<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">epidemiology</journal-id><journal-title-group><journal-title xml:lang="ru">Эпидемиология и Вакцинопрофилактика</journal-title><trans-title-group xml:lang="en"><trans-title>Epidemiology and Vaccinal Prevention</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2073-3046</issn><issn pub-type="epub">2619-0494</issn><publisher><publisher-name>«Numicom» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.31631/2073-3046-2025-24-5-52-58</article-id><article-id custom-type="elpub" pub-id-type="custom">epidemiology-2309</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПРАКТИЧЕСКИЕ АСПЕКТЫ ЭПИДЕМИОЛОГИИ И ВАКЦИНОПРОФИЛАКТИКИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PRACTICAL ASPECTS OF EPIDEMIOLOGY AND VACCINE PREVENTION</subject></subj-group></article-categories><title-group><article-title>Охват пневмококковой вакцинацией у пациентов с заболеваниями органов дыхания в Челябинской области</article-title><trans-title-group xml:lang="en"><trans-title>Coverage of Pneumococcal Vaccination in Patients with Respiratory Diseases in the Chelyabinsk Region</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3531-3491</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Антонов</surname><given-names>В. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Antonov</surname><given-names>V. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владимир Николаевич Антонов – д. м. н., профессор кафедры терапииинститута дополнительного профессионального образования, главныйнаучный сотрудник Института пульмонологии</p><p>454092, г. Челябинск, ул. Воровского64</p><p>+7 (351) 742-66-40</p></bio><bio xml:lang="en"><p>Vladimir N. Antonov – Dr. Sci. (Med.), Professor of the Department of Therapy at the Institute of Additional Professional Education, Chief Researcher atthe Institute of Pulmonology</p><p>64 Vorovskiy str., Chelyabinsk, 454092</p><p>+7 (351) 742-66-40</p></bio><email xlink:type="simple">ant-vn@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0877-6554</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Игнатова</surname><given-names>Г. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Ignatova</surname><given-names>G. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Галина Львовна Игнатова – д. м. н., профессор, заведующая кафедройтерапии института дополнительного профессионального образования,директор Института пульмонологии</p><p>454092, г. Челябинск, ул. Воровского64</p><p>+7 (351) 742-66-40</p></bio><bio xml:lang="en"><p>Galina L. Ignatova – Dr. Sci. (Med.), Professor, Head of the Department ofTherapy at the Institute of Additional Professional Education, Director at theInstitute of Pulmonology</p><p>64 Vorovskiy str., Chelyabinsk, 454092</p><p>+7 (351) 742-66-40</p></bio><email xlink:type="simple">iglign@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО «Южно-Уральский государственный медицинский университет»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Educational Institution of Higher Education «South Ural State Medical University2 of the Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>12</day><month>11</month><year>2025</year></pub-date><volume>24</volume><issue>5</issue><fpage>52</fpage><lpage>58</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Антонов В.Н., Игнатова Г.Л., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Антонов В.Н., Игнатова Г.Л.</copyright-holder><copyright-holder xml:lang="en">Antonov V.N., Ignatova G.L.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.epidemvac.ru/jour/article/view/2309">https://www.epidemvac.ru/jour/article/view/2309</self-uri><abstract><p>Актуальность. Streptococcus pneumoniae (pneumococcus) является одной из основных причин опасных для жизни инфекций, что приводит к значительной заболеваемости и смертности во всем мире. Вакцинация обеспечивает не только эффективную защиту от пневмококковых инфекций, осложнений, госпитализации, но также может способствовать стабилизации системы общественного здравоохранения за счет снижения заболеваемости респираторными инфекциями, позволяя сосредоточиться на профилактике, раннем выявлении и лечении хронических заболеваний. Цель. Оценка охвата вакцинацией против пневмококковой инфекции и заболеваемости пациентов с болезнями органов дыхания в Челябинской области за последние 5 лет. Материал и методы. Анализировались данные о пациентах старше 18 лет с заболеваниями органов дыхания, зарегистрированных в Челябинской области, согласно форме № 12 Росстата «Сведения о числе заболеваний, зарегистрированных у пациентов, проживающих в районе обслуживания медицинской организации» за 2019–2023 гг. Охват вакцинацией оценивался на основании информации, занесенной в единую медицинскую информационную систему Челябинской области ЕМИАС БАРС, раздел «Вакцинопрофилактика». Результаты. Охват вакцинированных пациентов с респираторной патологией составил 8 %, из них 40,8 % пациентов с ХОБЛ. При этом 71,2 % пациентов привиты ПКВ13, 28,8 % – ППВ23. Низкий процент вакцинированных зарегистрирован среди больных с другими респираторными заболеваниями: с различными формами хронического бронхита – 2,1 %, бронхиальной астмой – 3 %, постинфекционными бронхоэктазами – 14,6 %, интерстициальными заболеваниями легких – менее 1 %. Заключение. Приведенные данные говорят о недостаточном внимании к проблеме вакцинации против пневмококковой инфекции и о необходимости увеличения охвата более широких масс пациентов, в первую очередь из групп риска.</p></abstract><trans-abstract xml:lang="en"><p>Relevance. Streptococcus pneumoniae (pneumococcus) is one of the main causes of life-threatening infections, which leads to significant morbidity and mortality worldwide. Vaccination provides not only effective protection against pneumococcal infections, complications, and hospitalization, but can also help stabilize the public health system by reducing the incidence of respiratory infections, allowing you to focus on prevention, early detection, and treatment of chronic diseases. Аim. Аssess the coverage of vaccination against pneumococcal infection in patients with respiratory diseases in the Chelyabinsk region over the past 5 years.Material and methods. The analysis included patients over the age of 18 with respiratory diseases registered in the Chelyabinsk region, according to Rosstat form No. 12 in the period from 2019–2023. Vaccination coverage was assessed on the basis of information entered into the unified medical information system of the Chelyabinsk region EMIAS BARS, section «Vaccination prevention». Results. The total coverage of vaccinated patients with respiratory pathology was 8 %, of which 40.8 % were patients with COPD. At the same time, 71.2 % of patients were vaccinated with PCV13, 28.8 % with PPV23. A low percentage of vaccinated patients was registered among patients with other respiratory diseases: with various forms of chronic bronchitis – 2.1 %, bronchial asthma – 3 %, postinfectious bronchiectasis – 14.6 %, interstitial lung diseases – less than 1 %. The highest incidence of communityacquired pneumonia is observed in patients with chronic obstructive pulmonary disease (COPD). Conclusion. These data indicate a lack of attention to the problem of vaccination against pneumococcal infection and a great potential for increasing coverage of the wider masses of patients, primarily from at-risk groups. Awareness of the population and primary care physicians should be a priority and include various tools aimed at popularizing vaccine prevention.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>вакцинопрофилактика</kwd><kwd>полисахаридная коньюгированная вакцина</kwd><kwd>охват вакцинацией</kwd></kwd-group><kwd-group xml:lang="en"><kwd>vaccine prophylaxis</kwd><kwd>polysaccharide conjugate vaccine</kwd><kwd>vaccination coverage</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Prins-van Ginkel AC, Berbers GA, Grundeken LH, et al. Dynamics and Determinants of Pneumococcal Antibodies Specific against 13 Vaccine Serotypes in the Pre-Vaccination Era. PLoS One. 2016 Jan 21;11(1):e0147437. doi: 10.1371/journal.pone.0147437. PMID: 26796783; PMCID: PMC4721864.</mixed-citation><mixed-citation xml:lang="en">Prins-van Ginkel A.K., Berbers G.A., Grundeken L.H., et al. Dynamics and determinants of pneumococcal antibodies specific to 13 vaccine serotypes in the era preceding vaccination. PLoS One. 2016, January 21;11(1):e0147437. doi: 10.1371/journal.pone.0147437. PMID: 26796783; PMCID: PMC4721864.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Bogaert D, De Groot R, Hermans PW. Streptococcus pneumoniae colonisation: the key to pneumococcal disease. Lancet Infect Dis. 2004 Mar;4(3):144–54. doi: 10.1016/S1473-3099(04)00938-7. PMID: 14998500.</mixed-citation><mixed-citation xml:lang="en">Bogert D., De Groot R., Hermans P.U. Colonization of Streptococcus pneumoniae: the key to pneumococcal diseases. Lancet Infection Journal, March 2004, 4(3):144–54. doi: 10.1016/S1473-3099(04)00938-7. Identification number: 14998500.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Avdeev SN, Alyeva MH, Baranov AA, et al. Federal Clinical Guidelines on Vaccination of pneumococcal infection in children and adults. Russian Journal of Preventive Medicine. 2023;26(9–2):3–23. (In Russ.). https://doi.org/10.17116/profmed2023260923</mixed-citation><mixed-citation xml:lang="en">Avdeev S. N., Alieva M.Kh., Baranov A.A., et al. Federal clinical guidelines for the vaccination of children and adults against pneumococcal infection. Russian Journal of Preventive Medicine. 2023;26(9-2):3–23. (In Russ.) https://doi.org/10.17116/profmed2023260923</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Campling J, Vyse A, Liu HH, et al. A review of evidence for pneumococcal vaccination in adults at increased risk of pneumococcal disease: risk group definitions and optimization of vaccination coverage in the United Kingdom. Expert Rev Vaccines. 2023 Jan-Dec;22(1):785–800. doi: 10.1080/14760584.2023.2256394. Epub 2023 Sep 11. PMID: 37694398.</mixed-citation><mixed-citation xml:lang="en">Kempling J., Wise A., Liu H.H., et al. Review of evidence on vaccination against pneumococcal infection in adults at increased risk of pneumococcal diseases: identification of risk groups and optimization vaccination coverage in the United Kingdom. Expert Review of Vaccines. 2023, January-December;22(1):785–800. doi: 10.1080/14760584.2023.2256394. Published on September 11, 2023. PMID: 37694398.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Lu PJ, Hung MC, Srivastav A, et al. Surveillance of Vaccination Coverage Among Adult Populations -United States, 2018. MMWR Surveill Summ. 2021 May 14;70(3):1–26. doi: 10.15585/mmwr.ss7003a1. PMID: 33983910; PMCID: PMC8162796.</mixed-citation><mixed-citation xml:lang="en">Lu P. J., Hung MAK, Srivastav A, et al. Surveillance of adult vaccination coverage - United States, 2018. MMWR Review for 2021, May 14;70(3):1–26. doi: 10.15585/mmwr.ss7003a1. PMID: 33983910; PMCID: PMC8162796.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Feldman C, Anderson R. Recent advances in the epidemiology and prevention of Streptococcus pneumoniae infections. F1000Res. 2020 May 7;9:F1000 Faculty Rev-338. doi: 10.12688/f1000research.22341.1. PMID: 32411353; PMCID: PMC7212261.</mixed-citation><mixed-citation xml:lang="en">Feldman S., Anderson R. Recent advances in epidemiology and prevention of infections caused by Streptococcus pneumoniae. F1000Res. 2020 7;May 9th:F1000 Faculty of Rev-338. doi: 10.12688/f1000research.22341.1. PMID: 32411353; PMCID: PMC7212261</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Frangos E, Barratt J, Michel JP, Ecarnot F. Vaccines in Long-Term Care Settings: A Narrative Review. Gerontology. 2024;70(3):241–247. doi: 10.1159/000534998. Epub 2023 Dec 13. PMID: 38091961.</mixed-citation><mixed-citation xml:lang="en">Frangos E., Barratt J., Michel J. P., Ekarno F. Vaccination in long-term care: a brief overview. Gerontology. 2024;70(3):241–247. doi: 10.1159/000534998. Date of publication: December 13, 2023. PMID: 38091961.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Zavaleta-Monestel E, Hasselmyr Hasselmyr S, García-Montero J, Arguedas-Chacón S, Rojas-Chinchilla C, Díaz-Madriz JP. The Impact of Vaccination as a Strategy to Combat Bacterial Antimicrobial Resistance. Cureus. 2024 Jul 31;16(7):e65840. doi: 10.7759/cureus.65840. PMID: 39219910; PMCID: PMC11363808.</mixed-citation><mixed-citation xml:lang="en">Zavaleta-Monestel E, Hasselmir Hasselmir S, Garcia-Montero J, et al. The impact of vaccination as a strategy to combat bacterial antimicrobial resistance. Cureus. 2024, July 31;16(7):e65840. doi: 10.7759/cureus.65840. PMID: 39219910; PMCID: PMC11363808.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Lu EY, Chen HH, Zhao H, Ozawa S. Health and economic impact of the pneumococcal conjugate vaccine in hindering antimicrobial resistance in China. Proc Natl Acad Sci U S A. 2021 Mar 30;118(13):e2004933118. doi: 10.1073/pnas.2004933118. PMID: 33758096; PMCID: PMC8020802.</mixed-citation><mixed-citation xml:lang="en">Lu EI, Chen H.H., Zhao H., Ozawa S. The impact of pneumococcal conjugate vaccine on health and the economy in the fight against antimicrobial resistance in China. Protocol of the National Academy of Sciences of the USA dated March 30, 2021;118(13):e2004933118. doi: 10.1073/pnas.2004933118. PMID: 33758096; PMCID: PMC8020802.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Ignatova, G.L., Avdeev, S.N., Antonov, V.N. Comparative effectiveness of pneumococcal vaccination with PPV23 and PCV13 in COPD patients over a 5-year follow-up cohort study. Sci Rep 11, 15948 (2021). https://doi.org/10.1038/s41598-021-95129-w</mixed-citation><mixed-citation xml:lang="en">Ignatova G.L., Avdeev S.N., Antonov V.N. Comparative efficacy of pneumococcal vaccination PPV23 and PCV13 in patients with COPD during a 5-year cohort study. Sci Rep 11, 15948 (2021). https://doi.org/10.1038/s41598-021-95129-w</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Ignatova G.L., Avdeev S.N., Antonov V.N., Blinova E.V. Ten-year analysis of the efficacy of vaccination against pneumococcal infection in patients with chronic obstructive pulmonary disease. Pul’monologiya. 2023; 33 (6): 750–758 (in Russian). DOI: 10.18093/0869-0189-2023-33-6-750-758</mixed-citation><mixed-citation xml:lang="en">Ignatova G.L., Avdeev S.N., Antonov V.N., Blinova E.V. A ten-year analysis of the effectiveness of vaccination against pneumococcal infection in patients with chronic obstructive pulmonary disease. Pulmonology. 2023; 33 (6): 750–758 (in Russian). DOI: 10.18093/0869-0189-2023-33-6-750-758</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Пневмококковые вакцины: документ по позиции ВОЗ, 2012 год. Доступно на: http://www.who.int/immunization/position_papers/WHO_PP_pneumococcal_2012_RU.pdf.</mixed-citation><mixed-citation xml:lang="en">Pneumococcal vaccines: WHO position paper, 2012. Available at: http://www.who.int/immunization/position_papers/WHO_PP_pneumococcal_2012_RU.pdf .</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Приказ Министерства здравоохранения РФ от 6 декабря 2021 г. № 1122н «Об утверждении национального календаря профилактических прививок, календаря профилактических прививок по эпидемическим показаниям и порядка проведения профилактических прививок» (с изменениями и дополнениями). Доступно на: https://base.garant.ru/403258640/?ysclid=m3mxw6sm58991314056</mixed-citation><mixed-citation xml:lang="en">Order of the Ministry of Health of the Russian Federation No. 1122n dated December 6, 2021 «On approval of the national calendar of preventive vaccinations, the calendar of preventive vaccinations for epidemic indications and the procedure for preventive vaccinations» (with amendments and additions). Available at: https://base.garant.ru/403258640/?ysclid=m3mxw6sm58991314056</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Briko N.I., Lobzin Yu.V., Baranov A.A., Namazova-Baranova L.S., Il›ina S.V., Koroleva I.S., Kharit S.M., Sidorenko S.V., Tatochenko V.K., et al. Assessment of vaccination program effectiveness: basic approaches and issues. Pediatric pharmacology. 2014;11(4):8–15. (In Russ.) https://doi.org/10.15690/pf.v11i4.1057</mixed-citation><mixed-citation xml:lang="en">Briko N.I., Lobzin Yu.V., Baranov A.A., et al. Evaluation of the effectiveness of vaccination programs: main approaches and problems. Pediatric pharmacology. 2014;11(4):8–15. (In Russ.) Available at: https://doi.org/10.15690/pf.v11i4.1057</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Резолюция совета экспертов по вопросу использования тиамфеникола глицинат ацетилцистеината в лечении внебольничных респираторных инфекций / С. Н. Авдеев, Т. И. Гаращенко, Н. А. Геппе и др. Клиническая микробиология и антимикробная химиотерапия. – 2021. – Т. 23, № 2. – С. 195–196. – DOI 10.36488/cmac.2021.2.195-196. – EDN UJVVVW.</mixed-citation><mixed-citation xml:lang="en">Resolution of the Council of Experts on the use of thiamphenicol glycinate acetylcysteinate in the treatment of community-acquired respiratory infections / S. N. Avdeev, T. I. Garashchenko, N. A. Geppe [et al.] // Clinical microbiology and antimicrobial chemotherapy. – 2021. – VOL. 23, No. 2. – PP. 195–196. – DOI 10.36488/cmac.2021.2.195–196. – ED. UJVVVW.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">«О национальных целях развития Российской Федерации на период до 2030 года и на перспективу до 2036 года». Доступно на: http://www.kremlin.ru/events/president/news/73986</mixed-citation><mixed-citation xml:lang="en">On the National Development Goals of the Russian Federation for the period up to 2030 and for the future up to 2036. Available at: http://www.kremlin.ru/events/president/news/73986</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Global strategy for prevention, diagnosis and management of COPD: 2024 report. Доступно на: https://goldcopd.org/2024-gold-report/</mixed-citation><mixed-citation xml:lang="en">Global Strategy for COPD Prevention, Diagnosis and Treatment: report for 2024. Available at: https://goldcopd.org/2024-gold-report/</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Isturiz R, Webber C. Prevention of adult pneumococcal pneumonia with the 13-valent pneumococcal conjugate vaccine: CAPiTA, the community-acquired pneumonia immunization trial in adults. Hum Vaccin Immunother. 2015;11(7):1825–7. doi: 10.1080/21645515.2015.1043502. PMID: 26076136; PMCID: PMC4514202.</mixed-citation><mixed-citation xml:lang="en">Isturiz R., Webber S. Prevention of pneumococcal pneumonia in adults using a 13-valent pneumococcal conjugate vaccine: CAPiTA, a study on adult immunization against community-acquired pneumonia. An immunotherapeutic vaccine against humans. 2015;11(7):1825–7. doi: 10.1080/21645515.2015.1043502. PMID: 26076136; PMCID: PMC4514202.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Брико Н.И., Коршунов В.А., Миндлина А.Я., Полибин Р.В., Шамис А.В., Салтыкова А.Г. Роль образовательного компонента в формировании приверженности населения к вакцинации против пневмококковой инфекции. Эпидемиология и Вакцинопрофилактика. 2022;21(1):92-97. https://doi.org/10.31631/2073-3046-2022-21-1-92-9</mixed-citation><mixed-citation xml:lang="en">Briko N.I., Korshunov V.A., Mindlina A.Ya., et al. The role of educational programs in increasing public confidence in vaccination against pneumococcal infection. Epidemiology and vaccine prevention. 2022;21(1):92–97. (In Russ.)https://doi.org/10.31631/2073-3046-2022-21-1-92-97</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
