Abstract: The scientific discussion concerning the development of the promising approaches for phyto-diversity conservation and the rational use of plant resources in Russian Federation was held at the Presidium of the Russian Academy of Sciences in December 2019. After the reports of leading scientists from biological institutes, a resolution No. 195 dated December 10, 2019 «Global changes in terrestrial ecosystems of Russia in the 21st century: challenges and opportunities» was adopted. The resolution includes a set of priority scientific aims including the development and application of modern technologies for inventory of the plant communities and the development of vegetation classification in Russia. As a result of the opinion exchange between phytocoenologists from different regions, the Concept of Russian Vegetation Classification was proposed. It is based on the following principles. 1. The use of the ecological-floristic approach and the hierarchy of the main syntaxonomic categories applied for the Classification of Vegetation of Europe. 2. Development of the Russian archive of geobotanical relevés and syntaxa in accordance with international standards and with the remote access functions. 3. Application of strict rules for syntaxon names formulated in the International Code of Phytosociological Nomenclature. The Concept assumes the development of a special program «Russian Vegetation Classification» with the justification of the necessity for targeted funding of the program in Research Institutions and Universities involved for solving this scientific problem on the principle of network collaboration. The final results of this program will be represented in the multi-volume publication «Vegetation of Russia». A shortened version of the Concept (English version was kindly revised by Dr. Andrew Gillison, Center for Biodiversity Management, Cairns, Queensand, Australia) is below. Vegetation classification of Russia Research Program Concept Systematic classification and inventory of plant communities (phytocoenoses) is fundamental to the study and forecasting of contemporary complex processes in the biosphere, controlled among other factors, by global climate change. Vegetation classification serves as a common language that enables professionals in various fields of science to communicate and interact with each other in the process of studying and formulating practical ecosystem-related management decisions. Because plant community types can carry a great deal of information about the environment, nearly all approaches to simulation of changes in global biota are based inevitably on vegetation categories. Phytocoenosis is a keystone element when assessing the biodiversity genetic potential, formulating decisions in biological resource management and in sustaining development across Russian territories. Among the world’s vegetation classification systems, phytosociology is a system in which the concept of plant association (basic syntaxon) is the basic element in the classification of phytocoenoses. The phytosociological approach as applied in this concept proposal, has its origins in the Brussels Botanical Congress in 1910. However, despite the broad acceptance of phytocoenotic diversity as a fundamental methodological tool for understanding biosphere processes and managing biological resources nowadays, we still lack a unified approach as to its systematization at both global and country levels with the consequence that, there is no a single classification system. The results obtained by vegetation scientists working under European Vegetation Survey led by L. Mucina became the effective reference for international cooperation in vegetation classification. In the last 17 years they have produced a system of vegetation classification of Europe, including the European part of Russia (Mucina et al., 2016. «Vegetation of Europe: hierarchical floristic classification system of vascular plant, bryophyte, lichen, and algal communities»). Despite the fact that «Vegetation of Europe» is based on ecological and floristic principles, it nevertheless represents an example of the synthesis of one of the most effective approaches to systematizing vegetation diversity by different vegetation science schools. The synthetic approach implemented in this study assumes full accounting of the ecological indicative significance of the floristic composition and structure of plant community and habitat attributes. The approach has already demonstrated its high efficiency for understanding and forecast modeling both natural and anthropogenic processes in the biosphere, as well as in assessment of the environmental and resource significance of vegetation (ref). The demand for this approach is supported by its implementation in a number of pan-European and national projects: NATURE 2000, CORINE, CarHAB, funded at the state and pan-European levels. Currently, one of the main systems for the study and protection of habitats within the framework of environmental programs of the European Union (Davies, Moss, 1999; Rodwell et al., 2002; Moss, 2008; Linking..., 2015; Evans et al., 2018) is EUNIS (European Nature Information System), the framework of which is a multilevel classification of habitats in Europe has been established. EUNIS was used as the basis for the preparation and establishment of the Red List of European Habitats (Rodwell et al., 2013). It is approved by the Commission of the European Union (EU) (Habitats Directive 92/43 / EEC, Commission of the European Communities) for use in environmental activities of EU countries. In its Resolution of 10.12.2019, the Presidium of the Russian Academy of Sciences (RAS) expressed the need in a modern vegetation classification for the assessment of the ecosystem transformations under current climate changes and increasing anthropogenic impacts, as well as in development of effective measures for the conservation and rational use of plant resources of Russia. The resolution recommended the development of the Concept of Vegetation Classification of Russia to the Science Council for biodiversity and biological resources (at RAS Department of biological sciences — Section of Botany). As a consequence, a group of Russian vegetation researchers has developed the Concept for Vegetation Classification of Russia and proposed principles and a plan for its implementation. Aim Elaboration of a system of vegetation classification of Russia reflecting the natural patterns of plant communities formation at different spatial and geographical levels and serving as the fundamental basis for predicting biosphere processes, science-based management of bioresources, conservation of biodiversity and, ultimately, rational nature management for planning sustainable development of its territories. Research goals 1. Development of fundamental principles for the classification of vegetation by synthesis of the achievements of Russian and world’s vegetation science. 2. Inventory of plant community diversity in Russia and their systematization at different hierarchical levels. Elaboration and publication of a Prodromus of vegetation of Russia (syntaxon checklist) with an assessment of the correctness of syntaxa, their Nomenclatural validization and bibliography. Preparation and publication of a book series «Vegetation of Russia» with the entire classification system and comprehensive description of all syntaxonomic units. 3. The study of bioclimatic patterns of the phytocoenotic diversity in Russia for predictive modeling of biosphere processes. Assessment of qualitative changes in plant cover under global climate change and increasing anthropogenic impact in its various forms. 4. Assessment of the conservation value of plant communities and ecosystems. Habitat classification within Russia on the basis of the vegetation classification with a reference to world experience. 5. Demonstration of the opportunities of the vegetation classification for the assessment of actual plant resources, their future prognoses under climate and resource use change, optimization of nature management, environmental engineering and planning of projects for sustainable development. Basic principles underlying the vegetation classification of Russia I. Here we address the synthesis of accumulated theoretical ideas about the patterns of vegetation diversity and the significant features of phytocoenoses. The main goal is to identify the most significant attributes of the plant cover at different hierarchical levels of classification: floristic, structural-phytocoenotic, ecotopic and geographical.We propose the following hierarchy of the main syntaxonomical categories used in the classification of European vegetation (Mucina et al., 2016) by the ecological-floristic approach (Braun-Blanquet): Type of vegetation, Class, Order, Alliance, Association. Applying the ecological-floristic approach to the vegetation classification of Russia will maximize the use of the indicative potential of the plant community species composition to help solve the complex tasks of modern ecology, notably plant resource management, biodiversity conservation, and the forecast of vegetation response to environmental change of environment changes. II. We plan to establish an all-Russian archive of geobotanical relevés in accordance with international standards and reference information system on the syntaxonomical diversity coupled with implemented remote access capabilities. At present, the archives in botanical, biological, environmental and geographical institutes of the Russian Academy of Sciences, as well as those of universities, have accumulated a large mass of geobotanical relevés for most regions of Russia (according to preliminary estimates — more than 300,000). These documents, which are fundamental to solving the most important national tasks for the conservation and monitoring of the natural human environment, need to be declared a National treasure. In this respect, the development of the all-Russian Internet portal for the vegetation classification is an urgent priority. III. The vegetation classification procedure will be based on a generalization of field data (geobotanical relevés) performed in accordance with international standards, using up-to-date mathematical and statistical methods and information technology. IV. The vegetation classification of Russia will be based on strict rules for naming of syntaxa, according to their validity as formulated in the International Code of Phytosociological Nomenclature, which is constantly being improved (Weber et al., 2020). These underlying principles will help develop the ecological indicative potential of a wide range of vegetation features that can be used to focus on solving a range of global and regional ecology problems, plant resources management, biodiversity protection, and forecasting of the consequences of environmental changes. Prospects for the implementation of the concept «Vegetation classification of Russia» At present, the academic research centers and universities of Moscow, St. Petersburg, Novosibirsk, Vladivostok, Irkutsk, Murmansk, Crimea, Bashkiria, Komi and other regions have sufficient scientific potential to achieve the goals in the framework of the special Program of the Russian Academy of Sciences — that is, to develop a vegetation classification of Russia. To achieve this goal will require: - organization of a network of leading teams within the framework of the Scientific Program of the Russian Academy of Sciences «Vegetation classification of Russia», adjustment of the content of state assignment with the allocation of additional funding. - approval of the thematic Program Committee by the RAS for the development of organizational approaches and elaboration of specific plans for the realization of the Scientific Program, - implementation of the zonal-geographical principle in organization of activity on developing the regional classifications and integrating them into a single classification system of the vegetation of Russia. - ensuring the integration of the system of vegetation classification of Russia with similar systems in the countries of the former USSR, Europe, USA, China, Japan, etc. Potential organizations-participants in the scientific Program — 18 institutes of the Russian Academy of Sciences and 8 Universities. Estimated timelines of the implementation of the concept «Vegetation classification of Russia» — 2021–2030. General schedule for the entire period of research 2021. Approval of classification principles, unified methodical and methodological approaches by project participants. Discussion and elaboration of the rules of organization of the all-Russian archive of geobotanical relevés and syntaxa. 2022–2026. Formation of all-Russian archive of geobotanical relevés and syntaxa. Development of plant community classification and identification of the potential indicative features of units of different ranks based on quantitative methods and comparative syntaxonomic analysis with existing classification systems in Europe, North and East Asia. Justification of new concepts for key syntaxa. The study of environmental and geographical patterns of the vegetation diversity in Russia using up-to-date methods of ordination modeling and botany-geography ana­lysis. 2022. Publication of a Prodromus of vegetation classification of Russia. Schedule for the publication of volumes of the «Vegetation classification of Russia» 2023. «Boreal forests and pre-tundra woodlands» 2024. «Forests of the temperate zone» 2025. «Tundra and polar deserts» and «Alpine ve­getation» 2026. «Steppe vegetation» and «Meadow vegetation» 2027. «Aquatic and bog vegetation» 2028. «Halophytic vegetation» 2029. «Synanthropic vegetation» 2027–2030. Development of criteria for assessing the environmental significance of the plant community syntaxonomic categories for various natural zones based on world criteria. Preparation of the volume «Classification of habitats of Russia and assessment of their environmental significance».

Abstract: It has been reported that patients without standard modifiable cardiovascular (CV) risk factors (SMuRFs—diabetes, dyslipidaemia, hypertension, and smoking) presenting with first myocardial infarction (MI), especially women, have a higher in-hospital mortality than patients with risk factors, and possibly a lower long-term risk provided they survive the post-infarct period. This study aims to explore the long-term outcomes of SMuRF-less patients with stable coronary artery disease (CAD). Methods CLARIFY is an observational cohort of 32 703 outpatients with stable CAD enrolled between 2009 and 2010 in 45 countries. The baseline characteristics and clinical outcomes of patients with and without SMuRFs were compared. The primary outcome was a composite of 5-year CV death or non-fatal MI. Secondary outcomes were 5-year all-cause mortality and major adverse cardiovascular events (MACE—CV death, non-fatal MI, or non-fatal stroke). Results Among 22 132 patients with complete risk factor and outcome information, 977 (4.4%) were SMuRF-less. Age, sex, and time since CAD diagnosis were similar across groups. SMuRF-less patients had a lower 5-year rate of CV death or non-fatal MI (5.43% [95% CI 4.08–7.19] vs. 7.68% [95% CI 7.30–8.08] , P = 0.012), all-cause mortality, and MACE. Similar results were found after adjustments. Clinical event rates increased steadily with the number of SMuRFs. The benefit of SMuRF-less status was particularly pronounced in women. Conclusions SMuRF-less patients with stable CAD have a substantial but significantly lower 5-year rate of CV death or non-fatal MI than patients with risk factors. The risk of CV outcomes increases steadily with the number of risk factors.

Abstract: BACKGROUND: Microbiologic screening of extrapulmonary TB (EPTB) patients could inform recommendations for aerosol precautions and close contact prophylaxis. However, this is currently not routinely recommended in India. Therefore, we estimated the proportion of Indian patients with EPTB with microbiologic evidence of pulmonary TB (PTB). METHODS: We characterized baseline clinical, radiological and sputum microbiologic data of 885 adult and pediatric TB patients in Chennai and Pune, India, between March 2014 and November 2018. RESULTS: Of 277 patients with EPTB, enhanced screening led to the identification of 124 (45%) with concomitant PTB, including 53 (19%) who reported a cough 〉 2 weeks; 158 (63%) had an abnormal CXR and 51 (19%) had a positive sputum for TB. Of 70 participants with a normal CXR and without any cough, 14 (20%) had a positive sputum for TB. Overall, the incremental yield of enhanced screening of patients with EPTB to identify concomitant PTB disease was 14% (95% CI 12–16). CONCLUSIONS: A high proportion of patients classified as EPTB in India have concomitant PTB. Our results support the need for improved symptom and CXR screening, and recommends routine sputum TB microbiology screening of all Indian patients with EPTB.

Abstract: BACKGROUND: Approximately 10% of incident TB cases worldwide are attributable to alcohol. However, evidence associating alcohol with unfavorable TB treatment outcomes is weak. METHODS: We prospectively evaluated men (≥18 years) with pulmonary TB in India for up to 24 months to investigate the association between alcohol use and treatment outcomes. Unhealthy alcohol use was defined as a score of ≥4 on the Alcohol Use Disorders Identification Test-Concise (AUDIT-C) scale at entry. Unfavorable TB treatment outcomes included failure, recurrence, and all-cause mortality, analyzed as composite and independent endpoints. RESULTS: Among 751 men, we identified unhealthy alcohol use in 302 (40%). Median age was 39 years (IQR 28–50); 415 (55%) were underweight (defined as a body mass index [BMI] 〈 18.5 kg/m 2 ); and 198 (26%) experienced an unfavorable outcome. Unhealthy alcohol use was an independent risk factor for the composite unfavorable outcome (adjusted incidence rate ratio [aIRR] 1.47, 95% CI 1.05–2.06; P = 0.03) and death (aIRR 1.90, 95% CI 1.08–3.34; P = 0.03), specifically. We found significant interaction between AUDIT-C and BMI; underweight men with unhealthy alcohol use had increased risk of unfavorable outcomes (aIRR 2.22, 95% CI 1.44–3.44; P 〈 0.001) compared to men with BMI ≥18.5 kg/m 2 and AUDIT-C 〈 4. CONCLUSION: Unhealthy alcohol use was independently associated with unfavorable TB treatment outcomes, highlighting the need for integrating effective alcohol interventions into TB care.

Abstract: The article describes four clinical observations of patients with babesiosis detected in the European part of the Russian Federation, two of whom were under the direct supervision of the authors. The analysis of epidemiological data, clinical picture, results of laboratory studies in the dynamics of the disease. Differential diagnosis and treatment are discussed.