The article covers the analysis of universities' shift to a new model of development which meets the challenges of professional education remodeling into digital era. Having studied foreign and national literature we distinguished peculiarities of the fourth industrial revolution, that was called 'Industriz 4.0' and related requirements to the educational system. We considered features of evolutionary universities' models with enumeration from 1.0 to 4.0. The article shows the adaptation possibility of plan for success in digital transformation suggested by PWC experts to develop model 4.0 through the example of Pacific State Medical University.

The study briefly presents some ecological and epidemiological aspects of modern situation on hemorrhagic fever with renal syndrome (HFRS), orthohantavirus infection leading in incidence rate of rural population among all feral herd infections registered in the Russian Federation. We marked the main characteristics of epidemiological process in pest spots of orthohantaviruses Hantaan and Seoul. The study shows the influence of human economic activity on epizootic situation and incidences of HFRS in urban and rural pest spots of Primorskiy territory, and on the formation of different socio-professional groups at high risk of HFRS.

The review analyzes literature data and authors' materials on organization of uterus microvasculature and its regulatory mechanisms. It justifies the hypothesis that the adaptation of the microcirculatory system of the uterus to the changing conditions of the organ functioning is provided by regulatory mechanisms acting indirectly, by changing the lumen of the inflow and outflow vessels, or directly through the structural elements of the vessel wall, mainly the endothelium. It discusses the role of gasotransmitters in this process: nitric oxide, Обсуждается роль в этом процессе газотрансмиттеров: оксида азота, carbon monooxide, hydrogen sulfide.

Objective. We analyzed the complex impact of medico-social and environmental risk factors on probability of colorectal cancer development. Methods. The epidemiological analytical sampling analysis 'case-control' was carried out. The group 'case' included 204 patients with colorectal cancer (79 patients with colon cancer, 125 -with rectum cancer). The medico-social and environmental risk factors were assessed with survey questionnaire (patterned interview). Results. A binary choice model shows that the most significant factors, increasing the probability of colorectal cancer development with combined impact on population, were spicy food intake, polyposis of large intestine, duration of constipation; factors decreasing the probability of colorectal cancer were boiled tap water intake and frequent medical examinations. At the 5 % level, factors such as age, the presence of precancerous diseases and relatives of the 1^st and/or 2^nd degree of kinship with malignant neoplasms of the gastrointestinal tract or the reproductive system demonstrated significance. With an increase in age by one year, the probability of developing colorectal cancer increased by 1.5 %. The total results of the combined impact of studied factors showed that the incidence of colorectal cancer by 56.4 % was determined by above-mentioned risk factors. Conclusions. Determined associations of medico-social and environmental factors require in-depth study to identify additional risk factors and their interactions with genetic determinants in order to develop a primary prevention system of colorectal cancer.

Objective. Study objective is to analyze the features of epidemiological process of community-acquired pneumonia and the role of separate serotypes of Streptococcus pneumoniae in the etiology. Methods. We used the data of state statistical reports for 20062016. To assess the role of S. pneumoniae in the etiology of community-acquired pneumonia we conducted epidemiological study using molecular and genetic methods of diagnostics of pneumonia in two cities of the region with participation of 957 patients. Results. It was determined that Sverdlovsk region is a contamination zone of community-acquired pneumonia with long-term annual average of incidence rate of 517.6 per 100 000 population. The highest level of incidence rate was registered among children under 6 y.o. and adults over 60 y.o. It was separated 167 DNA of S. pneumoniae. The most significant serotypes from 15 serogroups in developing of community-acquired pneumonia were 14, 6 A/B/C/D, 15 A/F and 19F. Conclusions. To control the epidemic situation for community-acquired pneumonia, continuous monitoring of the circulating serotypes of the pathogen and optimization of the composition of the pneumococcal serotypes entering the vaccine against pneumococcal infection are necessary. The tactics of vaccinating children against pneumococcal infection requires further improvement, in terms of immunizing not only the children of the first year of life in the National calendar of preventive vaccinations, but also the "catch-up" immunization of all the unvaccinated until the age of 17.

Objective. The aim of the study was to assess the completeness and timeliness of vaccination of children in outpatient settings within the time limits regulated by the National calendar of preventive vaccinations. Methods. The analysis of 631 child development stories and maps of preventive vaccinations of children under 18 months of age. The completeness and timeliness of vaccination coverage for hepatitis B, tuberculosis, poliomyelitis, diphtheria, tetanus, pertussis, measles, rubella and mumps were evaluated, and the reasons for the lack of vaccination and the timing and continuation of vaccination were analyzed. Results. Insufficient coverage of children with vaccinations in the decreed ages (for all vaccinations In the national calendar, which were subject to evaluation) was revealed. The reasons for the unattractiveness of children in the maternity hospital were parents' refusal to vaccinate and medical contraindications (prematurity and low birth weight, respiratory failure, neonatal jaundice, HIV infection in the mother). In the clinic the leading causes of violation of the schedule of vaccination was temporary medical branches (acute illness and exacerbation of chronic), delayed appearance to the vaccine, and failure of parents. Defects of filling of medical records in the nursing home and in the clinic. Conclusions. In this regard, at the present stage, the important areas of work on vaccine prophylaxis are: high-quality filling of medical documentation, the creation of a single electronic database on vaccinations of the population with the ability to work in it specialists of medical organizations and public and private health care system, and the work of medical personnel with the population to abandon vaccination and improve the Executive discipline of parents in terms of timely.

Objective. The purpose of this study is to substantiate the assessment methodology with the Bayesian model of individual (personal) risk of developing colorectal cancer (CRC) in the population based on the Bayesian model for organizing primary prevention of the disease. Methods. Epidemiological studies (transverse and "case-control") were conducted to study the prevalence and significance of known risk factors in the development of CRC in the Omsk region population. Based on the analysis of literature data, 52 main known factors of development of colorectal cancer. To assess the probability of development of CRC in a particular participant with a certain combination of risk factors Bayes theorem was applied. Results. Risk factors for colorectal cancer were detected in 100 % of participants. Of the studied risk factors for the development of colorectal cancer among the participants in the study, residents of the Omsk region, confirmed their importance 22 factors. Based on the results of the survey, the participants in the study calculated conditional probability of detection of factors in the presence / absence of CRC. The established values of informativity and the chances were used to calculate the probability of development of CRC under a certain combination of risk factors. The results of the ROC analysis made it possible to determine the optimal operational characteristics of the proposed test with a decision threshold of 25 %o (area under the ROC curve - 0.89). In case of exceeding the threshold value, a specialist consultation can be recommended to the patient. Conclusions. Risk factors for development of colorectal cancer in Omsk region residents are 22 of 52 studied factors, of which the most significant are the presence of admixture of blood in the feces, false desires for stools, the presence of relatives of the first line with colorectal cancer, the presence of harmful substances in the workplace, the presence of polyps, hemorrhoids, cracks in the rectum, a preference for fatty foods. The proposed technique allows personifying the level of individual risk of colorectal cancer development taking into account regional prevalence, significance of risk factors, genotype and phenotypic features of a patient. The developed computer program for assessing the individual risk of developing colorectal cancer is valid and can be recommended for practical use.

Objective. More than 600 thousand cases of pneumonia are registered in the Russian Federation each year with an incidence of more than 400 per 100 thousand of the population. Since 2009, the country has registered pneumonia in statistical reports on infectious and parasitic diseases. The study objective is to assess the possibilities of epidemiological analysis of the incidence of pneumonia after a change in the registration system. Methods. A retrospective descriptive epidemiological study was conducted in one of the regions of the Asian part of Russia with a population of about 2.4 million people. The data on morbidity and mortality for 2012-2016 were compared from different forms of statistical observation. Results. The incidence varied from 588.3 to 690 per 100 thousand of the total population. In 2016 the discrepancy in morbidity rates in different statistical forms was 8-12 %. Using the data of the new accounting system, incidence was calculated in 2016 by population groups, cities and rural areas. The differences in the seasonal dynamics of incidence among children and adults in the summer are revealed. Mortality rate averaged 5.2 % with a spread in different age groups from 0.1 to 11.5 %. Conclusions. The introduction of the new accounting system has significantly improved the possibilities for analyzing the structure of morbidity, and mortality by age groups, by the weeks of the year and in the territorial aspect. However, in more than 75 % of cases, the etiology of pneumonia remains unresolved.

Objective. Because of product imports from different countries there is a pronounced migration of serotypes of salmonella into Russia, and there is a risk of import of more highly-virulent and antibiotic-resistant microorganisms with contaminated products. Methods. We have studied 457 strains of Salmonella Typhimurium, isolated from sick people, and 29 strains separated from food products samples in Siberia and Russian Far East. We have analyzed the plasmid features of 486 strains obtained from different ecological origins; sensitivity to antibiotics was studied by disc-diffusion method on Müller-Hinton agar in 102 of them. Results. It was established that population of S. Typhimurium, developed in different regions of Siberia and Russian Far East, is heterogeneous both in plasmid features and in sensitivity to antibiotics. The population is formed because of contaminated products delivery from different regions of Russia and abroad. Generally, imported strains of S. Typhimurium caused focal morbidity; meanwhile strains separated from local meat products caused sporadic morbidity. Strains of S. Typhimurium separated from sick people and livestock products in the region had a similar plasmid type and sensitivity to antibiotics; this is the evidence of their epidemiological relation. Conclusions. To optimize the system of epidemiological surveillance of salmonellosis caused by S. Typhimurium, it is advisable to examine imported livestock products for the presence of salmonella and sensitivity of separated strains to antibiotics.

Objective. The wide spread of nasopharyngeal carriage of Streptococcus pneumoniae among the population largely determines the epidemiological situation of pneumococcal infections. Methods. 65 foci of pneumococcal bacteria and 157 members of their families were examined in April-December, 2017. Nasopharyngeal swabs from 222 people were examined by a classical bacteriological method. Identification and determination of the sensitivity of pathogens to antibiotics were carried out by conventional methods and in the bacteriological analyzer Vitek. Results. Pneumococci were isolated in 16 out of 65 foci (24.6 %). When examining 31 foci, which included contact children and adults, pneumococci were isolated in 47.7 % of cases. When examining 34 foci, which included only contact adults, pneumococci were isolated in 5.9 % of cases. When 157 people from a family environment were examined, 65 S. pneumoniae bacteriostenes from mothers were sown in 6.7 %, from fathers in 4 %, from siblings in 42.9 % of cases. In total, pneumococcus were isolated in 21 people (13.4 % of cases) of the 157 family members, among which only two children received specific prophylaxis. Conclusions. More than ten percent of their families are infected in the foci of nasopharyngeal carriers of pneumococci. With the greatest frequency, infection is detected in siblings. The risk of infection increases in foci, which include children.

Objective. The epidemiological situation on chronic viral hepatitis C was assessed in Far Eastern Federal District. Methods. Incidence rate data characterizing the epidemiological situation of chronic viral hepatitis C for 2006-2015 was used. Results. It was established that the most unfavorable epidemiological situation of all territories of the Russian Federation is pri marily noted in the eastern regions of the country (Ural, Siberia, Russian Far East) and Northwestern Federal District. Integral criterion of main epidemiological factors enables to conduct more deep comparative analysis of epidemiological situation. According to this approach it was established that unfavorable situation of chronic viral hepatitis C in the Russian Far East was registered in Chukotka Autonomous Region, and the most favorable was registered in Jewish Autonomous Region and Primorskiy Territory. Conclusions. The proposed generalized incidence rate more objectively reflects the manifestations of the epidemic process, without distorting the standard value of the average value, and takes into account the main risks of the development of morbidity.

Objective. Information on risk factors for the development of surgical site infections (SSI) is the basis of preventive measures. However, the currently known risk factors are well studied mainly in populations of adult patients, while there is very little data on the predictors of SSI in pediatric surgery. In particular, there is insufficient data on "external" factors, associated with surgical intervention, and "internal" factors, associated with the patient>s condition, their correlation and significance in the development of SSI in pediatric surgery. Methods. The study was conducted in the Pediatric City Hospital No. 19. Three surgical departments were involved in the study: traumatology, surgical department and neurosurgery. The subject of the study were patients and medical records. The significance of "external" and "internal" risk factors for SSI was assessed during the study. 1246 patients from pediatric surgery departments participated in the study in the period from 2015-2017. SSI was detected using standard case definitions. For a number of risk factors with dichotomous characteristics a case-control study was conducted. Results. A significantly higher incidence of SSI was observed in a group of patients who had the wound class of 3 or more. When assessing the likelihood of development of SSI depending on the integral index of NNIS, it was revealed that the highest risk was observed with the NNIS index of 3 - 71.4 per 100 operations. The incidence of infection increased proportionally with the index: NNIS 0 - 3.0, NNIS 1 - 33.4, NNIS 2 - 28.6 per 100 surgical interventions. The odds ratio (ОШ) with confidence intervals for the urgency of the operation was 6.7, for drainage - 1.6, for the duration of surgery - 2.2. Such factors as the type of anesthesia, shaving, blood transfusion and the number of operations performed simultaneously were not significant in the development of SSI in the pediatric patient population. Evaluating the effect of "internal" risk factors for SSI has shown that among all the predictors studied only co-morbidities significantly increased the risk of SSI in children. Other risk factors for SSI that are significant in the adult population of surgical patients (age, obesity, length of hospital stay) did not contribute to an increase in the likelihood of SSI in pediatric surgery. Conclusions. It was revealed that the "external" factors associated with surgical interventions predominate in the structure of risk factors of SSI in pediatric surgery: type of operation, class of the surgical wound, urgency of the operation, drainage, duration of the operation. Among the "internal" factors associated with the patient>s condition only the presence of concomitant diseases is important.

Objective. The epidemiological assessment of influence of drug addiction prevalence rate among Primorskiy Territory population on manifestations of the epidemic process of HIV infection was given. Methods. Retrospective analysis for 2000-2016 was conducted with monitoring data of Regional Clinical Hospital No. 2, Regional Clinical Center for the Prevention and Control of AIDS and Infectious Diseases, and reports and records of Regional Drug Abuse Clinic (form No. 11: 'Report on drug addiction diseases'). Results. The parenteral use of psychoactive narcotic substances prevails (69 %) in the structure of the infection channels of cur rently registered HIV-infected people. During the study, the administrative territories of the region with high and low prevalence of HIV infection and drug addiction were identified. A strong direct relationship (r = 0.72) was established between the levels of drug addiction and HIV infection. Conclusions. The main way of HIV transmission in the Primorsky Territory is parenteral, which affects injecting drug users, remains relevant to this day. At the same time there is a tendency to increase the share of the sexual way of transmission of the human immunodeficiency virus, and often injecting drug users or people, who have ever used narcotic substances, sexually contaminate their partners. The number of HIV-infected people in the group of injecting drug users is also growing steadily.

Objective. Identification of causes and risk factors of mortality of socially significant co-infections Methods. Epidemiological аnаlisis of mаteriаls registration of coinfection аnd klinico-epidemiologicаl dаtes Results. The growth of the morbidity and at the same time reducing mortality from socially significant co-infections in St. Petersburg was revealed. The main cause for the increase in morbidity is the growing epidemic potential of tuberculosis, HIV infection and viral hepatitis in past years. Lethal outcomes mainly occur in the terminal stage of the disease, accompanied by high viral load and severe immunosuppression. Highest mortality rate (80-100 %o) was observed in case of generalized tuberculosis and multiple organ lesions of internal organs. The factors of adverse outcomes are drug use, alcohol use, refusal of tuberculosis and antiretroviral therapy. Conclusions. Improving the interaction and combining the efforts of specialists of different profiles is advisable on the basis of a single register of socially significant co-infections, which includes all the components of the integration of the epidemic process: tuberculosis, HIV infection, viral hepatitis B, C and D as the single infection, and in their combination.

Objective. Study objective is to monitor the microbial wound secretion in patients with burn injury and to assess the safety of risk-oriented technologies providing medical care. Methods. A retrospective epidemiological study was conducted based on cases of patients with thermal trauma treated in the burn department of Far Eastern Regional Medical Center of FMBA of Russia from 2008 to 2017. Results. The average annual record of purulent-septic infections for 1000 burned patients was 431.8 (95 % CI: 382.8-480.8). The highest record was in 2012 and it exceeded the average annual almost by 1.5: 625.0 and 431.8 %o, respectively. The identical situation (1.3 times higher) was noted in 2009. From 2008 to 2012, in addition to the above-mentioned periods, the dynamics of the indicator was in the range of the average annual. By 2017 the frequency of the purulent-septic infections decreased to 319.3 %. Representatives of the genus Staphylococcus were sown as much as possible in 2008 (79.8 ± 1.5 % of observations), with a decrease to 37.4 ± 1.3 % of observations in 2017. The reverse trend is determined by non-fermenting gram-negative microorganisms (Pseudomonas aeruginosa, Acinetobacter baumannii): an increase from 20.2 ± 1.5 % (2008) to 62.6 ± 1.1 % (2017). Conclusion. Risk-based technologies for providing medical care in thermal trauma, increasing epidemiological safety and improving rational antibiotic therapy, reduced the risk of purulent-septic infections in patients of burn hospital.

Objective. Although the incidence of tuberculosis in Russia has been steadily declining since 2006 (but still about twice as high as in the 1980s), there are factors of concern. Among them - an unfavorable change in the structure of the diseased. According to data for 2016, about a quarter of new cases of tuberculosis are caused by a pathogen with multiple drug resistance, and about a quarter of new cases of tuberculosis have been detected in HIV-infected people. Methods. For the statistical analysis of morbidity, the data of form No. 2, data on the proportion of children aged 14 years, seronegative for tuberculosis, as well as data on morbidity, given in the report of V.A. Aksenova (the main pediatric phthisiatrist of the Ministry of Health of Russia) 06.16.2017 in Novosibirsk. Results. From 2006 to 2016 the incidence of tuberculosis in both children and adults in Russia has declined annually. However, over the same years, the proportion of children who need revaccination decreased. The use of methods of mathematical modeling suggests that the activity of spreading the causative agent of tuberculosis over these years has increased approximately twofold. At the same time, about four times the number of children who were referred to the surveillance group IIIA (spontaneous cure) increased. Conclusion. The observed reduction in the incidence of tuberculosis in the Russian Federation is a consequence of the failure to improve the epidemiological situation, but changes in the criteria for diagnosing and the activity of detecting the disease.

Objective. The study objective is to analyze the epidemiological manifestations of HIV-infection and the reasons of mortality of patients with HIV-infection in the Siberian Federal District. Methods. We have studied the dynamics and mortality reasons of 24,339 patients with HIV-infection in the Siberian Federal District, died from different reasons during 2010-2015. A retrospective observational descriptive-evaluative epidemiological study was performed. A generally accepted algorithm for the epidemiological analysis of data from forms of statistical surveillance, newsletters, and notifications of the death of HIV-infected patients was used. Results. In the SFD at the beginning of 2018, 256,761 HIV cases were diagnosed, and the cumulative incidence rate was 1328.5 per 100,000 of population. During this period, 53,182 (20.7 %) patients died from various causes. More than 55 % of deaths (n = 29,654) occurred in two regions - Kemerovo and Irkutsk regions. Among the deceased, men predominated (71.5 %). 54 % of the dead were aged 30-39 y.o, 84.6 % of patients were in the sub-clinical stage and stage of secondary diseases. In antiretroviral therapy, about 70 % of the deceased needed it, but it was conducted in 2010 by 18.6 % (by 2015 this figure had risen to 27.3 %). In 42.1 % of cases, death was associated with the manifestation of mycobacterial infection. The percent of deaths from external causes decreased from 21.8 to 12.4 %. Conclusion. The obtained results show the need to improve approaches to the organization of early detection of HIV-infection, the formation of adherence to prevention and specific treatment, and the optimization of the system of epidemiological surveillance of HIV-infection.

Objective. Despite the international data available on healthcare-associated infections in selected groups of patients, there is a lack of large and good quality studies. Pediatric studies focusing on healthcare infections in this type of patients should be done in order to deepen our understanding on associated risk factors and possible intervention areas. Methods. The descriptive retrospective epidemiological study of Acinetobacter spp. and Klebsiella pneumoniae cases in children's departments of health care was performed in Kemerovo regions (2012-2017). Results. A total of 129,430 patient treatment outcomes were studied, in 1380 K. pneumoniae and 201 Acinetobacter spp. were isolated. The incidence of Acinetobacter spp. in adults, 3.2 times higher than in children. The risk of Klebsiella ssp. infection was in 13 times higher than Acinetobacter spp. infection. Conclusions. We revealed decreasing trend in colonization Klebsiella spp. and Acinetobacter spp. incidence. Patients who were treated by intensive care medical technologies were under at the highest risk of infections, especially in case of invasive and noninvasive respiratory constant positive airway pressure support by combination

Objective. An epidemiological situation was assessed for the combined forms of tuberculosis and HIV-infection in the Primorsky territory and factors promoting their formation. Methods. The cards of personal records of patients with tuberculosis combined with HIV-infection (form 263/у-TБ) of Primorskiy Regional Tuberculosis Dispensary for 2003-2017 were analyzed. We used the data of monitoring of the combined forms of HIV infection and tuberculosis of the Primorsky Center for the Prevention and Control of AIDS and Infectious Diseases. During the processing of data, we used common for epidemiology methods. Results. In the last five years, the epidemiological situation of the combined HIV / TB forms in Primorsky territory has gradually improved against the background of a decrease in the incidence of mono-tuberculosis in the population and the continuing increase in the incidence of HIV-infection. Factors that significantly influence the risk of forming mixed forms of HIV-infection and tuberculosis are: male sex, age, socially maladaptive population, the presence of co-morbidities, drug abuse, uncontrolled sexual behavior and alcohol abuse. Conclusions. Unfortunately, the current epidemiological surveillance system does not take into account the factors that currently determine the epidemiological features of tuberculosis and HIV-infection, as well as the risks of forming their combined forms. However, as new data on the conditions conducive to the development of the epidemic process appear, information flows need to be expanded to conduct epidemiological analysis and make timely management decisions in the field of preventing co-infected forms of HIV-infection and tuberculosis.

Objective. There are favorable conditions for an annual seasonal increase in the incidence of enterovirus infection in the Russian Far East. Methods. Molecular typing of PCR-positive samples of biological material from four outbreaks of enterovirus infection registered in the Far East in 2016-2017 was carried out. Results. The cause of all flares was the Coxsackie A6 virus. Phylogenetic analysis of the strains revealed their similarity to the Coxsackie A6 virus, which circulated in 2016-2017 in other regions of Russia, as well as in Asian countries in 2009-2013. Conclusions. With molecular typing, the Coxsackie A6 virus was identified in 2013 in five of the nine administrative regions of the Russian Far East and by 2017 it spread throughout its territory. In 2015, the first outbreak in the Far East caused by the Coxsackie A6 virus was registered, a phylogenetic analysis of the strains of which allowed them to be identified as belonging to genotype D and assume an approximate existence of a common ancestor in 2008, which coincided with an increase in the registration of Coxsackie outbreaks of A6 infection worldwide.

There were 1,316,231 people (1.1 % of all the population) with glaucoma in the Russian Federation on 01/01/2017. Such a situation can be explained by insufficient work management and the absence of Federal programs on protection of sense of vision. There is a range of regulatory documents on this problem in Primorskiy territory, and the only one glaucoma office is still working in Far East Federal District. According to the data of medico-demographic statistics, there was an increase in the incidence of glaucoma from 1.2 to 2.3 per 1000 population over 40 years in the region. In 2017, the number of newly identified patients with the first stage of glaucoma increased by more than 10 %o, and the primary disability for this disease increased by 4.2 %o. All these data suggest the need for effective measures to identify glaucoma, and most importantly - for proactive work among the population of the region.

The activity of Children's Eye Department of Regional Clinical Hospital No. 2 (Vladivostok) was analyzed. Over the past three years, 3995 children have been treated here. The percent of regional patients was more than 60 %. 116 people (9.5 % of the number of hospitalized patients). Steady growth of surgical activity was noted by 10 % and by the number of operations, and by the number of operated patients.