 2 was investigated. The biotransformed lignite and the produced humic substances were determined in vitro in a liquid medium and on a solid matrix. The bacterial strain was isolated from untreated Kazakhstani lignite and was shown to be capable of effectively solubilizing and transforming lignite (5% w/v). Fourier Transform Infrared (FTIR) and UHPLC-QqQ-MS/MS analyses were performed to examine the solubilization products and lignite humic substances processed by bacteria. The absorption peaks of FTIR showed the diverse nature of the bacteria-induced humic substances, and the vast majority of intense peaks detected are mainly below an m/z of 1000 Da (liquid chromatography-mass spectrometry [LC-MS] (QqQ)). Data analysis concluded that our isolate could depolymerize lignite and form bio-humic substances. Due to its ability to solubilize lignite Bacillus sp. RKB 2 may be useful in the coal-bed for in situ bioutilization of low-rank coal.







Features of pregnancy, childbirth and postpartum period of young mothers


Ayazbekov, A., Nurkhasimova, R., Kulbayeva, S., Bolat, K., Kurmanova, A.M., Yeskarayeva, A.,

Sarbassova, M., Kemelbekov, K.S.



Electronic Journal of General Medicine, 17 (6), статья № em260, pp. 1-8 (71 процентиль, Q2)

According to the article, pregnancy in adolescence is associated with a high risk of developing adverse outcomes both during pregnancy and childbirth in the later period. The purpose of our study was to identify the features of pregnancy and childbirth, the postpartum period in young mothers. Materials and methods. A retrospective analysis of the birth history of 299 maternity hospitals was performed. The research material was archived data from the Regional perinatal center No. 3 in Turkestan (Kazakhstan). The main (1) group was formed by 199 maternity women under 19 years of age (2019). The control (2) group was formed by 100 maternity women aged 20 to 30 years, whose sexual life began after the age of 18. Results. The age of the surveyed women in group 1 ranges from 15 to 19 years, averaging ~16.9 years. 17-year-old girls predominated (66.7%). The average age of women in group 2 was ~25.8 years. Adolescent pregnancy is a risk factor for adverse child outcomes, such as premature birth, low birth weight, fetal growth retardation, neonatal and infant mortality. In the adolescent pregnancy and delivery group, preterm birth occurred in 35 cases, which accounted for 6.8% of the total preterm birth population for 2019, but in the adolescent birth group it was 17.5%. Of the 199 births in 2 were multiple births (1%), 197 live births, the percentage of live births among adolescents was 98%, respectively, the stillbirth rate was 2% (4 cases). Conclusion: the frequency of teenage pregnancy in the dynamics of years does not tend to decrease, among young mothers only every 6 received pre-pregnancy training, and every 5 was re-pregnant and among re-pregnant women under 19 years.






Stroke Care Trends During COVID-19 Pandemic in Zanjan Province, Iran. From the CASCADE

Initiative: Statistical Analysis Plan and Preliminary Results


Ghoreishi, A., Arsang-Jang, S., Sabaa-Ayoun, Z., Yassi, N., Sylaja, P.N., Akbari, Y., Divani, A.A.,

Biller, J., Phan, T., Steinwender, S., Silver, B., Zand, R., Basri, H.B., Iqbal, O.M., Ranta, A., Ruland,

S., Macri, E., Ma, H., Nguyen, T.N., Abootalebi, S., Gupta, A., Alet, M., Lattanzi, S., Desai, M.,

Gagliardi, R.J., Girotra, T., Inoue, M., Yoshimoto, T., Isaac, C.F., Mayer, S.A., Morovatdar, N.,

Nilanont, Y., Nobleza, C.O.S., Saber, H., Kamenova, S., Kondybayeva, A., Krupinski, J., Siegler, J.E.,

Stranges, S., Torbey, M.T., Yorio, D., Zurrú, M.C., Rubinos, C.A., Shahripour, R.B.,

Borhani-Haghighi, A., Napoli, M.D., Azarpazhooh, M.R.



Journal of Stroke and Cerebrovascular Diseases, 29 (12), статья No 105321 (68 процентиль, Q2)

The emergence of the COVID-19 pandemic has significantly impacted global healthcare systems and this may affect stroke care and outcomes. This study examines the changes in stroke epidemiology and care during the COVID-19 pandemic in Zanjan Province, Iran. Methods: This study is part of the CASCADE international initiative. From February 18, 2019, to July 18, 2020, we followed ischemic and hemorrhagic stroke hospitalization rates and outcomes in Valiasr Hospital, Zanjan, Iran. We used a Bayesian hierarchical model and an interrupted time series analysis (ITS) to identify changes in stroke hospitalization rate, baseline stroke severity [measured by the National Institutes of Health Stroke Scale (NIHSS)], disability [measured by the modified Rankin Scale (mRS)], presentation time (last seen normal to hospital presentation), thrombolytic therapy rate, median door-to-needle time, length of hospital stay, and in-hospital mortality. We compared in-hospital mortality between study periods using Cox-regression model. Results: During the study period, 1,026 stroke patients were hospitalized. Stroke hospitalization rates per 100,000 population decreased from 68.09 before the pandemic to 44.50 during the pandemic, with a significant decline in both Bayesian [Beta: -1.034; Standard Error (SE): 0.22, 95% CrI: -1.48, -0.59] and ITS analysis (estimate: -1.03, SE = 0.24, p < 0.0001). Furthermore, we observed lower admission rates for patients with mild (NIHSS < 5) ischemic stroke (p < 0.0001). Although, the presentation time and door-to-needle time did not change during the pandemic, a lower proportion of patients received thrombolysis (-10.1%; p = 0.004). We did not see significant changes in admission rate to the stroke unit and in-hospital mortality rate; however, disability at discharge increased (p < 0.0001). Conclusion: In Zanjan, Iran, the COVID-19 pandemic has significantly impacted stroke outcomes and altered the delivery of stroke care. Observed lower admission rates for milder stroke may possibly be due to fear of exposure related to COVID-19. The decrease in patients treated with thrombolysis and the increased disability at discharge may indicate changes in the delivery of stroke care and increased pressure on existing stroke acute and subacute services. The results of this research will contribute to a similar analysis of the larger CASCADE dataset in order to confirm findings at a global scale and improve measures to ensure the best quality of care for stroke patients during the COVID-19 pandemic.







Enhanced Fatty Acid Synthesis Leads to Subset Imbalance and IFN-γ Overproduction in T Helper 1



Iwata, S., Zhang, M., Hao, H., Trimova, G., Hajime, M., Miyazaki, Y., Ohkubo, N., Satoh Kanda, Y.,

Todoroki, Y., Miyata, H., Ueno, M., Nagayasu, A., Nakayamada, S., Sakata, K., Tanaka, Y.



Frontiers in Immunology, 11, статья № 593103

(79 процентиль, Q1)

Recent reports have shown the importance of IFN-γ and T-bet+ B cells in the pathology of SLE, suggesting the involvement of IFN-γ-producing T-bet+ CD4+ cells, i.e., Th1 cells. This study determined the changes in Th1 subsets with metabolic shift and their potential as therapeutic targets in SLE. Compared with healthy donors, patients with SLE had higher numbers of T-bethiCXCR3lo effector cells and T-bet+Foxp3lo non-suppressive cells, which excessively produce IFN-γ, and lower number of non-IFN-γ-producing T-bet+Foxp3hi activated-Treg cells. These changes were considered to be involved in treatment resistance. The differentiation mechanism of Th1 subsets was investigated in vitro using memory CD4+ cells obtained from healthy donors and patients with SLE. In memory CD4+ cells of healthy donors, both rapamycin and 2-deoxy-D-glucose (2DG) suppressed T-bet+Foxp3- cells, and induced T-bet+Foxp3+(lo/hi) cells. Rapamycin induced IFN-γ-producing T-bet+Foxp3lo cells accompanied with enhanced lipid metabolism, whereas 2DG induced IFN-γ-non-producing T-bet+Foxp3hi cells. In memory CD4+ cells of SLE patients, inhibition of fatty acid synthesis, but not β-oxidation, suppressed IFN-γ production, and up-regulated of Foxp3 expression in T-bet+Foxp3+ cells. Metabolic regulators such as fatty acid synthesis inhibitors may improve the pathological status by correcting Th1 subset imbalance and overproduction of IFN-γ in SLE.







Prediction of miRNA interaction with mRNA of stroke candidate genes


Kondybayeva, А., Akimniyazova, A., Kamenova, S., Duchshanova, G., Aisina, D., Goncharova, A.,

Ivashchenko, А.



Neurological Sciences, 41 (4), pp. 799-808.

(74 процентиль, Q2)

The role of miRNA in tissue affected by stroke is actively studied, but it remains unclear which miRNAs and target genes are involved in the development of stroke. Methods: The MirTarget program defines the following features of a miRNA binding to a mRNA: the binding start site, the location of the binding site in mRNA, the free energy of a miRNA binding with a mRNA, and the interaction schemes of miRNA and mRNA. Results: The interaction of 6565 miRNAs with mRNAs of stroke candidate genes was determined. The association of the mRNAs of stroke candidate genes with miRNAs depends on the level of gene expression. Some highly expressed candidate genes are targets of miR-619-5p and miR-5095, which have binding sites located on overlapping mRNA nucleotide sequences (clusters). miR-619-5p and miR-5095 bind to mRNA of 15 genes. Clusters for the binding of miR-1273f,d,e are in mRNAs of highly expressed genes. The start sites of miR-1273d and miR-1273e binding in all clusters are in sequences with one and ten nucleotides, respectively. The clusters of multiple miR-574-5p and ID00470.5p-miR binding sites and the clusters of the miR-466, ID01030.3p-miR, and ID00436.3p-miR binding sites are in mRNAs of some genes expressed at low levels. Conclusion: The organization of miRNA binding sites into clusters reduces the length of mRNA and creates competition between miRNAs for binding to mRNA of a target gene. The characteristics of miRNA associations with target genes can be used to recommend markers for a diagnosis of stroke.









TP53 codon 72 polymorphism and human papilloma virus-associated cervical cancer in Kyrgyz women

Isakova, J., Vinnikov, D., Bukuev, N., Talaibekova, E., Aldasheva, N.


Asian Pacific Journal of Cancer Prevention, 20 (4), pp. 1057-1062. (55 процентиль, Q2)

The aim of this study was to ascertain the magnitude of association of gene TP53 Arg72Pro polymorphic marker with cervical cancer (CC) in Kyrgyz women. Methods: We identified and included 205 women of Kyrgyz ethnicity for this case-control study, of whom N=103 were women (mean age 53.5 ± 10.0 years) with histologically confirmed CC and N=102 controls (mean age 46.5 ± 8.5 years). We detected human papilloma virus (HPV) DNA types 16 and 18 using polymerase chain reaction (PCR) with hybridization/fluorescent detection. Genotypes of TP53 gene Arg72Pro polymorphism were identified using PCR-RFLP assay. Results: Eighty-eight percent (90/103) women with CC had HPV, of whom 43.4% (39/90) had HPV type 16, 24.4% (22/90) had HPV type 18, whereas 32.2% (29/90) carried both types. The univariate analysis of allele and genotype distribution of Arg72Pro polymorphic marker of TP53 gene showed no difference between CC and control groups (χ 2 =1.24, p=0.54). However, when CC cases associated with HPV were tested against controls, Arg72 allele and Arg72Arg genotype prevalence were greater compared to controls (χ 2 =7.25; p=0.027 for genotypes and χ 2 =6.83; p=0.009 for alleles). In HPV-positive women, Arg72Arg genotype of TP53 gene was associated with a 1.85-fold increase in the likelihood of CC (OR=1.85 [95% confidence interval (CI) 1.03-3.32]), whereas Arg72 allele increased this likelihood 1.94-fold (OR=1.94 [95% CI 1.20-3.15]). Conclusions: Arg72Arg genotype and Arg72 allele of TP53 gene in Kyrgyz women increase the risk of HPV-associated CC.





The occupational burden of nonmalignant respiratory diseases an official American thoracic society and european respiratory society statement

Blanc, P.D., Redlich, C.A., Annesi-Maesano, I., Balmes, J.R., Cummings, K.J., Fishwick, D.,
Miedinger, D., Murgia, N., Naidoo, R.N., Reynolds, C.J., Sigsgaard, T., Torén, K., Vinnikov, D.


American Journal of Respiratory and Critical Care Medicine, 199 (11), pp. 1312-1334 (99 процентиль, Q1)

Workplace inhalational hazards remain common worldwide, even though they are ameliorable. Previous American Thoracic Society documents have assessed the contribution of workplace exposures to asthma and chronic obstructive pulmonary disease on a population level, but not to other chronic respiratory diseases. The goal of this document is to report an in-depth literature review and data synthesis of the occupational contribution to the burden of the major nonmalignant respiratory diseases, including airway diseases; interstitial fibrosis; hypersensitivity pneumonitis; other noninfectious granulomatous lung diseases, including sarcoidosis; and selected respiratory infections. Methods: Relevant literature was identified for each respiratory condition. The occupational population attributable fraction (PAF) was estimated for those conditions for which there were sufficient population-based studies to allow pooled estimates. For the other conditions, the occupational burden of disease was estimated on the basis of attribution in case series, incidence rate ratios, or attributable fraction within an exposed group. Results: Workplace exposures contribute substantially to the burden of multiple chronic respiratory diseases, including asthma (PAF, 16%); chronic obstructive pulmonary disease (PAF, 14%); chronic bronchitis (PAF, 13%); idiopathic pulmonary fibrosis (PAF, 26%); hypersensitivity pneumonitis (occupational burden, 19%); other granulomatous diseases, including sarcoidosis (occupational burden, 30%); pulmonary alveolar proteinosis (occupational burden, 29%); tuberculosis (occupational burden, 2.3% in silica-exposed workers and 1% in healthcare workers); and community-acquired pneumonia in working-age adults (PAF, 10%). Conclusions: Workplace exposures contribute to the burden of disease across a range of nonmalignant lung conditions in adults (in addition to the 100% burden for the classic occupational pneumoconioses). This burden has important clinical, research, and policy implications. There is a pressing need to improve clinical recognition and public health awareness of the contribution of occupational factors across a range of nonmalignant respiratory diseases.





Defining the toxicity of current regimens for extranodal NK/T cell lymphoma: a systematic review and metaproportion

Pokrovsky, V.S., Vinnikov, D.




Expert Review of Anticancer Therapy, 19 (1), pp. 93-104.

(85 процентиль, Q1)

The aim of this study is to compare the toxicity profiles of SMILE versus less intense L-asparaginase-containing regimens, CCRT or “sandwich” RT+CT regimens. Methods: PRISMA protocol was used to search Pubmed and Embase for studies of treatment regimens for extranodal NK/T-cell lymphoma, nasal type (ENKTL) in English published before March 2018. Pooled data were grouped into five categories: A) CHOP-like regimens; B) Gemcitabine-based regimens; C) SMILE-like regimens; D) Concurrent and “sandwich” RT + CT; and E) Methotrexate-based combinations. We pooled prevalence of selected adverse events from each study to calculate the weighted overall prevalence using meta-proportion in Stata. Results: Group C was the most toxic with the pooled neutropenia 72% (95 CI 64;80) and thrombocytopenia 48% (95% CI 40;55) prevalence. The use of Group D treatment regimens was associated with the lowest anemia (10% (95% CI 1;19)) prevalence. Group E was the least toxic with regard to thrombocytopenia (6% (95% CI 1;11). Conclusion: Our analysis confirms that SMILE regimen, which is current standard to treat advanced-stage ENKTL may be associated with more severe hematological toxicity compared to other L-asparaginase combinations, including methotrexate-based (AspaMetDex, MESA and MEDA) or gemcitabine-based (GELOX, PGEMOX, DDGP, GDL, GOLD, GLIDE) or CCRT-based regimens.





ADIPOQ, KCNJ11 and TCF7L2 polymorphisms in type 2 diabetes in Kyrgyz population: A case-control study

Isakova, J., Talaibekova, E., Vinnikov, D., Saadanov, I., Aldasheva, N.


Journal of Cellular and Molecular Medicine, 23 (2), pp. 1628-1631. (60 процентиль, Q2)

The aim of this study was to ascertain the polymorphic markers profile of ADIPOQ, KCNJ11 and TCF7L2 genes in Kyrgyz population and to analyze the association of polymorphic markers and combinations of ADIPOQ gene's G276T locus, KCNJ11 gene's Glu23Lys locus and TCF7L2 gene's VS3C>T locus with type two diabetes (T2D) in Kyrgyz population. In this case-control study, 114 T2D patients 109 non-diabetic participants were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Two individual polymorphisms (ADIPOQ rs1501299, KCNJ11 rs5219) were found to be associated with T2D. We found two (Lys23Lys/CC and Glu23Lys/CT) of the overall nine combinations, which were more prevalent in T2D group compared to controls (χ2 = 4.21, P = 0.04). Lys23Lys/CC combination was associated with a 2.65-fold increased likelihood of T2D (OR = 2.65, 95% CI 1.12-6.28), whereas the Glu23Lys/CT combination also increased such likelihood (OR = 3.88, 95% CI 1.27-11.91). This study demonstrated some association of 276T allele and ADIPOQ gene G276T heterozygous genotype as well as KCNJ11 gene 23Lys allele with T2D in ethnic Kyrgyz, but study results should be interpreted with caution because of the limited statistical power. © 2018 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.





Cytisine for nicotine addiction treatment: a review of pharmacology, therapeutics and an update of clinical trial evidence for smoking cessation

Tutka, P., Vinnikov, D., Courtney, R.J., Benowitz, N.L.


Addiction, 114 (11), pp. 1951-1969. (96 процентиль, Q1)

To review cytisine's history of use, pre-clinical evidence, clinical pharmacokinetics, efficacy, adverse reactions (ARs) and safety for smoking cessation. Methods: A synoptic review of the use of cytisine as a smoking cessation medication, mechanism of action, pharmacokinetics and safety. Relevant literature on data included in these sections were identified through a search of 11 databases with additional literature obtained from reports and monographs. Three databases (PubMed, EMBASE and www.elibrary.ru) were systematically searched for studies published from 2012 to August 2018 in any language to provide an updated meta-analysis of cytisine's efficacy and ARs for smoking cessation compared with placebo. We pooled the relative risks (RR) of abstinence in the efficacy analysis and RR of ARs, either reported by the authors or calculated from the reports. Results: Cytisine has been in use since 1964 and is currently marketed in 18 countries. Systemic bioavailability from oral ingestion is high and clearance is primarily renal, with minimal or no metabolism. Brain uptake in animal models is moderate. The plasma half-life averages 4.8 hours. Eight studies were included for meta-analysis of efficacy. With heterogeneous results, the overall RR versus placebo of successful continuous abstinence at the longest follow-up was 1.74 [95% confidence interval (CI) = 1.38–2.19]. Nausea, vomiting, dyspepsia, upper abdominal pain and dry mouth that were mild or moderate were the most common ARs, with RR versus placebo 1.10 (95% CI = 0.95–1.28). The cost of cytisine in eastern and central Europe is several-fold less than that of other smoking cessation medications. Conclusions: Cytisine is a low-cost medication found to increase the likelihood of smoking cessation. The most frequently reported ARs of cytisine involve gastrointestinal symptoms that are mostly reported as either mild or moderate in severity.





Exposure to nickel from the metal equipment in the gym [version 1; peer review: Awaiting peer review]

Vinnikov, D., Tulekov, Z., Dushpanova, A., Romanova, Z., Sokolov, A., Sokolova, V., Nurpeisov, T.


F1000Research, 8, статья No 68 (81 процентиль, Q1)

It remains unclear whether gym customers are exposed to any nickel from the metal equipment and if the exposure is associated with the duration of contact. Therefore, the aim of this study was to ascertain exposure to nickel measured through nickel concentration in the hair in those exercising in a fitness gym. We enrolled 100 amateur athletes in one of the gyms in Almaty, Kazakhstan (all men, median age 30 (interquartile range (IQR) 10) years), exercising from 2 to 7 days a week for 40 to 180 minutes and their age- and sex-matched controls who did not exercise. All subjects filled in the questionnaires on the exercising patterns, smoking and occupational exposure and then donated 0.25 g of head hair, in which nickel was measured using atomic absorption spectrophotometry. Hair nickel concentration ranged from 0 to 8.5 µg/g with notable left-skewness towards low concentrations in both groups. Hair nickel concentration was not associated with age, smoking or occupation, but was significantly lower in amateur athletes compared to controls (median 0 (IQR 0.5) vs. 0.9 (IQR 1.4) µg/g). More days a week in a gym, longer workout history, longer workout duration or supplements use did not increase the probability of being stratified in a high-exposure subgroup (defined as 75 percentile of hair nickel concentration and higher); however, there were more smokers in a low-exposure group (p<0.05). With the mixed pattern of exposure, gym goers may be unlikely exposed to more nickel from the metal equipment in the gym, however the exposure may depend on the specific alloy composition.





Age and work duration do not predict burnout in firefighters

Vinnikov, D., Tulekov, Z., Akylzhanov, A., Romanova, Z., Dushpanova, A., Kalmatayeva, Z.


BMC Public Health, 19 (1), статья No 308 (77 процентиль, Q1)

The aim of this study was to ascertain the prevalence of burnout in Kazakhstan firefighters with regard to position and to identify predictors of faster burnout in order to plan future preventive strategies. Methods: Data on demographics, lifestyle, fatigue (Fatigue Severity Scale (FSS)), SF-8 health-related quality of life (HRQL) and Maslach Burnout Inventory (MBI) emotional exhaustion (EX), cynicism (CY) and professional efficacy (PE) were obtained from 604 (94% men, median age 27 (interquartile range (IQR) 12) years) firefighters from all 18 fire departments of the city of Almaty. Associations between predictors and burnout EX, CY and PE dimensions were tested using multivariate logistic regression analyses. Results: Burnout scores were low in this sample, including EX (0.6; IQR 1.55), CY (1.2; IQR 1.8) and PE (4.8; IQR 2.4). The highest median EX score (1.5 (IQR 2.0)) was in managers as opposed to the lowest in drivers (0.4 (IQR 1.4)), (p < 0.01). The greatest CY difference was between managers (2.1 (IQR 2.2)) and trainees (0.4 (IQR 1.1)) (p < 0.001). Age, work duration, education or fatigue were not associated with EX or CY in adjusted models. Better HRQL predicted lower EX and CY burnout, whereas alcohol never-use and language barrier predicted high CY. Male sex and no university degree predicted high PE burnout. Conclusions: Firefighting managers are at risk for higher burnout, irrespective of age and work duration, and the targeted intervention to combat burnout should include better uniform, mitigation of language barrier, general health improvement and less alcohol.





Occupational burnout and lifestyle in Kazakhstan cardiologists

Vinnikov, D., Dushpanova, A., Kodasbaev, A., Romanova, Z., Almukhanova, A., Tulekov, Z., Toleu,
E., Ussatayeva, G.


Archives of Public Health, 77 (1), статья No 13 (57 процентиль, Q2)

No data exist in the published literature on burnout in physicians from Central Asia. The aim of this analysis was to assess burnout prevalence in doctors and nurses of a cardiological hospital in Almaty, Kazakhstan and ascertain whether smoking, alcohol and physical activity may predict job-associated burnout. Methods: The staff of the City Cardiological Centre of Almaty (N = 259, 82% females) filled in the questionnaire with the questions on demographics, lifestyle, including smoking, alcohol and physical activity, as well as fatigue (using Fatigue Severity Scale (FSS)) and burnout using Maslach Burnout Inventory (MBI) Human Services Survey for Medical Personnel. We compared the scores of emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA) between doctors and nurses. Results: We found significant differences in the smoking prevalence, alcohol use and regular physical activity, but no mean scores of burnout between men and women. High DP was prevalent in 52% doctors and 45% nurses, whereas high EE was found in 32 and 26% and PA in 16 and 32%, accordingly. In contrast with EE and DP, PA score was greater in nurses (median 38, interquartile range (IQR) 17) compared to doctors (median 41, IQR 9). Age, sex, work duration, smoking or physical activity could not predict higher burnout, whereas FSS score was associated with higher burnout of all dimensions (p < 0.05), and never-alcohol could predict higher PA burnout (p < 0.05). Conclusions: In Kazakhstan cardiologists, high prevalence of DP burnout should target specific preventive strategies and the association of alcohol use with PA needs further deeper insight.





Medico-social effectiveness of biological monitoring of iodine deficiency status (IDS) among women of reproductive age in Kazakhstan

Beisbekova, A., Raushanova, A., Juszkiewicz, K., Kainarbayeva, M., Chuyenbekova, A.,
Khassenova, G., Kozhakhmetova, A., Kenessary, D.


Annals of Agricultural and Environmental Medicine, 26 (1), pp. 73-77. (50 процентиль, Q2)

Iodine deficiency is one of the most important public health problems in the world. It mostly affects pregnant women and children. The lack of iodine leads to an increase in the numbers of perinatal mortality and mental retardation. Materials and method. In 2012-2014, a survey was carried out of 2,342 women, of whom 2284 were analyzed for salt to measure the content of iodine, and 2,242 women of reproductive age had their urine samples analyzed by the ceriumarsenite method based on the Sandell-Kolthoff reaction. Determination of the medical and social effectiveness of biological monitoring of IDS was carried out in 3 stages. Results. The study revealed that in the eastern Kazakhstan region the relative risk (RR) of overall prevalence of iodine deficiency among women was 1.1 times higher (95% ID: 0.35-3.61; Z statistic = 0.192) among household respondents (≤15mkg/kg). In the Pavlodar region, the RR of the prevalence of total iodine deficiency is 0.5 times higher in households where the salt was not sufficiently iodized. In the Zhambyl region the RR of the iodine deficiency prevalence was about twice as high due to insufficient iodized salt. Conclusions. The introduction of biological monitoring of IDS among women, especially pregnant women, may positively affect the detection of the risk limits for the birth of infants with reduced mental abilities or other diseases during pregnancy, using timely targeted preventive measures to exclude factors that affect the spread of IDS.





Lifetime occupational history, respiratory symptoms and chronic obstructive pulmonary disease: Results from a population-based study

Vinnikov, D., Raushanova, A., Kyzayeva, A., Romanova, Z., Tulekov, Z., Kenessary, D., Auyezova,


International Journal of COPD, 14, pp. 3025-3034. (90 процентиль, Q1)

To ascertain the effect of lifelong occupational history, ambient air pollution, and biochemically verified smoking status on chronic obstructive pulmonary disease (COPD) in a general population of one the largest cities in Central Asia, Almaty. Patients and methods: 1500 adults (median age 49, interquartile range (IQR) 28 years), 50% females, were randomly selected from a registry of enlisted population of a primary care facility in Almaty, Kazakhstan and they filled in the questionnaire on demographics, respiratory symptoms (CAT and mMRC), smoking status, verified by exhaled carbon monoxide, and detailed lifetime occupational history. COPD was defined as postbronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) below lower limit of normal (LLN) using Belintelmed MAS-2 spirometer (Belarus). Results: 230 (15%) subjects had CAT≥10; 136 (9%) participants had mMRC score ≥2. Greater CAT score was associated with age, smaller income, and less exercise, but not with smoking or living closer to a major road. 26% of the population was ever exposed to vapors, gases, dusts, and fumes (VGDF). In age group 40 years and above (N=1024), COPD was found in 57 participants (prevalence 5.6%), more in men (8.7% vs 3.4%). In the multivariate model adjusted for age, sex, ever-smoking, income, and exercise, any exposure to VGDF increased the odds of COPD (odds ratio (OR) 1.71; 95% confidence interval (CI) 1.03; 2.84), more in the highest exposure category (OR 2.36 (95% CI 1.20; 4.66)). Conclusion: Lifetime exposure to VGDF, found in ¼ of the general population, increased the odds of COPD independent of smoking by 71%.





Bacterial resistance in the intensive care unit of developing countries: Report from a tertiary hospital in Kazakhstan

Viderman, D., Brotfain, E., Khamzina, Y., Kapanova, G., Zhumadilov, A., Poddighe, D.


Journal of Global Antimicrobial Resistance, 17, pp. 35-38. (55 процентиль, Q2)

The aim of this study was to describe the patterns of antimicrobial resistance (AMR) of bacterial isolates causing hospital-acquired infections (HAIs) in the intensive care unit (ICU) of a tertiary hospital in Kazakhstan. Methods: This was a retrospective analysis of AMR in the ICU of the National Research Center for Oncology and Transplantation (Astana, Kazakhstan) during the year 2015. Results: During the study period, 546 patients were admitted to the ICU, of whom 135 (24.7%) developed at least one HAI. Most HAIs caused by Gram-positive bacteria were due to Enterococcus faecalis, which were resistant to aminoglycosides in >70% cases. Gram-negative bacteria were isolated in ca. 50% of cases, thus representing the greatest burden of HAIs. Very high resistance rates to ceftriaxone, cefotaxime and cefuroxime were observed. Moreover, Pseudomonas aeruginosa and Acinetobacter baumannii were resistant to carbapenems in <20% and in ca. 45% of cases, respectively. Conclusion: This study demonstrates the urgent need to implement more rational use of antimicrobials in Kazakhstan, which can be done only by establishing a proactive surveillance system along with an appropriate infection control programme.

DOI: 10.1016/j.jgar.2018.11.010




Injury registration for primary prevention in a provincial Russian region: Setting up a new trauma registry

Unguryanu, T.N., Grjibovski, A.M., Trovik, T.A., Ytterstad, Bø., Kudryavtsev, A.V.


Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 27 (1), статья No
47 (88
процентиль, Q1)

The Shenkursk Injury Registry (SHIR) was established in the Shenkursk District, Northwestern Russia in 2015 for the purposes of primary prevention. The SHIR covers all injuries (ICD-10 diagnoses from S00 to T78) for which medical aid is given at the Shenkursk central district hospital and includes data about injury circumstances. We used the SHIR data to assess the quality of the SHIR as an evidence basis and for the local preventive applications. Methods: Completeness, representativeness, and reliability of the SHIR data were assessed using a sample of 1696 injuries which have occurred in July 2015-June 2016. Chi-square tests were used to assess differences between the registered and missed cases in the registry and Cohen's kappa were applied to assess the agreement between independent data entries. Results: The completeness of the SHIR with respect to the coverage of cases treated at the Shenkursk central district hospital was 86%. There were no differences between the registered and the missed injuries by sex, ICD-10 codes, weekday of admission, but there were differences in their distribution by attending physicians. Also, higher proportions of child injuries and injuries in the summer time were among the missed cases. Signs of lower injury severity (different distribution by ICD-10 codes and lower proportion of traffic injuries) were observed among injuries in rural areas which were not covered by the registry because of treatment at rural primary health care units without referrals to the central hospital. Two independent data entries from standard paper injury registration forms showed a 79-99% agreement, depending on the variable considered. Conclusion: With consideration of possible insubstantial overestimates of the average injury severity, the SHIR data can be considered sufficiently complete, reliable, and representative of the injury situation in the Shenkursk District. Therefore, SHIR is an adequate evidentiary basis for planning local injury prevention.

DOI: 10.1186/s13049-019-0627-1




Seroprevalence of markers of hepatitis C virus exposure and associated factors in adults aged 18-39 years in the Arctic Russian city of Arkhangelsk: a cross-sectional study

Balaeva, T., Grjibovski, A.M., Samodova, O., Sannikov, A., Klouman, E.


International Journal of Circumpolar Health, 78 (1), статья No 1648970 (55 процентиль, Q2)

Hepatitis C, caused by the hepatitis C virus (HCV), is a major public health issue in Russia. The aim of our study was to assess the seroprevalence of markers of HCV exposure and factors associated with HCV seropositivity among the general population aged 18–39 years in the city of Arkhangelsk, Northwest Russia. A social research agency applied a quota sampling method to recruit study participants using cell phone numbers. All participants (n = 1243) completed a self-administered questionnaire and provided a blood sample. Sixty-five participants (5.2%, 95% confidence interval [CI] 4.9–5.5) tested positive for HCV IgM+G antibodies, and of these, 55 (84.6%) did not know that they were exposed to HCV. In multivariable logistic regression analysis, HCV seropositivity was significantly associated with older age, a history of injecting drug use, and having ever received a blood transfusion. To reach the goal of the World Health Organisation’s Global Health Sector Strategy on Viral Hepatitis, regional preventive programmes should include measures to reduce injecting drug use as well as scaling up harm-reduction and treatment programs for drug addicts.





Cigarette consumption estimates for 71 countries from 1970 to 2015: Systematic collection of comparable data to facilitate quasi-experimental evaluations of national and global tobacco control interventions

Hoffman, S.J., Mammone, J., Rogers Van Katwyk, S., Sritharan, L., Tran, M., Al-Khateeb, S.,
Grjibovski, A., Gunn, E., Kamali-Anaraki, S., Li, B., Mahendren, M., Mansoor, Y., Natt, N., Nwokoro,
E., Randhawa, H., Yunju Song, M., Vercammen, K., Wang, C., Woo, J., Poirier, M.J.P.


The BMJ, 365, статья No l2231 (93 процентиль, Q1)

Objectives To collect, appraise, select, and report the best available national estimates of cigarette consumption since 1970. Design Systematic collection of comparable data. Setting and population 71 of 214 countries for which searches for national cigarette consumption data were conducted, representing over 95% of global cigarette consumption and 85% of the world's population. Main outcome measures Validated cigarette consumption data covering 1970-2015 were identified for 71 countries. Data quality appraisal was conducted by two research team members in duplicate, with greatest weight given to official government sources. All data were standardised into units of cigarettes consumed per year in each country, a detailed accounting of data quality and sourcing was prepared, and all collected data and metadata were made freely available in an open access dataset. Results Cigarette consumption fell in most countries over the past three decades but trends in country specific consumption were highly variable. For example, China consumed 2.5 million metric tonnes (MMT) of cigarettes in 2013, more than Russia (0.36 MMT), the United States (0.28 MMT), Indonesia (0.28 MMT), Japan (0.20 MMT), and the next 35 highest consuming countries combined. The US and Japan achieved reductions of more than 0.1 MMT from a decade earlier, whereas Russian consumption plateaued, and Chinese and Indonesian consumption increased by 0.75 MMT and 0.1 MMT, respectively. These data generally concord with modelled country level data from the Institute for Health Metrics and Evaluation and have the additional advantage of not smoothing year-over-year discontinuities that are necessary for robust quasi-experimental impact evaluations. Conclusions Before this study, publicly available data on cigarette consumption have been limited; they have been inappropriate for quasi-experimental impact evaluations (modelled data), held privately by companies (proprietary data), or widely dispersed across many national statistical agencies and research organisations (disaggregated data). This new dataset confirms that cigarette consumption has decreased in most countries over the past three decades, but that secular country specific consumption trends are highly variable. The findings underscore the need for more robust processes in data reporting, ideally built into international legal instruments or other mandated processes. To monitor the impact of the WHO Framework Convention on Tobacco Control and other tobacco control interventions, data on national tobacco production, trade, and sales should be routinely collected and openly reported.






Epidemiology of childhood blindness: A community-based study in Bangladesh

Hussain, A.H.M.E., Ferdoush, J., Mashreky, S.R., Rahman, A.K.M.F., Ferdausi, N., Dalal, K.


PLoS ONE, 14 (6), статья No e0211991 (92 процентиль, Q1)

This study aimed to investigate the prevalence and causes of childhood blindness in a rural area of Bangladesh. We adopted a cross-sectional quantitative study design for this study, which was performed in three unions (sub-districts) located in Raiganj Upazila of the Sirajganj district in Bangladesh. Using a validated tool, a screening program was conducted at the household level. After initial screening, a team of ophthalmologists confirmed the diagnoses by clinical examinations. The prevalence of childhood blindness was observed to be 6.3 per 10,000 children, whereas the rate of uniocular blindness was 4.8 per 10,000 children. Congenital problems were the major causes of both uniocular and binocular blindness (uniocular blindness: 84% and binocular blindness: 92%). The whole globe was the site responsible for binocular blindness (28.0%, 95% confidence interval [CI]: 13.1, 47.7), whereas the cornea was responsible for uniocular blindness (57.8%, 95% CI: 35.3, 78.1). Childhood blindness is a public health problem in Bangladesh and is highly prevalent, regardless of sex. The major causes of childhood blindness are congenital.







Past, present, and future of global health financing: A review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995-2050

………….......Dalal K.......................


The Lancet, 393 (10187), pp. 2233-2260. (99процентиль, Q1)

Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries. Methods: We estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories-government, out-of-pocket, and prepaid private health spending-and estimated development assistance for health (DAH) from 1990 to 2018. We estimated future scenarios of health spending using an ensemble of linear mixed-effects models with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. We used demographic decomposition methods to assess a set of factors associated with changes in government health spending between 1995 and 2016 and to examine evidence to support the theory of the health financing transition. We projected two alternative future scenarios based on higher government health spending to assess the potential ability of governments to generate more resources for health. Findings: Between 1995 and 2016, health spending grew at a rate of 4.00% (95% uncertainty interval 3.89-4.12) annually, although it grew slower in per capita terms (2.72% [2.61-2.84]) and increased by less than $1 per capita over this period in 22 of 195 countries. The highest annual growth rates in per capita health spending were observed in upper-middle-income countries (5.55% [5.18-5.95]), mainly due to growth in government health spending, and in lower-middle-income countries (3.71% [3.10-4.34]), mainly from DAH. Health spending globally reached $8.0 trillion (7.8-8.1) in 2016 (comprising 8.6% [8.4-8.7] of the global economy and $10.3 trillion [10.1-10.6] in purchasing-power parity-adjusted dollars), with a per capita spending of US$5252 (5184-5319) in high-income countries, $491 (461-524) in upper-middle-income countries, $81 (74-89) in lower-middle-income countries, and $40 (38-43) in low-income countries. In 2016, 0.4% (0.3-0.4) of health spending globally was in low-income countries, despite these countries comprising 10.0% of the global population. In 2018, the largest proportion of DAH targeted HIV/AIDS ($9.5 billion, 24.3% of total DAH), although spending on other infectious diseases (excluding tuberculosis and malaria) grew fastest from 2010 to 2018 (6.27% per year). The leading sources of DAH were the USA and private philanthropy (excluding corporate donations and the Bill & Melinda Gates Foundation). For the first time, we included estimates of China's contribution to DAH ($644.7 million in 2018). Globally, health spending is projected to increase to $15.0 trillion (14.0-16.0) by 2050 (reaching 9.4% [7.6-11.3] of the global economy and $21.3 trillion [19.8-23.1] in purchasing-power parity-adjusted dollars), but at a lower growth rate of 1.84% (1.68-2.02) annually, and with continuing disparities in spending between countries. In 2050, we estimate that 0.6% (0.6-0.7) of health spending will occur in currently low-income countries, despite these countries comprising an estimated 15.7% of the global population by 2050. The ratio between per capita health spending in high-income and low-income countries was 130.2 (122.9-136.9) in 2016 and is projected to remain at similar levels in 2050 (125.9 [113.7-138.1]). The decomposition analysis identified governments' increased prioritisation of the health sector and economic development as the strongest factors associated with increases in government health spending globally. Future government health spending scenarios suggest that, with greater prioritisation of the health sector and increased government spending, health spending per capita could more than double, with greater impacts in countries that currently have the lowest levels of government health spending. Interpretation: Financing for global health has increased steadily over the past two decades and is projected to continue increasing in the future, although at a slower pace of growth and with persistent disparities in per-capita health spending between countries. Out-of-pocket spending is projected to remain substantial outside of high-income countries. Many low-income countries are expected to remain dependent on development assistance, although with greater government spending, larger investments in health are feasible. In the absence of sustained new investments in health, increasing efficiency in health spending is essential to meet global health targets.





Evaluation of knowledge and competence of Kazakhstani athletes about nutrition

Yerzhanova, Y., Sabyrbek, Z., Dilmakhanbetov, E., Madiyeva, G., Milasius, K.


Sport Mont, 17 (2), pp. 87-91. (56 процентиль, Q2)

Knowledge and competences are important for every person, especially they are important for physically active people. Although the knowledge and competence of athletes about nutrition is investigated, this subject is still a relatively new area in the science of nutrition of Kazakhstan athletes. Knowledge and competence is characterized as the ability of an individual to obtain, process and understand basic information on nutrition. The purpose of the work is to determine the level of knowledge, sources and the method of their acquisition by the investigated athletes. 199 students from Al-Farabi Kazakh National University and Abay Kazakh National Pedagogical University were enrolled in 1-4 courses in physical education and sports and 60 athletes of high sportsmanship - 15 volleyball players of Burevestnik teams, 15 judo wrestlers of the Kazakhstan national team, 15 wrestlers of the club team and 15 triathletes of the Kazakhstan national team were engaged in the study of the level of knowledge, method of acquisition of information on nutrition. The questionnaire prepared by Steptoe et al., (1995) was applied during the survey of students, directly interviewing each respondent. Kazakhstani athletes get basic information on nutrition from trainers and family members, and too few are accounted for by doctors and nutritionists. Public information systems are relatively ineffective. A survey of students showed that 26.2% of women and 43.3% of men receive information on nutrition from their trainer and teacher. They do not receive enough information on nutrition from media, radio and television. However, 26.2% of women and 18.5% of men receive such information via the Internet. When regulating body weight, women are mainly guided by their opinions, while men prefer coach recommendations.






Adolescent girls' attitudes toward female genital mutilation: A study in seven African countries [version 1; referees: 2 approved]

Biswas, A., Dalal, K., Kalmatayeva, Z., Mandal, S., Ussatayeva, G., Lee, M.S.


F1000Research, 7, статья No 343, (81 процентиль, Q1)

The study's aim is to examine adolescent girls' attitudes toward the continuation or discontinuation of female genital mutilation (FGM) in association with their demographics in seven different countries in Africa. Methods: Data from the women's survey of the Demographic and Health Surveys (DHS) conducted by the respective ministries (of Health and Family Welfare) in Egypt, Guinea, Kenya, Mali, Niger, Senegal and Sierra Leone were used. Adolescent girls (15-19 years) were included in the current analysis: Egypt (N=636), Guinea (N=1994), Kenya (N= 1767), Mali (N=2791), Niger (N=1835), Senegal (N=3604), Sierra Leone (N=1237). Results: Prevalence of supporting the continuation of FGM among adolescent girls was in Egypt 58%, Guinea 63%, Kenya 16%, Mali 72%, Niger 3%, Senegal 23%, and Sierra Leone 52%. Being Muslim and having low economic status were significantly associated with supporting the continuation of FGM in five of the participating countries. Girls having no education or only primary education in Guinea, Kenya, Mali and Sierra Leone exhibited a higher likelihood of supporting FGM than girls with secondary or higher education. In Egypt, Niger and Senegal there was no association between education and supporting FGM. The girls who stated that they had no exposure to media showed the higher likelihood of supporting FGM in Guinea, Kenya, and Senegal than those with exposure to media. Conclusions: The current study argues that increasing media coverage and education, and reducing poverty are of importance for shifting adolescent girls' attitudes in favor of discontinuation of FGM.





Mutations of rpoB, katG, inhA and ahp genes in rifampicin and isoniazid-resistant Mycobacterium tuberculosis in Kyrgyz Republic

Isakova, J., Sovkhozova, N., Vinnikov, D., Goncharova, Z., Talaibekova, E., Aldasheva, N., Aldashev,


BMC Microbiology, 18 (1), статья No 22 (66 процентиль, Q2)

The aim of this study was to identify mutations of rpoB, katG, inhA and ahp-genes associated Mycobacterium tuberculosis resistance to rifampicin (RIF) and isoniazid (INH) in Kyrgyz Republic. We studied 633 smear samples from the primary pulmonary tuberculosis (TB) patients. We verified Mycobacterium tuberculosis susceptibility to RIF and INH using culture method of absolute concentrations, and commercially available test named "TB-BIOCHIP" (Biochip-IMB, Moscow, Russian Federation). Results: For RIF-resistance, TB-BIOCHIP's sensitivity and specificity were 88% and 97%, 84% and 95% for INH-resistance, and 90% and 97% for multi-drug resistance (MDR). In RIF-resistant strains, TB-BIOCHIP showed mutations in codons 531 (64.8%), 526 (17.3%), 516 (8.1%), 511 (5.4%), 533 (3.2%), 522 (0.6%) and 513 (0.6%) of rpoB gene. The most prevalent was Ser531 > Leu mutation (63.7%). 91.2% of mutations entailing resistance to INH were in katG gene, 7% in inhA gene, and 1.8% in ahpC gene. Ser315→Thr (88.6%) was the most prevalent mutation leading to resistance to INH. Conclusions: In Kyrgyz Republic, the most prevalent mutation in RIF-resistant strains was Ser531 → Leu in rpoB gene, as opposed to Ser315 → Thr in katG gene in INH-resistant Mycobacterium tuberculosis. In Kyrgyz Republic, the major reservoir of MDR Mycobacterium tuberculosis were strains with combined mutations Ser531 → Leu in rpoB gene and Ser315 → Thr in katG gene. TB-BIOCHIP has shown moderate sensitivity with the advantage of obtaining results in only two days.





Prevalence of supplement use in recreationally active Kazakhstan university students

Vinnikov, D., Romanova, Z., Dushpanova, A., Absatarova, K., Utepbergenova, Z.



Journal of the International Society of Sports Nutrition, 15 (1), статья No 16 (92 процентиль, Q1)

Little is known about the supplements use and recreational sport practices in Kazakhstan university students. Therefore, the aim of this study was to ascertain supplements use prevalence and their predictors in this population. Methods: Cross-sectional survey of both undergraduate and graduate level students was completed in 2017 et al.-Farabi Kazakh National University, the largest higher institution in the country, from almost all Schools. A 45-item questionnaire was used to record physical activity, supplements use, lifestyle attributes (smoking, alcohol, sleep, etc.) and eating habits, and adjusted regression models were used to verify predictors of supplements use. Results: Of the entire sample of 889 students (70% females), 526 (59%) were practicing recreational physical activity (RPA), and walking, jogging and track and field was the most popular activity type (38%). N = 151 (29%) students reported the use of any supplement (31% in men and 27% in women), whereas the most popular supplement type were vitamins. Supplement use was most prevalent in swimmers (55%). Age (odds ratio (OR) 1.19 (95% confidence interval (CI) 1.04-1.37), use of fitness tracker (OR 6.26 (95% CI 3.90-10.03)) and low-fat diet (OR 1.95 (95% CI 1.23-3.10)), but not income predicted supplements use in adjusted models. Conclusions: With more than half of students exercising regularly, only less than one-third use supplements with a very strong association with fitness tracker use.





Impact of Rhinitis on Work Productivity: A Systematic Review

Vandenplas, O., Vinnikov, D., Blanc, P.D., Agache, I., Bachert, C., Bewick, M., Cardell, L.-O.,
Cullinan, P., Demoly, P., Descatha, A., Fonseca, J., Haahtela, T., Hellings, P.W., Jamart, J.,
Jantunen, J., Kalayci, Ö., Price, D., Samolinski, B., Sastre, J., Tian, L., Valero, A.L., Zhang, X.,
Bousquet, J.


Journal of Allergy and Clinical Immunology: In Practice, 6 (4), pp. 1274-1286.e9. (72 процентиль, Q2)

Allergic rhinitis (AR) is increasingly acknowledged as having a substantial socioeconomic impact associated with impaired work productivity, although available information remains fragmented. Objective: This systematic review summarizes recently available information to provide a quantitative estimate of the burden of AR on work productivity including lost work time (ie, absenteeism) and reduced performance while working (ie, presenteeism). Methods: A Medline search retrieved original studies from 2005 to 2015 pertaining to the impact of AR on work productivity. A pooled analysis of results was carried out with studies reporting data collected through the validated Work Productivity and Activity Impairment (WPAI) questionnaire. Results: The search identified 19 observational surveys and 9 interventional studies. Six studies reported economic evaluations. Pooled analysis of WPAI-based studies found an estimated 3.6% (95% confidence interval [CI], 2.4; 4.8%) missed work time and 35.9% (95% CI, 29.7; 42.1%) had impairment in at-work performance due to AR. Economic evaluations indicated that indirect costs associated with lost work productivity are the principal contributor to the total AR costs and result mainly from impaired presenteeism. The severity of AR symptoms was the most consistent disease-related factor associated with a greater impact of AR on work productivity, although ocular symptoms and sleep disturbances may independently affect work productivity. Overall, the pharmacologic treatment of AR showed a beneficial effect on work productivity. Conclusions: This systematic review provides summary estimates of the magnitude of work productivity impairment due to AR and identifies its main determinant factors. This information may help guide both clinicians and health policy makers.





Occupational exposure to metals and other elements in the tractor production

Vinnikov, D., Semizhon, S., Rybina, T., Zaitsev, V., Pleshkova, A., Rybina, A.


PLoS ONE, 13 (12), статья No e0208932 (92 процентиль, Q1)

Exposure to metals via air sampling in workplace has been extensively studied; however, the magnitude of individual exposure in various occupational groups may vary dramatically. The aim of this cross-sectional study was to ascertain exposure to selected metals from metal fumes in a series of typical workplaces of contemporary tractor production. Methods Ninety-eight (median age 41 (interquartile range (IQR) 23) years, all men) workers from Minsk Tractor Plant were categorized into four groups, including assembly shop workers (group 1); thermal shop staff (group 2); steelmakers (group 3) and welders (group 4). Hair samples (0.25 g) of each worker were tested for Ca, Mg, P, Cu, Fe, Zn, Al, Mn, Cr, Ni, Pb and Cd using atomic emission spectrophotometry. We then tested between-group differences of log-transformed element concentrations using analysis of variance, followed by logistic regression to determine the odds ratio (OR) with its 95% confidence interval (CI) of high exposure for four selected groups. Results The median work duration in workers was 6 (IQR 15) years, more in group 1 (10 (IQR 23)). Eight out of 12 included elements yielded significant between-group differences, including Mg, P, Fe, Zn, Mn, Cr, Ni and Cd. Steelmakers had higher Mn hair concentrations (F-ratio 10.41, p<0.001); whereas Fe (F-ratio 12.48, p<0.001), P (F-ratio 12.68, p<0.001), Zn (F-ratio 6.07, p<0.001) and Cr (F-ratio 20.54, p<0.001) were higher in welders. OR of high exposure to Mg in group 3 was 10.00 (95% CI 1.14–87.52), whereas the OR of high exposure to P in group 4 was 18.64 (95% CI 2.22–156.85) compared to group 1. Conclusions In the modern full-cycle tractor production, welders may have higher exposure to Fe, P, Zn and Cr, as opposed to steelmakers with higher Mn hair concentrations. © 2018 Vinnikov et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.





Influence of a health technology assessment on the use of pediatric cochlear implantation in Kazakhstan

Kosherbayeva, L., Medeulova, A., Hailey, D., Yermukhanova, L., Uraz, R., Aitmanbetova, A.


Health Policy and Technology, 7 (3), pp. 239-242. (60 процентиль, Q2)

To evaluate the influence of a health technology assessment (HTA) on pediatric cochlear implantation (CI) in Kazakhstan and to provide a further perspective on the use of the technology in that country. Ideally, children should be implanted as young as possible, have adequate rehabilitation, and be integrated into the regular school system. Methods: Administrative data for 2013–2016 relevant to pediatric CI in Kazakhstan were obtained from the Ministry of Health and from a survey of authorities in the 16 regions of the country. The data were compared with those for 2007–2012 used in preparation of the HTA report. Results: Funding continued to be available only for unilateral CI, a clinical protocol for the procedure was finalized and availability of equipment for audiological screening had improved considerably. In Kazakhstan the proportion of children over 5 years old at implantation had decreased by 65%, while that for children less than 2 years old had increased from 12 to 35%. Rehabilitation of children post-implantation was limited by the small numbers of suitable specialists. There was an increase in numbers of children enrolled in schools for those with moderate or profound hearing impairment. The number of children educated in standard schools remains low. Conclusion: The HTA made a useful contribution to the development of cochlear implantation services in Kazakhstan. The shortage of specialists for provision of rehabilitation and the limited placement of implanted children in general schools are matters for government decision - makers to consider.

DOI: 10.1016/j.hlpt.2018.06.002









Seroprevalence of markers of hepatitis B virus infection, associated factors, and vaccination status in young adults in Arkhangelsk, Northwest Russia: A population-based cross-sectional study

Balaeva, T., Grjibovski, A.M., Samodova, O., Sannikov, A., Klouman, E.


International Journal of Environmental Research and Public Health, 15 (9), статья No 1905 (66 процентиль, Q2)

Russia had a high incidence of hepatitis B virus (HBV) infection before the vaccination campaigns of 1997, 2001, 2007, which targeted newborns, adolescents, and adults, respectively. The aim of our study was to assess the prevalence of serological markers of HBV infection, associated factors, and vaccination status among young adults in Arkhangelsk, Northwest Russia. In this cross-sectional, population-based study, we used a quota sampling method to recruit 1243 adults aged 18–39 years. Participants completed a self-administrated questionnaire and were tested for hepatitis B markers. Associations between positivity for markers and selected sociodemographic and behavioral factors were studied by logistic regression. 10.9% of our participants were positive for at least one marker of hepatitis B, 1.2% were positive for HBsAg, and 42.1% were negative for all markers. In multivariable logistic regression analyses, age 30–34 years; lack of self-reported vaccination; and having ≥2 sexual partners in the last 6 months were associated with positivity for markers of hepatitis B. Hepatitis B vaccination was confirmed in 46.9% of participants. Although half of our study sample was vaccinated, four in 10 were still susceptible to infection and more than one participant in 100 showed evidence of an active infection.





Special features of consumption of water and drinks by Kazakhstan athletes

Yerzhanova, Y., Sabyrbek, Z., Kalmatayeva, Z., Milasius, K.


Sport Mont, 16 (3), pp. 63-68. (56 процентиль, Q2)

In Kazakhstan, the regime and habits of consuming liquids by athletes in various sports have not been suffi ciently explored yet. The purpose of the study is to determine the amount, schedule and characteristics of consumption of drinks by sportsmen after the example of diff erent sports. In 2017 15 volleyball players of the Burevestnik team in Almaty, 15 judo wrestlers of the national team of Kazakhstan, 15 wrestlers of the club team and 15 triathletes of the national team of Kazakhstan took part in the estimation of the regime of water and other liquids consumption. A valid questionnaire was used to study the data on the volume and water consumption schedule and other liquids. The amount of water and other drinks consumed was studied by reproducing drinking during 24 hours. The questionnaire put questions about the amount of water and beverages consumed prior to training, during and after it, and furthermore certain types of beverages were determined. Our research showed that 63.34% of the Kazakhstan athletes under examination drink the recommended norm (2-3 liters per day), another 6.69% of the investigated consume from 3 to 6 liters of liquid. The researched athletes do not consume enough liquid 2 hours before training. Only 20% of volleyball players, judoists and triathletes of national teams consume the recommended norm of liquid (400-600 ml). Most of the investigated athletes consume necessary amount of water and other beverages during training. 70.0% of respondents drink water and juices during training, and only 16.7% of them drink sport drinks.





Accessibility of inclusive higher education through the eyes of students with disabilities

Ispambetova, G., Alimkhanov, Y., Madiyeva, G., Sabyrbekova, L., Shepetyuk, N., Adilzhanova, M.,
Khokhlov, A.


Astra Salvensis, 6 (1), pp. 505-515. (98 процентиль ,Q1)

Currently, the problem of providing optimal conditions for the creative development, self-education and professional development of persons with disabilities is increasingly relevant for higher educational institutions of the Republic of Kazakhstan. In this regard, of major importance is to study the peculiarities of organizing work with students in the context of inclusive education. The main purpose of the study was to analyze and determine the degree of accessibility of high-quality higher education as viewed by students with disabilities, and based on the research results, to offer recommendations for addressing the identified problems. The survey included 52 students aged 17-23 years enrolled in different courses and faculties of the Al-Farabi Kazakh National University with disabilities of various types: visual impairments-16 students; musculoskeletal disorders- 20 students; somatic diseases-16 students. The questionnaire was developed by specialists of the Resource Advisory Center of the Ministry of Education and Science of the Republic of Kazakhstan.






Morbidity in the Mountainous Province of Kyrgyzstan: Results from a Population-Based Cross-Sectional Study

Brimkulov, N., Louton, L., Sydykova, S., Vinnikov, D., Imanalieva, F.
Morbidity in the


High Altitude Medicine and Biology, 18 (4), pp. 338-342. (56 процентиль, Q2)

The aim of this study was to identify the main causes of using primary care facilities in the mountainous Naryn Province of Kyrgyzstan to set resources allocation priorities. We collected data on all admissions to family doctors in three Family Medical Centers (FMCs) in Naryn Province: (1) the city of Naryn (2200 meters above sea level [MASL]); (2) the town of At-Bashy (3200 MASL); and the town of Kochkor (1800 MASL) by using an original questionnaire during one full week (5 days) in spring 2016. Within 1 week, we recorded 1136 cases in Naryn and 782 cases in Bishkek after exclusion of missing data. The top three reasons for admissions were respiratory (23% of all in Naryn and 36% in Bishkek), nonspecific general (19% and 17%), and neurological (13% and 9%). Naryn residents were 3.84 times (confidence interval [95% CI] 2.07-7.11) more likely to apply with musculoskeletal and 3.05 times (95% CI 1.02-9.12) more likely to apply with cardiovascular conditions. This first population-based study in Naryn stresses the need to prioritize cardiovascular and rheumatological care in these mountainous conditions.





Occupation and chronic obstructive pulmonary disease in Minsk tractor plant workers

Vinnikov, D., Semizhon, S., Rybina, T., Savich, L., Scherbitsky, V., Manichev, I.


American Journal of Industrial Medicine, 60 (12), pp. 1049-1055. (59 процентиль, Q2)

The aim of this study was to measure the association of exposure to dust at workplace with COPD using objective methods of exposure and outcome classification. Methods: Forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) <70%; FVC below LLN, and FEV1 below LLN from the annual screening of Minsk Tractor Plant workers (N = 458) were tested for predictors in an adjusted logistic regression model. Results: In a regression model, adjusted for pack-years of smoking, age, sex, and work duration, work in highly exposed workplaces was associated with FEV1/FVC<70% (odds ratio (OR) 2.10 (95% confidence interval (CI) 1.16;3.83); and FEV1





The association of polymorphic markers Arg399Gln of XRCC1 gene, Arg72Pro of TP53 gene and T309G of MDM2 gene with breast cancer in Kyrgyz females

Isakova, J., Talaibekova, E., Aldasheva, N., Vinnikov, D., Aldashev, A.


BMC Cancer, 17 (1), статья No 758 (68 процентиль, Q2)

The association of genes XRCC1, TP53 and MDM2 with breast cancer (BC) has never been tested in Kyrgyz population. We, therefore, aimed to identify an association of alleles and genotypes of polymorphic markers Arg399Gln of gene XRCC1, Arg72Pro of gene TP53, and T309G of gene MDM2 with the risk of BC in Kyrgyz women. Methods: This was a case-control study of 219 women of Kyrgyz origin with morphologically verified BC (N = 117) and 102 controls, age-matched with BC cases. The mean age of subjects in this study was 52.2 ± 10.8 years. We extracted DNA from the venous blood and genotyped polymorphic markers Arg399Gln of gene XRCC1, Arg72Pro of gene TP53 and T309G of gene MDM2 using polymerase chain reaction and the method of restriction fragment polymorphism. Results: Allele 399Gln (OR 1.57; 95% CI 1.05-2.35), Arg399Gln of gene XRCC1 heterozygous genotype (OR 2.77; 95% CI 1.60-4.80), the combination of Arg399Gln/Arg72Pro of genes XRCC1/TP53 heterozygous genotype (OR 3.98; 95% CI 1.57-10.09), Arg399Gln/T309G of genes XRCC1/MDM2 (OR 3.0; 95% CI 1.18-7.56), as well as Arg399Gln/Arg72Pro/T309G of genes XRCC1/TP53/MDM2 (OR 6.40; 95% CI 1.18-34.63) were associated with BC in Kyrgyz women. Conclusions: This is the first study to identify the inter-loci interaction and to find molecular markers of individual risk of BC in Kyrgyz women.





L-Asparaginase for newly diagnosed extra-nodal NK/T-cell lymphoma: systematic review and meta-analysis

Pokrovsky, V.S., Vinnikov, D.


Expert Review of Anticancer Therapy, 17 (8), pp. 759-768 (85 процентиль, Q1)

The aim of this review was to compare the efficacy of asparaginase (ASP)-containing vs ASP-absent regimens in the first-line treatment of ENKTL patients. Methods: The PRISMA protocol was used to search PubMed and Embase for both controlled and uncontrolled studies of ASP or alternative chemotherapy (CT) for newly diagnosed ENKTL, published in English by March 2017. The regimens were compared to calculate relative risk (RR) with 95% confidence interval (CI) of the overall response rate (ORR), complete response (CR) or partial response (PR). Results: Out of 38 studies included, eight were controlled trials, with the pooled RR of ORR in stage I-II 1.54 (95% CI 1.34–1.77); stage I-IV 1.34 (95% CI 1.09–1.64). In stage III-IV CT combined with radiotherapy (RT), RR of ORR was 2.30 (95% CI 1.66–3.18). ASP was also superior in achieving CR. When all single arms combined, RR of ORR after CT with ASP was 1.52 (95% CI 1.38–1.67) in stage I-II (15 studies); 1.44 (95% CI 1.32–1.57) in all stages (29 studies); 1.31 (95% CI 1.24–1.38) and 1.66 (95% CI 1.18–2.34) in stages I-II and III-IV combined with RT, correspondingly. Conclusions: ASP-based CT significantly improved ORR and CR in patients with newly diagnosed both early-stage and advanced-stage ENKTL.





Tobacco use among Kyrgyzstan medical students: An 11-year follow-up cross-sectional study

Brimkulov, N., Vinnikov, D., Dzhilkiadarova, Z., Aralbaeva, A.


BMC Public Health, 17 (1), статья No 625, (77 процентиль, Q1)

Medical students are the first line active force to combat tobacco epidemic, but they may suffer from high smoking prevalence and wrong attitude themselves. The aim of the study was to assess the effect of current curriculum on smoking behavior of medical students in Kyrgyzstan. Methods: 20% random sample of all 6 years of the School of Medicine in Kyrgyz State Medical Academy were interviewed in spring 2016. The questionnaire included sections on tobacco products consumption and knowledge and attitude to counseling. We verified smoking status with exhaled CO measurement using Bedfont Smokelyzer. Results: In 618 students (48% female), the overall daily cigarette smoking prevalence was 21% (34% in males and 6% in females), being highest in years 1 and 3 and least in year 5 (prevalence difference 14%). With very low smokeless products and electronic cigarettes use prevalence, ever-smoking prevalence of waterpipe use was very high, reaching 85% in 6-year male students with alarmingly high prevalence in female students also. Only 74% students responded there was 100% evidence of harmful effects of tobacco, unchanged throughout the course of study. Conclusions: The use of tobacco products, especially smoking waterpipe, in Kyrgyzstan medical students remains very high. Coupled with poor knowledge and high demand for more information, this demonstrates urgent need for more active and advanced training on tobacco control in medical school.





Occupation and Obstructive Sleep Apnea: A Meta-Analysis

Schwartz, D.A., Vinnikov, D., Blanc, P.D.


Journal of Occupational and Environmental Medicine, 59 (6), pp. 502-508 (74 процентиль, Q2)

Obstructive sleep apnea (OSA) remains a prevalent condition, but its occupational burden is unclear. We carried out a systematic review to characterize the consistency and magnitude of occupational associations with OSA. Methods: We studied OSA within three occupational categories: commercial drivers, organic solvent-exposed workers, other selected occupations. We performed a meta-analysis on the prevalence of OSA among drivers and the risk of OSA associated with solvent exposure. Results: The pooled OSA prevalence in drivers was 41% (95% confidence interval [CI] 26% to 56%) for apnea hypopnea-index (AHI) is greater than 5, and 15% (95% CI 12% to 19%) for AHI is greater than 15. Exposure to solvents was associated with increased but non-statistically significant risk of OSA: summary relative risk, 2.38 (95% CI 0.89 to 6.32). Evidence of occupational association was inconsistent for other factors. Conclusions: OSA is common among commercial drivers and potentially associated with occupations involving likely solvent exposure.






Fatigue and sleepiness determine respiratory quality of life among veterans evaluated for sleep apnea

Vinnikov, D., Blanc, P.D., Alilin, A., Zutler, M., Holty, J.-E.C.


Health and Quality of Life Outcomes, 15 (1), статья No 48, (74 процентиль, Q2)

In those with symptoms indicative of obstructive sleep apnea (OSA), respiratory-specific health-related quality of life (HRQL) may be an important patient-centered outcome. The aim of this study was to assess the associations between sleepiness, fatigue, and impaired general and respiratory-specific HRQL among persons with suspected OSA. Methods: We evaluated military veterans consecutively referred for suspected OSA with sleep studies yielding apnea-hypopnea index (AHI) values. They also completed the sleepiness (Epworth Sleepiness Scale [ESS]), and fatigue (Fatigue Severity Scale [FSS]) questionnaires, as well as two HRQL instruments (the generic Short-Form SF-12v2 yielding the Physical Component Scale [PCS] and the respiratory-specific Airways Questionnaire [AQ]-20R). Multiple linear regression tested the associations between ESS and FSS (standardized as Z scores for scaling comparability) with AQ-20R, accounting for AHI, SF-12v2-PCS and comorbid respiratory conditions other than OSA. Results: We studied 1578 veterans (median age 61.1 [IQR 16.8] years; 93.9% males). Of these, 823 (52%) met AHI criteria for moderate to severe OSA (AHI ≥15/h). The majority reported excessive daytime sleepiness (53%; median ESS 11 [IQR 9]) or fatigue (61%; median FSS 42 [IQR 23]). The median AQ-20R was 4 [IQR 1-8]. Controlling for AHI, SF-12v2-PCS, respiratory co-morbid conditions, body mass index, and demographics, both ESS and FSS were significantly associated with poorer AQ-20R: for each; ESS, 1.6 points (95% CI 1.4-1.9), and for FSS, 2.5 points (95% CI, 2.3-2.7). Conclusions: Greater daytime sleepiness and fatigue are associated with poorer respiratory-specific HRQL, over and above the effects of OSA, respiratory comorbidity, and generic physical HRQL.