Introduction. Efficient use of bed capacity is a key element in improving the quality and accessibility of inpatient care. The “bed turnover” indicator reflects the intensity of bed utilization and is included among the indicators of national healthcare projects. The purpose is to analyze trends in the main performance indicators of 24-hour inpatient facilities in the Tyumen Region from 2013 to 2023 and to identify the determinants of changes in bed turnover. Materials and methods. A retrospective study was conducted using official statistical data from the Tyumen Region Department of Health and the Tyumen Regional Medical Information and Analytical Center (MIAC). Trends were assessed by absolute and relative changes; associations were examined using Spearman’s rank correlation (p<0.05). Results and conclusion. From 2013 to 2019, bed availability rate per 10 000 patients decreased from 66.1 to 59.3 (–10.29%), average length of stay declined from 10.11 to 9.84 days (–2.67%), and bed turnover increased from 33.1 to 34.0 (+2.72%). During the COVID-19 pandemic (2020–2021), average length of stay rose to 10.10 days and turnover fell to 33.3; by 2021 the turnover had recovered, rising up to 35.9. By the end of 2023, length of stay reached 8.8 days and bed turnover peaked at 38.4 patients. Correlation analysis revealed a strong negative association of bed turnover with both lengths of stay and bed availability and a positive association with bed occupancy and in-hospital mortality. Over the decade, the Tyumen Region increased bed utilization intensity: bed turnover rose by 16%, while average length of stay fell by 12%. The main drivers of these changes were reduced treatment durations and optimization of bed numbers.><0.05). Results and conclusion. From 2013 to 2019, bed availability rate per 10 000 patients decreased from 66.1 to 59.3 (–10.29%), average length of stay declined from 10.11 to 9.84 days (–2.67%), and bed turnover increased from 33.1 to 34.0 (+2.72%). During the COVID-19 pandemic (2020–2021), average length of stay rose to 10.10 days and turnover fell to 33.3; by 2021 the turnover had recovered, rising up to 35.9. By the end of 2023, length of stay reached 8.8 days and bed turnover peaked at 38.4 patients. Correlation analysis revealed a strong negative association of bed turnover with both lengths of stay and bed availability and a positive association with bed occupancy and in-hospital mortality. Over the decade, the Tyumen Region increased bed utilization intensity: bed turnover rose by 16%, while average length of stay fell by 12%. The main drivers of these changes were reduced treatment durations and optimization of bed numbers.

In the context of increasing demand for cross-border medical services, the special significance of the analysis of Russian regional exports continues to grow. The Tyumen region, which has a developed medical infrastructure, needs a systematic assessment of its competitive advantages for integration into the international market. Nosological analysis allows to identify the most demanded areas of medical care among foreign patients, which helps to optimize resources and form a targeted marketing policy of the region. Despite the active development of federal programs for the medical service export, most studies focus on all-Russian data, while regional specifics (including geographical, economic and clinical features) remain poorly studied. The objective is to study the medical service export of this Russian Federation region while taking into account the priority nosological groups, as well as to direct the study to assess the structure of the region's medical service export, highlighting the nosologies with the greatest export potential. Another objective is to determine the contribution of individual diseases to the regional medical service export based on the graphical data. The unified reporting format ensures comparability of data, which allows the methodology to be used as a standardized approach to analyzing the nosological structure of exports. The results of the study identify key priorities for the development of the export potential of medical services. The methodological advantage of the study is based on the use of a unified reporting system, which provides comparability of data between regions; allows the application of standardized analytical approaches; forms a unified methodological base for management decisions and can be replicated in other Russian regions participating in the implementation of the Federal project on the medical service export.

Background. The article shows the results of rating the psychosocial factors that are important for primary care physicians working at primary healthcare organizations in Moscow and the Moscow Oblast who decide to leave the profession. The research was conducted using the author's questionnaire. Purpose. To determine the significance of psychosocial factors to leave the profession among physicians. Materials and methods. The survey involved primary care physicians from city polyclinics in Moscow and the Moscow Oblast (n=400). The sociological, statistical, and analytical methods were used. Results. The study presents the ranking of psychosocial factors that cause physicians to leave the profession and indicates stress as the leading determinant.

Maintaining the professional stability of a specialist, which determines their efficiency in conditions of stress and high emotional and physical burden that are typical for nurses working at multidisciplinary urban medical organizations, is an urgent task. In the context of the modern healthcare system, where the burden on specialists is growing, studying professional sustainability is becoming particularly relevant. Purpose: to analyze the professional stability of nurses at multidisciplinary urban medical organizations. Materials and methods. The professional sustainability of 50 nurses working at a multidisciplinary urban medical organization was assessed using a sociological method — a questionnaire developed by the authors of this study, which is based on the Connor-Davidson sustainability scale (CD-RISC), the Maslach Professional Burnout questionnaire (MBI), and the ProQOL professional life quality scale. Using published data on methods of correcting professional stability, a workshop was scientifically justified, and its effectiveness was evaluated. Results. The majority of nurses showed insufficient levels of factors forming professional stability, such as stress tolerance, support, self-regulation, and job satisfaction, as well as high levels of emotional burnout. Based on the obtained data, a workshop was developed. The activities carried out among 50 nurses proved to be effective: after the seminar, the nurses significantly increased their awareness levels by 2 times, self-regulation skills by 2.2 times, emotional stability by 1.8 times due to stress levels decreasing by 1.9 times, and professional burnout by 2.2 times. Conclusion. The study revealed a low level of professional resilience among most nurses due to insufficient stress tolerance, self-regulation, peer support, and job satisfaction. A high level of emotional burnout exacerbates this situation. The workshop increased the nurses' awareness and improved self-observation and understanding of reactions. Regular mindfulness practices have reduced stress and emotional burnout and improved self-regulation skills and emotional resilience. This improved the response to stressful situations, confidence, and team support.

Introduction. Occupational stress leads health workers to somatic symptom disorders. Purpose. To identify somatic symptom disorders of healthcare workers. Methods and materials. The study involved a sample of 648 medical workers, who took part in the assessment on a voluntary basis. The authors used Apanasenko's method for assessing somatic health level and the Aleksandrovich symptomatic questionnaire modified by the V. M. Bekhterev National Research Medical Center for Psychiatry and Neurology, according to which somatic symptom disorders are part of the neurotic disorder. The Pearson correlation coefficient and the Chaddock scale were used for assessing and tracking somatic symptom disorders. Results. The following somatic symptom disorders among healthcare workers were identified: above-average level of allergic ailments, breathing difficulties, general discomfort in unpleasant situations, loss of appetite, sensation of blood rushing to the head, redness of the face, neck, chest, hunger attacks, tightness, excessive saliva accumulation, dry mouth, excessive thirst, lump in the throat and muscle tension; moderate level of heart pain, headache interfering with daily activities, dizziness, slight decrease in lung capacity, nervous sweating, sensitivity to noise, light or touch, increased systolic blood pressure, prolonged heart rate recovery time, somatization complaints, reduced grip strength, bodyweight gain, increased heart rate, rapid heartbeat with no activity, head rush, and tinnitus.

Background. Modern scientific research have identified the most important biological components and pathological processes that contribute to the causes and development of an autistic specter disorder (ASD). However, autism management using psychological and pedagogical methods are of greater importance rather than medical examination and treatment. The purpose of the present study was to analyze the dynamics of ASD-related psychoneurological and laboratory indicators during the treatment using biomedical technologies. Materials and methods. The study included 68 children with moderate and severe ASD. In this work, psychopathological, psychometric, clinical, laboratory and statistical methods were used. Results revealed a pro-inflammatory state, heterogeneous changes in metabolic status, endocrine dysfunction with various degrees of impairment compensation. Personalized biomedical intervention helps to reduce the severity of psychoneurological symptoms and improve physical well-being, which is confirmed by laboratory tests. Conclusion. Interventions aimed at eliminating inner factors contributing to homeostasis disorders such as inflammation, metabolic dysfunction and hormonal imbalance contribute to the age- and gender-specific innate behavioral patterns, which results in successful outcomes in terms of normal child development. Keywords: autism spectrum disorder; neuroinflammation; metabolic dysfunction; hormonal imbalance; behavioral patterns; rehabilitation

The goal was to define the role of psychosocial factors and eating disorders in a metabolic health model. Materials and methods. The study included 2176 participants, 64.8% (n=1411) of whom were women and 35.2% (n=765) were men with the median age of 41 [27; 53] years. Socio-demographic characteristics, behavioral risk factors, symptoms, and manifestations of eating disorders were assessed using the DSM-5 criteria and the Dutch Eating Behavior Questionnaire (DEBQ); for the risk assessment of carbohydrate metabolism disorders, the FINDRISK scale was used; anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS); the severity of depressive disorders were defined using the Beck Depressive Inventory (BDI); and the level of reactive and personal anxiety was assessed using the State-Trait Anxiety Inventory (STAI). Results. Confirmed bulimia nervosa or binge eating disorders increase the risk of carbohydrate metabolism disorders by 2.8 times (95% CI: 1.8-3.2, p = 0.033). The combination of traditional risk factors and an eating disorder increase the risk of carbohydrate metabolism disorders. In individuals over 45 years with confirmed eating disorders, the risk of developing prediabetes and diabetes associated with an eating disorder is increased by 2.2 times (95% CI: 1.9-2.5; p=0.003). The combination of obesity and an eating disorder increases the probability of developing carbohydrate metabolism disorders by 2.8 times (95% CI: 2.4-3.2, p=0.005). Reactive and personal anxiety in patients with an eating disorder increases the risk of carbohydrate metabolism disorders by 2.9 and 3.4 times, respectively (p<0.05). The combination of traditional risk factors and an eating disorder increase the risk of carbohydrate metabolism disorders by 8 times (95% CI: 6.7-9.8, p=0.001). Conclusion. Eating disorders are associated with psychosocial factors and the risk of developing metabolism disorders, which allows to consider them as predictive factors for the development of carbohydrate metabolism disorders.

Introduction. Managing incidence in a smart city requires modern approaches based on predictive analytics and big data processing. However, in Russia, the use of smart systems in healthcare is faced with legislative, technological, and economic restrictions. The article explores the possibilities and risks of introducing artificial intelligence (AI) in healthcare management, as well as the existing aspects related to regulatory requirements, data safety, and the integration of such solutions. The purpose of the study is to use the SWOT analysis to briefly consider the capabilities, risks, difficulties, and advantages of introducing AI for analysis and management of population health in certain territories, including the Russian Federation. Materials and methods. Analysis and compilation of data from public databases, regulatory legal acts of foreign countries and the Russian Federation, as well as full publications featured in the Russian scientific quoting index available for free on the PubMed portal. Results. The study showed that, despite the high efficiency of AI in various fields, Russia does not have smart strategic planning tools officially approved at the territory level that can be classified as medical products (software). The main obstacles are the long and expensive process of software registration, the risks of confidential data leaks, and the medical workers’ distrust of the algorithms. At the same time, global trends showcase increased investment in AI in healthcare. The solution requires an interdisciplinary approach, including goal-setting, adaptation of legislation, increasing cybersecurity, and the development of explainable AI models. The use of large language models capable of maintaining management decisions in healthcare is recognized as a promising area.

Introduction. Improving quality of life (QoL) has become an objective equal in importance to prolonging survival in prostate cancer (PC). The objective of this work was to review the latest scientific studies assessing the QOL of patients with PC both before and after treatment. The search for scientific studies was conducted using leading international databases (PubMed, Scopus and Web of Science). Material and methods. A systematic search of PubMed, Scopus and Web of Science (2010 – 2025) was performed using the terms “prostate cancer”, “quality of life”, “postoperative outcomes”, “predictors”. 17 original studies were included. The list of questionnaires used included EPIC-26/CP, EORTC QLQ-C30/PR25, FACT-P, PROMIS and FoP-Q-SF. Results. Adverse clinicopathological predictors of poor QoL included age ≥ 65 years, multimorbidity, Gleason score ≥ 8 and prior TURP. Anatomic MRI-derived markers (short membranous urethra < 10 mm, prolonged pubic–apex length) reliably forecasted long-term incontinence and erectile dysfunction after robot-assisted prostatectomy. Psychosocial factors—fatigue, fear of cancer recurrence and insomnia–made a comparable impact: severe fatigue increased the odds of poor physical health, while high fear of recurrence reduced global QLQ-C30 scores by ≥ 10 points. High socioeconomic status and robust family support mitigate QoL deterioration by approximately 30 %. Radical treatments (prostatectomy, external-beam radiotherapy, androgen-deprivation therapy) produced persistent functional impairment yet did not worsen mental well-being when active rehabilitation programs were implemented. Conclusion. QoL in men with PC is shaped by a multifactorial interplay of clinical, anatomical and psychosocial predictors; integrating routine PROM screening with MRI-based nomograms and targeted psychosocial support enables truly personalized care.

The purpose of this work was to determine the optimal technological parameters for the production of insect protein concentrate from mealworm (Tenebrio molitor), house cricket (Acheta domesticus) and black soldier fly (Hermetia illucens) with a protein content of at least 65% with possible scalability for modern food industry purposes. Materials and methods. In this work, frozen and dried biomass of mealworm, house cricket and black soldier fly was studied. Extraction, filtration and drying methods to isolate the insect proteins were used. To analyze protein concentration, Kjeldahl, Lowry and Bradford methods were used. Lipid concentration was analysed according to GOST 23042-2015. Results. Based on the review of scientific literature on modern deep-processing methods of plant-based raw materials (legumes) and the author’s own research on isolating protein and lipid fractions from insect biomass, a technology of protein concentrate extraction from insects was developed. The key stages include obtaining protein, lipid, and chitin fractions. The crucial role in the process of obtaining purified protein involve extraction, concentration, purification and drying. The developed scheme was tested on the biomass produced from A. domesticus, T. molitor, and H. illucens, resulting in three freeze-dried samples of insect protein containing at least 65% protein. Conclusion. Optimal technological parameters for the production of insect protein concentrate from innovative food raw materials, namely, Tenebrio molitor, Acheta domesticus and Hermetia illucens, were determined. The optimized conditions for isolating lipid and protein fractions enable not only to obtain purified insect protein without costly and toxic reagents, but also the transition from laboratory to semi-industrial protein production. Studies of insect protein concentrate (minimum 65% protein content) proved its high biological value, comparable to traditional sources of complete protein.

Introduction. Digital technologies are becoming an integral part of modern healthcare, especially in inpatient care. It improves efficiency, accuracy, and personalization of medical care, which is substantial in emergency care provision and complex clinical case management. International experience demonstrates significant improvement in clinical outcomes through the integration of digital solutions, including artificial intelligence, the Internet of Things, and telemedicine. The purpose of the work is to conduct a review to identify best international practices of digital technologies in hospital medical care. Materials and methods. This study is a literary review of 45 relevant scientific publications in English, selected by Google Scholar from 2020 to May 2025, focused on digital technologies in surgical departments of clinical hospitals. Priority was given to the sources containing verified data on digital technologies (video systems, robotic surgery systems, IT platforms, etc.) of inpatient medical care included in Scopus and Web of Science. Results. The literature review has shown that digital technologies are radically transforming inpatient medical care, expanding the scope of diagnostic, treatment, and monitoring frameworks. International experience demonstrates successful application of telemedicine technologies, the Internet of Things, robotic systems, and AI in healthcare, including surgery and rehabilitation. The technologies improve the quality of medical services and reduce staff workload; however, they bring challenges of unified standards and cybersecurity. In Russia their successful implementation requires an interdisciplinary approach and proper technological competencies. Furthermore, it is important to rely on international experience, increase collaboration with friendly countries, and plan workforce capacity in digital healthcare.

Introduction. Prosthodontic care holds a special place in the healthcare system, restoring lost dental functions, improving the quality of life, and preventing complications associated with tooth loss and malocclusion. The need for high-quality prosthodontic care is steadily increasing in the context of population aging, rises in life expectancy, and the growing burden of chronic diseases. Therefore, delivering prosthodontic care becomes a topic of both clinical and socioeconomic interest. Purpose. To identify and analyze the organizational factors that determine the accessibility and quality of prosthodontic care, as well as to verify the directions to improve them within the healthcare system. Materials and methods. The study applied a systematic and interdisciplinary approach to assessing processes of healthcare organization. The following methods were used: content analysis of legal acts and policy documents of the Ministry of Health of the Russian Federation, comparative analysis of regional care models, and logical and structural analysis of organizational factors. Results. Limited geographic access to prosthodontic care is one of the key organizational barriers. In most Russian regions, dental services are concentrated in large cities, while there are no structural units equipped for prosthetics in rural and remote areas. Another critical factor is the shortage of qualified personnel. Both public and private healthcare organizations, especially single-specialty clinics, experience a shortage of prosthodontists. Vulnerable groups have significantly limited access to prosthodontic care, as it is mostly provided on a fee basis. The deteriorated dental laboratory equipment and poorly implemented digital technologies are also important organizational factors. The modern dental care system is characterized by a lack of connection between therapeutic, surgical, and prosthodontic services.

Introduction. The global maritime industry is undergoing a structural shift: the proportion of women in mixed crews is increasing while the requirements for occupational health, safety, and well-being of the ship’s crew are becoming more complex. Unlike onshore production, the ship is a limited, regimented, and technologically saturated environment, combining long-term autonomy, shift work, high physical, psychological, and emotional stress, multinational teams, and a rigid hierarchy of decision-making. In these circumstances, the task of creating a health-saving environment for female seafarers goes beyond the simple adaptation of occupational health and safety standards: we are talking about rethinking the design of everyday life, supplies, personal protection, medical and psychosocial support, and institutional arrangements for preventing discrimination. Purpose. To develop the framework of a science-based organizational and methodological model for creating a health-saving shipboard environment for female seafarers. Materials and methods. Comparative institutional research was conducted based on a multi-level case analysis. The work combined the desk research of regulatory and corporate documents, the structured content analysis of public reporting by shipping companies and industry coalitions, and the comparison of practices through a single analytical matrix “problem area – intervention – mechanism of impact – outcomes.” The analysis covered the period from 2019 to 2025, when the topic of DEI (diversity, equity & inclusion) and the crew’s well-being have been at the top of global agenda. Results. The basic requirements for accommodation and hygiene are set out in the Maritime Labour Convention. They serve as the minimum that companies complement with corporate standards and procedures in successful cases. Preventing bullying and harassment onboard is at the core of corporate security management systems: the industry guidelines of the International Chamber of Shipping (ICS) and the International Federation of Transport Workers (ITF) recommend clear communication channels, privacy protection, and commander training. The experience of the largest shipping companies shows that sustainable changes onboard are only possible when local inclusion and health-saving initiatives turn into an industry standard supported by coalition mechanisms.

Introduction. The development of the private sector in the Russian healthcare system has been an important area of state socio-economic policy over the course of recent decades. Private medical organizations perform a significant function by expanding the availability of medical care, diversifying the forms of service provision, introducing innovative technologies, and increasing the competitiveness of the entire medical market. As the public sector becomes saturated and patient demands grow, it is private clinics that are at the forefront of introducing new management models, digital solutions, and customer-oriented services. At the same time, the current stage of private healthcare development is characterized by a number of acute organizational and managerial challenges. The purpose of the work is to identify the key challenges faced by private medical organizations, as well as to substantiate promising areas for improving management systems, taking into account the current realities of the medical services market. Materials and methods. The study used methods of systematic, comparative, and content analysis of regulatory documents, health development strategies, and statistical data from the Ministry of Health of the Russian Federation, as well as materials from practical experience in managing private medical organizations. A qualitative analysis of management models was used, as well as an analysis of publications in specialized medical and management publications. Results. Modern management challenges in private medicine require organizations to switch to strategically oriented and client-centered management models that can ensure sustainability and adaptability in the face of competition, staff shortages, digitalization, and limited participation in the compulsory health insurance system. The implementation of priority development directions — the formation of a service management logic, integration into public-private partnerships, the development of a project approach, strengthening human resources, and building digital ecosystems — allows not only to increase the effectiveness of private medical organizations but also to strengthen their role in ensuring accessibility and quality of medical care in the country.

Modern medical charity is an important element of the healthcare system, complementing public and private initiatives to ensure the availability of medical services. In the context of socio-economic crises, pandemics and the increasing incidence of chronic diseases, charities play a key role in supporting patients and medical institutions. The purpose of the work was to carry out the literature review and identify the main directions of medical charity development in an international context. Materials and methods. In this study, reports from the World Health Organization (WHO), the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Bill and Melinda Gates Foundation, national statistical agencies from various countries, as well as scientific publications and analytical studies, documents from national and international programs, reports and press releases from charitable organizations, data from crowdfunding platforms, media materials and interviews were used. Such research methods as comparative analysis, statistical analysis, and content analysis of documents and publications were applied. Thus, the study is based on an integrated approach, including the analysis of quantitative data, the study of practical cases and a systematic review of trends in international and national medical charity. Results. The article examines current trends in the field of medical charity, including implementation of digital technologies and the development of online platforms, strengthening of public-private partnerships, active involvement of volunteers, target audience expansion, introduction of environmentally sustainable solutions and international cooperation. An analysis of statistical data, examples of successful initiatives, and regulatory aspects of medical charity regulation are presented. The conducted research allows to conclude that there is a need for an integrated approach in the development of charitable initiatives aimed at increasing the availability of medical care, improving patients’ quality of life and ensuring the sustainable development of the healthcare system in various countries, including those with limited resources.

Introduction. Scientific and academic staff perform a strategic function in public health — they build the scientific basis for the development and implementation of disease prevention programs, improvement of medical care, and public health promotion, as well as training human resources for healthcare. Labor organization in public health is highly complex and multilevel, due to the interdisciplinary nature of the field itself. The purpose of the study is to identify and systematize the peculiarities of labor organization for scientific and academic staff in public health and to assess the impact of digital technologies on the organization of scientific and academic staff’s labor. Materials and methods. The study of the peculiarities of labor organization for scientific and academic staff in public health is carried out by combining methods of quantitative and qualitative analysis and using a set of methods including content analysis of scientific sources, comparative analysis, and statistical analysis. A systematic approach was used to integrate the obtained data and build a holistic model of the factors influencing labor organization for scientific and academic staff, while taking into account interdisciplinary connections, the regulatory environment, and global challenges. Results. The modern labor organization for scientific and academic staff in public health is a dynamic system, sensitive to external challenges and internal constraints. The optimization of this system should be based on an integrated approach, including the development of new models for allocating time and resources between research, teaching, expert, and project activities; creating conditions for effective interdisciplinary collaboration between research teams; the introduction of digital technologies and automated systems for managing research processes; improvement of personnel policy aimed at equalizing the provision of regions with public health specialists; etc.