Introduction. Cardiovascular diseases (CVDs) (Chapter IX “Diseases of the circulatory system” according to ICD–10) are the leading cause of death among non–communicable diseases worldwide and a major cause of disability. In this regard, the identification of CVD risk factors and of prevalence assessment is a priority for public health policy, as well as preventive and clinical medicine. The issue is extremely relevant for the management professionals of the EMERCOM of Russia who perform complex and high–responsibility tasks under extreme working conditions.

The objective is to assess the prevalence of CVD risk factors among management professionals of the EMERCOM of Russia and to justify prevention strategies.

Methods. Health examination data regarding CVD risk factors were obtained from 226 management professionals of the EMERCOM of Russia who underwent in–depth medical examination in the departments of the Nikiforov Russian Center of Emergency and Radiation Medicine EMERCOM of Russia (St. Petersburg) between 2019 and 2023. The examinations included a cardiologist, neurologist, comprehensive imaging and lab test diagnostics for the respective medical profiles. Patient characteristics and quantitative variables were compared using the Mann–Whitney test for continuous non–normally distributed variables and the c2 test for categorical variables. Correlation analysis was performed using Spearman coefficients with a significance threshold of p < 0.05.

Results and their analysis. The age of the EMERCOM management professionals ranged from 33 to 65 years, with the mean age (48.9 ± 6.2) years. The cohort showed a high prevalence of major CVD risk factors: overweight and obesity (92.9 %), arterial hypertension (54.4 %), dyslipidemia (71.8 %), hyperglycemia (elevated blood glucose ³ 5.6 mmol/l in 29 %, type 2 diabetes and/or glucose levels ³ 7.0 mmol/l in 9.7 %). The obtained rates were higher than in the general male population of the same age. Statistical analysis revealed reliable correlation between body mass index and the severity of hypertension (r = 0.292), triglyceride (r = 0.403) and glucose levels (r = 0.271), decreased high–density lipoprotein cholesterol (r = –0.224), C–reactive protein (r = 0.273), lesions of the white matter microstructure visualized on the MRI (r = 0.239). A reliable correlation was found between the hypertension severity and the number of atherosclerotic plaques in the carotid arteries (r = 0.316), as well as the degree of vascular stenosis (r = 0.258). Occupation and lifestyle were major contributors to the high CVD risk rates among the management professionals of the EMERCOM of Russia. The subjects reported insufficient physical activity (31.9 %), persistent work–rest cycle irregularities and sleep disorders. Physical activity level showed a reliable negative correlation with hyperglycemia (r = –0.458), body mass index (r = –0.161), C–reactive protein (r = –0.378), triglyceride levels (r = –0.161), and high–density lipoprotein cholesterol (r = 0.165). Positive trends included decreased prevalence of smoking (28.7 % were current smokers, whereas 35 % of all smokers had quitted smoking). A comprehensive approach, including primary and secondary prevention measures, is required to reduce the prevalence of CVD risk factors.

Conclusion. The results of the study indicate a significant prevalence of cardiovascular risk factors among the management professionals of the EMERCOM of Russia. To reduce the CVD risks and complications, improved preventive screening and monitoring for cardiovascular risk factors, as well as timely intervention are of paramount importance. Our research demonstrates that these measures are critical in the healthcare of the management professionals of the EMERCOM of Russia enrolled in our research, given the significance of their duties for the entire population of the Russian Federation.

Relevance. Biological emergencies caused by infectious agents are characterized by acute onset, rapid spread, and involvement of large populations in the epidemic process. Epidemics develop especially quickly in large, densely populated areas sharing the same living, eating, and working conditions, which is typical of shift workers involved in major construction sites. Vaccination remains the most effective method to prevent socially significant infectious diseases and avoid epidemic outbreaks.

The objective is to analyze the experience of mass vaccination organization and management among shift workers at a large construction to prevent socially significant infectious diseases.

Methods. The focus of the study is immunoprophylaxis of socially significant infections at a large construction site in the Far Eastern region of Russia; the study subjects are shift workers residing in the Russian Federation, neighboring, or far–fetched countries. For the study period from January 2020 through December 2024, the daily average number of on–site workers was (27,182 ± 2,625) (ranging from 12,508 to 39,120 depending on the phase of work). During their on–site stay, workers were accommodated in temporary camps equipped with dormitories made from modular buildings; meals was served in camp canteens, and transportation to and from the work locations was provided by company buses. Vaccines represented domestic formulations used for immunoprophylaxis of the following socially significant infections: influenza (“Ultrix Quadri”, “Sovigripp”, “Grippol Plus”), pneumococcal infection (“Prevenar–13”), coronavirus infection (vector vaccines “Sputnik V”, “Sputnik Lite”), measles (live–attenuated) and tick–borne viral encephalitis (“EnceVir”, “Klesch–E–Vac”). All vaccines administered in accordance with the official guidelines. The effectiveness of vaccination organization and management was assessed using logical analysis, expert evaluation, and epidemiological research. Statistical data processing was carried out using generally accepted methods of statistical analysis.

Results and discussion. The retrospective analysis of mass vaccination measures among shift workers of a large construction site against socially significant infections were obtained. Vaccination of shift workers was carried out in a designated vaccination room, a temporary vaccination station of the on–site infectious disease hospital, as well as in mobile vaccination stations deployed in temporary shift camps accommodating construction workers. The paper elaborates the layout of vaccination infrastructure, logistics, and information on the total number of preventive vaccinations performed at the site in 2020–2024. In fall 2020, before Covid–19 vaccines were available, mass influenza vaccination was administered, covering 80.7 % of the total number of workers staying at the construction site, thus allowing to prevent an outbreak of influenza and acute respiratory viral infections amid the ongoing epidemic of a new coronavirus infection. Thereafter, influenza vaccination was conducted annually, covering at least 60–65 % of the total number of project employees. Vaccination against pneumococcal infection was conducted jointly with influenza vaccination, primarily in managers, engineers, and technical staff, as well as in high–risk individuals. These efforts prevented the development of severe invasive pneumococcal infection and significantly reduced the incidence of non–invasive clinical cases. The estimated data on the cost–effectiveness of influenza and pneumococcal vaccination was confirmed by decreased incidence of influenza, acute respiratory viral infections, and pneumonia. Mass vaccination against COVID–19 was carried out in 2021 and 2022, eventually allowing to completely stabilize the epidemiological situation at the site and minimize the incidence of a new coronavirus infection. Due to the emerging threat of imported measles, a large–scale (more than 16,000 shift workers) preventive vaccination against measles was conducted in winter–spring 2020. In 2023–2024, measles vaccination was conducted mainly for epidemic indications. The annual vaccination against tick–borne viral encephalitis allowed to eliminate clinical cases of the disease among project employees, despite a significant number of tick bites, including virus–positive cases. Overall, over 130,000 immunizations against socially significant infections were administered during 2020–2024.

Conclusion. Mass vaccination of shift workers against most critical socially significant infections allowed to prevent epidemic outbreaks of infectious diseases and enabled timely and prompt progress of a large–scale construction project.

Relevance. Firefighters rank among the ten most dangerous professions in the world. According to the working conditions criterion, firefighting belongs to dangerous occupations, impregnated the risk of acute diseases or even death.

The objective is to analyze the medical and statistical indicators for major nosologies among the fire and rescue units based on the International Classification of Diseases and Health Related Problems, 10th revision (ICD–10) and respective disease chapters, with a focus on prevention measures.

Methods. From 2020 through 2024, the outpatient department of the Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia, performed regular medical examinations in 3,037 firefighters, including 77 % of officers with specialized ranks and 22.6 % of employees serving in fire and rescue units of the Federal Fire Service of the EMERCOM of Russia. The firefighters’ age ranged from 19 to 54 years (mean age of 34.3 ± 0.14 years), with their professional experience spanning from 6 months to 36 years (mean value of 10.5 ± 0.13 years). All subjects were split in two subgroups by age (19–34 years vs. ³ 35 years) and in three subgroups by professional experience (0–5 years; 6–14 years; ³ 15 years). The results were calculated in ppm per 1,000 firefighters. A statistically significant extra morbidity rate was calculated for the subgroup aged ³ 35 years and the subgroup with ³15 years of work experience. The normality of data distribution was tested using the KolmogorovSmirnov test. Long–term average rates were calculated as the sum of absolute indicators over 5 years of observation. Average annual rates were calculated as arithmetic mean values and standard errors (M ± m) derived from annual rates. The similarity (or difference) in nosology indicators across disease chapters was determined using the Kruskal–Wallis test.

Results and analysis. Based on the regular medical examination results obtained from 2020 through 2024, the average long–term morbidity rate among firefighters was 2700.4 ‰, with an average annual rate of 2946.4 ± 315.2 ‰. A decrease in overall morbidity and somatic burden was observed over time depending on age and work experience. For example, the morbidity rate among firefighters aged ³ 35 years was 2.5 times higher than among the 19–34 (p < 0.001) years subgroup; in the subgroup with ³ 15 years of work experience, the morbidity rate was almost 3.3 times higher than in the subgroup with 0–5 years of experience (p < 0.001). Although the firefighter morbidity rate was calculated by age and work experience, negative occupational factors exercised a more significant impact, e.g. the extra occupational contribution to the average long–term morbidity rate was 426.7 ‰ with statistically significant differences, if calculated by disease chapters, vs. 327 ‰ calculated by blocks. Among the general cohort of firefighters, 6 nosologies were identified responsible for ³ 5% of morbidity rate (listed top to bottom by prevalence): Dorsopathies (M40–M54) with an average long–term rate of 282.2 ‰ and 11 % of the total incidence; Disorders of ocular muscles, binocular movement, accommodation and refraction (H49–H52) 276.9 ‰ and 10.8 %; Diseases of oesophagus, stomach and duodenum (K20–K31) 252.6 ‰ and 9.8 %; Metabolic disorders (E70–E90) 172.2 ‰ and 6.7 %; Other diseases of upper respiratory tract (J30–J39) 157.7 ‰ and 6.1 %; Obesity and other hyperalimentation (E65–E68) 153.8 ‰ and 6.0 %, respectively. The total contribution of these disease blocks was 50 % of the total morbidity rate.

Conclusion. Efficient medical care and preventive measures contributed to a decrease in the age–related morbidity among firefighters. Unfortunately, greater exposure to adverse occupational factors has been registered as well noted. Early disease diagnosis, treatment and rehabilitation can significantly improve the morbidity rates among firefighters.

Relevance. Professional health preservation in the military personnel is a pivotal objective of military medicine. The current situation demonstrates a shortage of comprehensive data regarding the risk factors contributing to the development of upper digestive tract pathologies among combatants.

The objective is to assess the apparent prevalence of upper gastrointestinal tract diseases including both newly diagnosed cases and exacerbations of pre–existing conditions by evaluating the impact, quantity, and intensity of specific risk factors among servicemen of the Russian National Guard operating under different military service conditions, with a focus on combatants.

Methods. The study enrolled the military personnel (n = 256) of the Russian National Guard North Caucasus District who are characterized by a complicated gastrointestinal history, including 118 combatants and 138 non–combatants. The groups were formed randomly as the patients were admitted to hospital for treatment and rehabilitation. Based on the incidence data from February 2022 to February 2023, the prevalence of upper gastrointestinal tract diseases (Chapter XI of the International Classification of Diseases and Related Health Problems, ICD–10) was assessed by frequency analysis using contingency tables. The epidemiological significance of risk factors was evaluated using attributable risk metrics, including attributable fraction, relative risk, and odds ratio.

Results and analysis. Comparative incidence of gastrointestinal diseases showed a higher prevalence of isolated and combined acute erosive and ulcerative lesions of the esophageal, gastric, and duodenal mucosa, as well as chronic duodenal ulcers (K20–K31 in the ICD–10) among combatants, predominantly observed in career officers 93 (79 %). Meanwhile, in the control group, chronic peptic ulcer disease was more prevalent (41 %), with fewer cases of combined erosive and ulcerative lesions (7 %), likewise predominantly among career officers (29 %). These observed clinical and epidemiological patterns and statistically significant group differences were not random, but linked to specific risk factors. Risk analysis in the combatant group confirmed the significance of 11 controllable risk factors (total attributable weight 43 %) and 9 partially controllable factors (total attributable weight 33 %) contributing to the development of the identified gastrointestinal pathologies.

Conclusion. Understanding the dynamics in the prevalence of upper gastrointestinal tract diseases considering both new cases and exacerbations of existing conditions and their association with specific risk factors, including their number and intensity of impact in the examined military personnel of the Russian Guard deployed for military service under various conditions (using combat veterans as an example) provides a framework for further risk management strategies. This approach is essential to reduce the incidence of digestive system diseases among military personnel and is a critical component of health preservation strategies in combat environments.

Relevance. Russia’s national security is constantly exposed to military threats from a number of unfriendly states. The current international realities compel modern Russia to focus on defense capacity building as its major strategic priority. Since December 1, 2024, the Russian Armed Forces (AF) have increased the army and navy corps by 180,000 military professionals through contract service recruitment.

The study objective is to assess the health indicators, physical development and fitness among the Orenburg region citizens applying for contract military service in the Armed Forces of Russia.

Methods. The study analyses medical data provided by the Military Commissariat of the Orenburg region for the 2014 to 2023 timespan. Medical examinations were conducted in accordance with the Regulation on Military Medical Examination. June 1, 2023 through October 1, 2023, physical development and fitness was assessed in 500 randomly selected applicants for contract military service. The results were evaluated according to the Manual on Physical Training in the Russian Armed Forces. The evaluation criteria included proportional chest development, strength and vitality indices, body fat content, and overall physique strength. Physical fitness was tested through pull–ups and running exercises over distances of 100 and 1,000 meters. The representativeness of the sample was determined using the A.M. Merkov and L.E. Polyakov formula.

Results and discussion. As a result of medical examinations conducted over a decade, a total of 12,902 individuals (88.8 %) were identified as fit for contract military service (i. e. A and B categories), including 68.8 % as A category and 20 % as B category. In general, the key physical development parameters were positive, with applicants meeting or outperforming the physical fitness standards, especially when performing exercises requiring muscle strength, speed, and endurance.

Conclusion. Medical assessment results showed a generally good health status, adequate physical development and fitness of citizens applying for contract military service in the Russian Armed Forces.

Relevance. Nearly 40 years ago, the Chernobyl nuclear power plant (ChNPP) suffered a catastrophic radiation accident. However, until nowadays the information regarding the preconditions and causes of the disaster remains largely unknown to the contemporary generation. Meanwhile, recent global events, particularly the ongoing Special Military Operation in Ukraine, highlight the growing risks faced by nuclear power facilities in Russia. In this context, revisiting the various aspects of the 1986 Chernobyl accident remains highly relevant. Over the years, numerous studies have analyzed the environmental, social, and medical consequences of the disaster. However, research on the preconditions and causes of the accident is relatively scarce and often contradictory

Objective. This study aims to analyse existing publications in order to provide an insight into the preconditions and causes of the Chernobyl nuclear power plant accident.

Methods. Data was collected and analyzed from scientific publications available in open sources and selected in accordance with the research objective.

Results and analysis. The review identified key preconditions and causes of the Chernobyl accident. Those include technical design flaws in the RBMK–1000 reactor (a high–power channel reactor with 1000 MW electric capacity), including significant neutron field non–uniformity, which had destabilized the nuclear reaction control; design miscalculations, such as flawed estimates in the lowering of graphite rods, which, when lowered, absorb neutron and reduce the fission rate; political and economic factors, including concealed information about other incidents at Soviet nuclear power plants to nuclear professionals, reduction of costs in nuclear industry policies, and a lack of transparency about the Chernobyl accidents and consequences.

Conclusion. The findings indicate that the primary cause of the Chernobyl disaster was unstable reactor operation caused by defective design, as well as flawed test and operation procedures beyond the protection design.

Relevance. Emergency accidents of natural and technogenic nature, including maritime accidents, are often characterized by significant sanitary losses and various injuries, frequently involving with acute massive blood loss. In emergency situations the latter is a leading cause of death in severely injured patients, often leading to the development of hypocoagulation. To address hypocoagulation, medications and blood components, including lyophilized (freeze–dried) plasma, are utilized. However, current data regarding the effectiveness and safety of such emergency medical care in pre–hospital settings remain contradictory.

The objective is to conduct an analytical review to evaluate the effectiveness and safety of lyophilized plasma the clinical setting of prehospital emergency medical care provided to victims of emergency accidents.

Methods. The research used scientific publications from open access databases (eLibrary.ru, PubMed). The studies based on registered controlled clinical trials were analyzed to evaluate the efficacy and safety of lyophilized plasma administered in prehospital emergency settings. In addition, we investigated annual reports on posttransfusion reactions and complications, available in international and national blood safety surveillance systems.

Results and discussion. The analysis of randomized clinical trials and results did not reveal statistically significant differences in clinical outcomes, complication rates, or severity of coagulopathy in patients receiving lyophilized plasma in prehospital emergency medical care for injuries and wounds in peacetime, in comparison with patients receiving standard treatment. However, available observational studies suggest that lyophilized plasma can effectively used in patients with injuries and bleeding in prehospital emergency care, including during ground and air medical evacuation. Reports of posttransfusion reactions and complications associated with lyophilized plasma transfusion remain incompletely accounted for and are characterized by a low degree of evidence.

Conclusion. The results of clinical studies support the feasibility of using lyophilized plasma in adult patients at risk of post–traumatic coagulopathy at the pre–hospital stage of emergency medical care in peacetime. Nonetheless, comprehensive evaluation of the efficacy and safety of lyophilized plasma administration in such patients requires further randomized clinical trials, involving different patient cohorts in various emergency scenarios.

Relevance. Given the unstable geopolitical situation in the world, there is a need to clarify international indicators that reflect the safety of living conditions for the populations across countries.

The objective is to analyze the involvement of countries in armed conflicts and the safety of their populations using the Global Peace Index (GPI) and its components over the decade from 2014 to 2023.

Methods. We studied world data on armed conflicts, their casualty rates, and economic costs provided by the Uppsala Conflict Data Program (UCDP) and the Peace Research Institute Oslo (PRIO). Obtained for over a decade, Global Peace Index data and their components were analyzed for 162 countries, based on annual reports published by researchers of the Institute for Economics & Peace. Due to high political sensitivity, data for Russia were not analyzed. We tested the data for normality distribution using the Kolmogorov–Smirnov test. Arithmetic means and standard errors (M ± m) were taken in account as well. Trends were evaluated using time series analysis and second–order polynomial trend modeling.

Results and analysis. According to UCDP/PRIO, from 2014 to 2023, a total of 538 armed conflicts and wars were recorded globally. Those include 19 (3.5%) interstate and 519 (96.5%) intrastate conflicts. These conflicts and wars resulted approximately 1.479 million deaths, including 1,011,600 combatants (68.3%), 235,900 civilians (16%), and 231,700 unidentified individuals (15.7%). A trend towards increase was noted in both the number of conflicts and fatalities. The economic costs associated with preventing, mitigating, and responding to violence globally totaled 153.6 trillion USD. Those include 42.4% of military expenditures and 28.8% of domestic security spending. The average annual cost was $15.4 ± 0.6 trillion, accounting for 12.2 ± 0.3% of global GDP and 2,024.2 USD ± 58.2 per capita. Over the decade, 22.1% of countries improved their involvement in ongoing internal and external armed conflicts; 69.3% experienced deterioration; public safety and security improved in 66.9% of countries and worsened in 29.4%; militarization improved in 15.3% and worsened in 70.6%. The distribution of countries by GPI rating was: 8.6% for very high peace level countries; 29.1% high; 40.1% medium; 14.2% low; and 8.0% very low. GPI improvements were observed in 43% of countries, declines in 52.1%, and mixed trends in 4.9%.

Conclusion. There is a noticeable trend of declining Global Peace Index score, increased militarization, and growing economic costs associated with violence prevention. These findings may help improve policies and programs aimed at enhancing population safety in various countries.

Relevance. Terrorism represents a significant threat to international security, with the diversity and complexity of terrorist attack motives complicating comprehensive analysis. The application of machine learning methods, particularly clustering, allows to identify hidden patterns and trends, providing deeper insights into the underlying causes and preconditions of terrorism.

Objective. The study aims to apply the KMeans method to cluster terrorist attack motives, assess the density distribution of data within the identified clusters, and reveal key patterns in the motivational structure of terrorist activities.

Methods. The research comprises a dataset of terrorist attack motives extracted from the Global Terrorism Database (GTD), containing descriptions of 209,707 terrorist incidents. The analysis included 22,623 records with clearly defined motives, clustered into 10 groups using the KMeans method. The density and distribution of motives were evaluated using quantitative indicators allowing to assess data concentration within each cluster.

Results and analysis. The clustering process allowed to identify 10 clusters of different density and motive structure. The largest cluster (Cluster 0, 12,530 records) is characterized by protest and anti–government motives. Clusters 2, 7, and 9 demonstrated significant data concentration, reflecting distinct motivational trends predominantly related to political and religious extremism. Cluster 7, characterized by sectarian violence motives, exhibited the highest density. Economic motives were significantly underrepresented compared to political and religious ones.

Conclusion. The findings confirm the effectiveness of the KMeans method for identifying key terrorist attack motives, despite the complexity and heterogeneity of the initial data. A comprehensive approach to develop preventive measures and counter–terrorism strategies is therefore a collateral.