bluuebunny/crossref_metadata_2025 huggingface dataset:
The evolving landscape for Real World Evidence in Poland: physicians' perspective
Authors: Jahnz-Różyk Karina
Published: July 2023

Real World Evidence is increasingly being demanded by national payers and HTA agencies to substantiate and validate outcomes from clinical trials. Yet, the access and quality of existing databases is often very limited, what creates hurdles to evaluate evidence in ‘normal’ healthcare setting. In Poland key stakeholders have not yet fully embraced RWE as an evidence source though they have growing need for more evidence to allocate scarce resources. The coming years are crucial for the shape and accessibility of RWE in Poland – however, the standpoint and the needs of the key stakeholders are not yet recognized. Therefore, an exploratory survey was undertaken to map current awareness and expectations of physicians related to practical outcomes data and to identify pharmaceutical industry’s role in RWE generation. Consideration of stakeholder needs seems to be the natural step in the beginning of preparation for real world evidence system in Poland. The analysis showed significant physicians interest in practical evidence and broad spectrum of possible actions that can be undertaken to improve formal use of RWE in Poland. The differences in priorities between specializations are a good indicator of the unmet needs in certain therapeutic areas. Broadening doctors’, payers’, insurers’ and service-providers’ knowledge on RWE significance, raising awareness of practical implementation and improving accessibility could be crucial for shaping the RWE landscape in Poland and, consequently, for improving patient treatment results.
Multi-criteria decision analysis (MCDA) and its alternatives in health technology assessment
Authors: Vorobiev Pavel , Hołownia-Voloskova Malwina
Published: July 2023

Article presents application of multi-criteria decision analysis and its alternatives in Russian Federation. There are presented pros and cons for this type of analysis, as well as their Western (Forsight) and Russian alternatives (rule of square of decision making, P. Vorobiev, 2003). There are also presented stages of MCDA, questions of MCDA and types of MCDA.
COPD in Ukraine: overview of the status and prospects for improvements and developments in health care system
Authors: Tolubaiev Viacheslav , Irynchyn Hryhoriy , Piniazkho Oresta , Maksymovych Natalia
Published: July 2023

Chronic Obstructive Pulmonary Disease (COPD) is an actual problem for healthcare systems in different countries taking in account it`s high morbidity, mortality, impact on quality of life and related costs. COPD in Ukraine could be one of the most valuable medical and socio-economic problems as for developing country, the human capital affected by COPD is the most important national asset. The access to drugs is critical especially for COPD patients, medications for basic therapy are very expensive, while intended for use permanently. This study was performed to investigate the status with COPD in Ukraine and determine possible ways for improvements and developments in COPD management and related processes in healthcare system in Ukraine. The following areas were investigated: epidemiological data, data in COPD management, health economics data and targeted literature review. Results showed that very limited epidemiological COPD data are available in Ukraine. There are favorable conditions for good COPD management in Ukraine because of availability of the adopted guidance and the unified clinical protocol that cover prophylaxis, diagnostics, treatment and rehabilitation of COPD patients. Ukrainian clinical guidance in COPD management has external validity and is expected to be updated on regular basis. There were several country-specific Health Economic studies focused on COPD but these studies have limitations due to substantial assumptions and extrapolations from small to large populations. More Health Economics large-scale studies needs to be performed in Ukraine. Results of current study, also, showed that COPD is a relevant topic for pulmonology research in Ukraine.
Idiopathic Pulmonary Fibrosis as a Challenge for the Polish Healthcare System
Authors: Kwiecień Marcin , Budasz-Świderska Małgorzata , Kaczor Marcin
Published: July 2023

Idiopathic pulmonary fibrosis (IPF) is a rare disease characterised by age-dependent incidence, unclear aetiology and progressive course. Given the complexity of the diagnostic pathway and limited therapeutic options, and according to the fact that the Polish society is ageing, healthcare and social security expenditure are considerable and likely to rise. Until recently, there was no effective treatment for patients with IPF. After diagnosis only procedures that relieve the symptoms of the disease and treat its complications or lung transplantation were offered. In recent years a huge interest in this clinical entity has been seen. This resulted in the introduction of new drugs, whose efficacy has been confirmed in reliable clinical trials and whose slow the progression of the disease and improve survival of patients. The first such drug was pirfenidone; however such treatment is not available in Poland. Furthermore, due to the inadequacy of Polish legislative reimbursement solutions, which do not take into account the specific nature of rare disease, there are not used any favourable solution during the assessment of public funding of orphan drugs. This is contrary to European consensuses on an egalitarian approach to the use of orphan drugs. It is necessary to develop standards of care for IPF patients, including systemic solutions and the inclusion of the drugs used in the treatment of IPF on the reimbursement list. In long term this will reduce the financial burden associated with the disease, and thus reduce the direct and indirect costs resulting from its prevalence.
What should we know about the Zika virus?
Authors: Różyk Aleksandra
Published: July 2023

Zika virus (ZIKV) is a vector-borne arbovirus of the Flaviviridae family, which also includes dengue, West Nile, yellow fever and Japanese encephalitis viruses. It is transmitted by daytime-active Aedes mosquitoes. Similarly to other flavivirus infections, Zika virus disease, or Zika fever is usually asymptomatic, and only in 20% of cases non-specific symptoms such as mild fever, rash, conjunctivitis, and arthralgia, may develop. In 2015, an epidemic of ZIKV infection was reported in South and Central America and the Carribbean. It caused major concern because of a possible association between maternal infection and adverse fetal outcomes, such as congenital microcephaly as well as a possible association with Guillain-Barré syndrome. Currently, no vaccine or medication exists to prevent or treat Zika virus infection. On February 1st 2016, World Health Organization (WHO) declared current Zika virus outbreak to be a Public Health Emergency of International Concern.
The study of the need for interprofessional collaboration in the health care system in Poland - experience of Lesław A. Paga Foundation
Authors: Świeczkowski Damian
Published: July 2023

Background: Interprofessional collaboration (IC) in healthcare is a process by which professionals from different disciplines collaborate to provide an integrated and cohesive approach to patient care. The Lesław A. Paga Foundation for many years supports the idea of cooperation between professional, promoting it among representatives of public and social life in Poland and Eastern Europe. The foundation’s project dedicated to health care is Healthcare Leaders. Thanks to the program, participants of Healthcare Leaders have a chance to experience IC under the conditions of Polish healthcare system. Methods: A self-administered, anonymous questionnaire was distributed to 90 participants of The Healthcare Leaders project in November 2015. Comparisons were performed using e.g. chi-square tests and descriptive statistics. All statistical analyses were performed using SPSS 20.0. Results: The response rate was 42,2%. More than 80% of respondents are familiar with the concept of interprofessional collaboration in healthcare system. 36 respondents (94,7%) also agree that IC among healthcare practitioners may help to generate financial savings in the Polish healthcare system. Accordingly 34 respondents to implement IC to the healthcare system necessary is mutual respect (89,5%). This point of view is shared mainly by the people who has medical or pharmaceutical professional education (p<0,05). Conclusion: IC is well-known phenomena among participants of Healthcare Leader Program. Furher research should be considered as necessary and useful.
Adoption of Real World Evidence in decision-making processes on public funding of drugs in Poland
Authors: Wilk Norbert , Wierzbicka Natalia , Tomassy Justyna , Kloc Krzysztof , Moćko Paweł
Published: July 2023

Background: The aim of the study was to assess the use and impact of RWE in decision-making processes on public funding of drugs in Poland. Methods: The analysis was based on data from the Agency for Health Technology Assessment and Tariff System (AOTMiT) in Poland published between January 2012 and September 2015 in Verification Analyses (VA), Statements of the Transparency Council (STC) and Recommendations of the President of AOTMiT (RPA). Results: RWE related to effectiveness or safety was identified in 53% of VAs, 21% of STCs and 35% of RPAs. Predominantly, RWE was included in reimbursement applications by MAH, however in 4% of VAs AOTMiT analysts found RWE themselves. Most of RWE related to safety (89%) and less to effectiveness (55%). The longitudinal analysis of RWE in AOTMiT evaluations shows steady increase in the number of processes with RWE in 2012–2014 with apparent decline in 2015 to estimated 36 processes p.a. Furthermore, the share of processes with RWE had a peak in 2014 (59% vs. 48% in both 2012 and 2013). Conclusions: RWE on effectiveness or safety is identified in surprising 53% of decision-making processes on public funding of drugs in Poland. Applications with RWE more often had a positive Statement/Recommendation/Decision compared to those without RWE. There is a considerable lack of consistency in identification of RWE on the three distinct levels of assessment and appraisal within the HTA Agency. A growing importance of RWE can be observed in Poland, however, the pace of the growth will mainly depend on building capabilities of the stakeholders in healthcare system.
Optimization of approaches to the treatment of metastatic colorectal cancer wild-type gene KRAS
Authors: Bashlakova Ekarterina , Solodun Ilya , Evdoshenko Evgeniy
Published: July 2023

The results of the literature review of drug use for the treatment of metastatic colorectal cancer (mCRC) are presented. Analysis of the data showed that cetuximab (Erbitux) and panitumumab (Vectibix) are effective drugs for mCRC patients with KRAS wild-type in the first-line therapy, and the combination of standard chemotherapy regimen FOLFOX in combination with targeted therapy cetuximab (Erbitux) is the most optimal medical technology as compared with other combinations of chemotherapy and targeted drugs.
Protection of sensitive data in telemedicine services
Authors: Śliwa Joanna , Jasiul Bartosz
Published: July 2023

The article presents security risks related to the use of telemedicine services and technical guidelines for protection of the medical records in terms of their confidentiality, integrity and availability. It also mentions regulations related to protection of sensitive data that are required by the Polish government.
Budget impact analysis of breast cancer in the Russian Federation
Authors: Vorobiev Pavel , Hołownia-Voloskova Malwina
Published: July 2023

Breast cancer is one of the leading causes of cancer-related morbidity and mortality in the female population of the Russia and its incidence is rapidly growing. Advanced breast cancer is a disease currently intreatable, but up-to-date management strategies result in significant improvement of symptoms, life expectancy and quality of life. Implementation of new technologies always results in extended healthcare expenditures, therefore requiring pharmacoeconomical justification. Russian Society for Pharmacoeconomics and Outcomes Research performed health economics evaluation of typical management strategies of patients with advanced hormone-dependent HER2-negative breast cancer, based on survey of experts. The questionnaire developed for this purpose including data relevant to epidemiological and pharmacoeconomic assessment of management of such patients. Calculation of expenses incurred by medications and medical care was performed based on experts’ data and according to the medical care standard #612н. Markov model in Microsoft Excel® application, as developed by York Health Economics Consortium, was used for pharmacoeconomic analysis. The model was based on approaches to treating patients with breast cancer for the duration of 5 years. Managing postmenopausal patients diagnosed with advanced hormone-dependent HER2-negative breast cancer with and without administration everolimus were assessed as alternative approaches, and the method of health economic analysis of budget impact was used to compare them. According to the analysis results, implementation of everolimus administration in the treatment strategies for postmenopausal patients with advanced hormone-dependent HER2-negative breast cancer does not incur significant increases of healthcare budget expenses in the Russian Federation.
To assess the perceived burnout symptoms and coping strategies among critical care nurses in selected hospitals of Pune City with a view to develop an information booklet on burnout management
Authors: Kuruva Mallikarjuna
Published: July 2023

Burnout is a form of chronic stress related to one's job. The study aims to identify the association between the selected demographic variables of the samples and the perceived symptoms of burnout of critical care nurses, to find correlations between the symptoms of burnout and coping strategies. A Descriptive Research Design with Survey approach and Cluster Sampling Technique is used to select a sample(n=60). Tool was developed in 3 sections which includes Demographic variables, Structured Self report Questionnaire on Perceived symptoms of burnout and Self Structred Questionnaire on Coping Strategies. Reliability of Tool calculated by Chronbach's Alpha mehtod using SPSS and reliability found to be 0.931 for Structured Self report Questionnaire on Perceived symptoms of burnout, Reliability 0.801 for Self Structred Questionnaire on Coping Strategies. The sample consists of 68.3% of age group 23-26 years, and 78.3% Unmarried. Only 2% of respondents were suffering from severe burnout, 50% of respondents with moderate burnout and 46.7% mild burnout. only 3.3% respondents were having poor coping strategies and 46.7% of respondents showd good coping strategies and 50% of respondents shown excellent coping strategies. Conclusion of the study is the Perception of burnout symptoms was inversely proportional to the level of coping strategies as its very clear that as the coping levels of the respondents increases, the perception of burnout symptoms was decreased. There was significant association between burnout and education, coping and working area, burnout scores and education. Using non parametric method Spearman Rho, found that 48.4% negative correlation between burnont and coping variable which is at 5% level of significance.
Contracts for providing publically funded outpatient medical services - criteria for tenders evaluation as a tool of health policy in Poland
Authors: Siebielska-Gasek Magdalena
Published: July 2023

The Polish health care system is essentially divided into three basic levels of service: basic health care, outpatient specialist care, hospital treatment. Since 2003 the payer is the National Health Fund. Medical facilities include contracts for healthcare services with the NHF. In order to be able to provide medical services for a broad group of patients in the actual system of health care and regarding the economic situation of the society, having a contract with the public payer is of key importance. Until 2017, the most common contracting mechanism was competition process. As of October 2017, according to legal changes, hospital treatment along with hospital outpatient clinics will be implemented mostly within the framework of the Primary Hospital Security. Network of hospitals, without the need to obtain a contract within the tender offer. Outpatient counseling clinics will continue to receive contracts through competitive tenders. It means not only the necessity to meet certain predefined requirements but also to demonstrate competitive prevalence of a bidding medical institution vs. other participating stakeholders. It is necessary for success to know the criteria which decide about the bidding institution’s position in the ranking of entities which have responded to the call to tender. The criteria for evaluating offers can undoubtedly form part of the state health policy.
Treatment options in chronic lymphocytic leukemia (CLL) – a Polish perspective
Authors: Monica Magdalena , Władysiuk Magdalena , Hus Iwona
Published: July 2023

Chronic lymphocytic leukemia (CLL) is the most frequent type of leukemia among the elderly people in Western societies. CLL is genetically and molecularly heterogeneous disease that translates into clinical outcomes. Currently, the most unfavorable prognosis is associated with the presence of deletion of the short arm of chromosome 17 (del17p) and/or mutation of the TP53 gene (mTP53) that requires an individualized therapeutic approach. Allogenic hematopoietic stem cells transplantation (allo-HSCT) is still the only potentially curative treatment option in patients with CLL. Nevertheless, it is associated with high toxicity and treatment-related mortality. Therefore, it can be used only in selected patients, mostly young and fit without significant comorbidities. Moreover, allo-HSCT should be performed in patients who achieve disease remission. Recent advances in molecular biology have led to the better understanding of CLL pathophysiology and development of new targeted therapies. Recently developed and approved drugs such as new anti-CD20 monoclonal antibodies (obinutuzumab, ofatumumab), B-cell receptor inhibitors (BCRi) (ibrutinib, idelalisib) and B-cell lymphoma 2 (BCL-2) protein inhibitor (venetoclax) provide better clinical outcomes in CLL patients than previously used standard chemotherapy regimens. Most of those new drugs have been included in treatment algorithms described in Polish, European and global clinical practice guidelines. However, not all of them are available for Polish patients due to the lack of reimbursement, leaving them in the clinical unmet need state. This review summarizes recent advances in CLL treatment, focusing on the Polish perspective.
Economic analysis of Noqturina® (oral lyophilisate) use in the symptomatic treatment of nocturia due to idiopathic nocturnal polyuria
Authors: Dzik Maciej , Chłosta Piotr , Dobruch Jakub , Miotła Piotr , Rechberger Tomasz , Bierut Adam , Jesionowski Maciej
Published: July 2023

Nocturia relates to the need to urinate at night when micturition was preceded by sleep and immediately followed by a period of sleep. The aim of this analysis is to examine the cost-effectiveness of desmopressin at a dose of 25 μg oral lyophilisate for women and 50 μg oral lyophilisate for men (DDAVP) in comparison to the best supportive care (BSC) used in Polish clinical practice in the treatment of nocturia (≥2 nocturnal micturition) caused by idiopathic nocturnal polyuria. Methods: The economic analysis uses a model combining the aspects of the partitioned-survival model and state-transition model (STM). The projection was carried out over a 30-year time horizon, which corresponds to 120 quarterly modelling cycles. The costs were calculated from a common perspective, including expenses incurred by the public payer (Narodowy Fundusz Zdrowia, National Health Found) and expenses incurred by the patient. Health effects of medical technologies have been estimated on the basis of unit data from CS40 and CS41 studies. The literature, statistical databases and information provided by clinical experts were used to develop the remaining input data, including utility. Results: The ICER for DDAVP + BSC compared to BSC was 56.1 kPLN (13.0 kEUR) and is below the cost-effectiveness threshold in force in Poland (135.5 kPLN; 31.2 kEUR). The multi-directional sensitivity analysis shows a profitability rate of 98.6%. Conclusions: The economic model shows that the addition of orodispersible DDAVP to standard treatment allows reducing the expected number of nocturnal micturition, improving the quality of life and reducing the number of injuries and fractures in the group of patients with nocturia caused by idiopathic nocturnal polyuria. Considering the total direct medical costs of treatment, desmopressin administered at a dose of 25 μg for women and 50 μg for men is a cost-effective therapy when added to the BSC.
AHTAPol appraisals and reimbursement decisions made by the Polish Minister of Health in oncological indications – surrogate endpoints as an argument for negative positions of the Transparency Council and recommendations of the AHTAPol's President.
Authors: Kordecka Anna , Łapa Joanna , Walkiewicz-Żarek Ewa , Kordecki Mariusz
Published: July 2023

Background: Reimbursement decisions are a part of the decision-making process specified in applicable legal provisions. In the Polish system, the key stakeholders are the Agency for Health Technology Assessment and Tariff System (AHTAPol) (President of the Agency and the Transparency Council), and the Minister of Health (MoH). Methods: The analysis included orders regarding oncological drugs, directed to the AHTAPol's assessment in the years 2009-2018 and a review of announcements of the MoH published between 01.2012-09.2018. Reasons for negative positions/recommendations (nCP/nRP), especially lack of results or lack of a statistically significant improvement in overall survival (OS), were analysed. Results: For the analysed orders, 16% of the Council’s positions and 18% of the President`s recommendations were positive. 40% of positions and recommendations were negative. Limitations of OS results were pointed out in 51% of nCP and 66% of nPR (QoL: 28% of nCP; 41% of nPR). In 2018, a fewer number of nCP/nPR with that justification was noted. Over half of the analysed orders ended with a reimbursement decision, but it is usually significantly postponed in time (for drug programmes: an average of 11 months after a PR is issued, not including time needed for AHTAPol's appraisal). Conclusions: Limitated results regarding clinically significant endpoints and drawing conclusions based on surrogate endpoints were the frequent reasons for nCP/nPR. Differences in the approach to surrogate endpoints between regulatory agencies and the AHTAPol were identified. The decision to include a technology in the reimbursement announcement is significantly delayed in relation to the President`s recommendation.
The safe use of drugs on the example of qualitative analysis of opinions of Internet users about drugs containing the recalled valsartan - an exploratory study
Authors: Świeczkowski Damian , Jaguszewski Miłosz
Published: July 2023

Background The recall of medicines from the pharmaceutical market is one of the most important responsibilities for pharmacists working in community pharmacies ensuring that patients receive medicines of the highest quality and safety. The aim of the study was to evaluate how Internet users in Poland perceived recall of valsartan. The study was conducted as a qualitative analysis of opinions posted on Internet forums. The study is an exploratory in its nature. Methods The study was conducted as a qualitative analysis of opinions posted on Internet forums. Thematic analysis was used and the data was coded to generate codes and categories, and subsequently to identify patterns between above-mentioned elements. The initial categories were organized and aggregated in themes. Posts were coded until theoretical saturation was achieved. All selected Internet forums were dedicated to laypeople and professionally-oriented platforms were excluded from our investigation. Moreover, to achieve full anonymity, we do not provide any additional details about investigated platforms, e.g. website name. Results Three themes were identified: i) impact of falsified medicines on the health status (abbreviated as 'health status'), ii) responsibility of the pharmaceutical industry and government agencies ('responsibility''), iii) legal issues, e.g. consequences and repercussions of introducing poor-quality medicines into routine clinical usage ('legal issues'). In general, posts were highly emotional. Health and responsibility were motives mostly highlighted in posts. Conclusions Recall of medicines from the market has been widely described on the Internet forums. Patients expressed doubts about the impact of recalled medicines on health, raised the issue of the responsibility of persons and institutions involved in pharmaceutical distribution, and finally mentioned legal repercussions of undesirable actions on the pharmaceutical market. Further, more representative studies are warranted.
Quality of life of residents of nursing and day care homes in Poland
Authors: Ciećko Weronika , Zarzeczna-Baran Marzena , Bandurska Ewa
Published: July 2023

Aim The aim of this study was to assess the quality of life of the residents of Nursing and Day Care Homes. Material and methods The study was conducted in March 2019 among the residents of the Nursing and Day Care Home Senior + in Naklo upon Noteć. The sixy-six patients participated in the study, including 45 women and 21 men. A standardized tool was used in the study – validated Polish version of the EQ-5D-5L questionnaire. Results The analysis of quality of life parameters showed a reduced level of quality of life of the respondents. In 31.8% of the respondents it was found that they were not able to move independently, while the majority of the respondents (28.8%) stated that they had no problems with self-care. Taking into account the performance of usual activities, 25.8% of the respondents stated that this is not a problem for them, while 24.2% felt moderate difficulties in this respect. Self-esteem in terms of pain/discomfort was worse; in 30.3% of respondents, pain remained at the level of 4 - strong. Anxiety and depression did not affect 34.8% of the patients. Averaging the results, the EQ-5D-5L questionnaire showed that the most unfavourable factor affecting the quality of life was anxiety/depression (3.8 points). Conclusions The residents of the Nursing and Day Care Home are characterized by the reduced horizontal quality of life. The analysis of the results showed that the lowest quality of life dimension among the respondents was anxiety/depression feeling.
Indirect costs of atopic dermatitis (AD) – systematic review and Polish perspective
Authors: Plisko Robert , Polkowska Marta , Lis Joanna
Published: July 2023

OBJECTIVE: Atopic dermatitis (AD) is a common chronic, pruritic inflammatory skin disease. It is associated with a high personal burden of illness and economic consequences. The main purpose of this analysis is to present the indirect costs of atopic dermatitis, including their specific aspects. METHODS: The analysis was based on a systematic review of the literature (23 October 2019). Keywords related to indirect costs and AD were used in the search strategy. RESULTS: 35 publications were included in the final analysis. They showed that a significant reduction in the quality of life of patients with atopic dermatitis is associated with high costs from a social perspective. A systematic review of the literature indicates that the costs arising from the absence of AD patients at work (absenteeism) or their reduced effectiveness during the performance of work duties (presenteeism) are much higher than those of people without AD (weekly productivity loss between 3-5%). Factors particularly affecting the amount of costs (direct and indirect) generated by AD include the severity of the disease and its control, as well as the type of treatment used and the patient's response to it. In Europe and USA, annual indirect costs (only productivity loss) due to AD are estimated at 2,3 billion EUR and 619 million USD respectively. Indirect costs in patients with atopic dermatitis are significantly higher than in people without this condition, which is due to reduced work productivity. Available literature indicate that the more advanced the form of AD, the greater the loss of productivity, and thus the higher indirect costs, and this observation is confirmed by data from various countries. The amount of indirect costs in AD is higher in the case of an uncontrolled form of the disease than in the case of a controlled disease. The use of ineffective treatment significantly increases the indirect costs of atopic dermatitis. Currently therapeutic options available in Poland are not sufficiently effective to provide disease control in all patients with AD, are characterized with adverse reactions, their use is limited in time and therefore their use will not bring savings in indirect costs in patients with severe AD. CONCLUSIONS: In this systematic review, we observed some aspect that likely have a major impact on the indirect costs in patients with AD: effectiveness of treatment, disease control (maintenance therapy between successive exacerbations). Ineffective treatments significantly increase the indirect costs of atopic dermatitis.
Drug Program Resource Analysis: "TREATMENT OF CHRONIC SPONTANEOUS URTICARIA (ICD-10 L50.1)
Authors: Szpruch Dalinda
Published: July 2023

Introduction Since January 2020 treatment of patients with chronic spontaneous urticaria is possible under drug program B.107: "TREATMENT OF CHRONIC SPONTANEOUS URTICARIA." This is the first drug program designed specifically for this group of patients. The reimbursement process was long and lasted nearly 5 years from the time the marketing authorization holder had submitted the reimbursement application. The aim of this paper is to summarize the first year of the implementation of program B.107. Methods The statistical analysis was based on the data published by the National Health Fund (NFZ) Board in the NFZ Operations Report for Q4 2020. Results 225 patients were treated under drug program B.107 in 2020. The NFZ assigned the following amounts of money for the provision of healthcare services under this program: PLN 2,936,812 — for the medicines and PLN 452,512 — for the management of the program. The use of the aforementioned amounts was 86% for the drug in the program and 63% for the management of the program. The treatment has been carried out by 46 centers across Poland. Conclusions There was a strong unmet medical need indicating the necessity to provide treatment for this group of patients. A large group of medical specialists can diagnose and treat urticaria in line with Polish and international recommendations. Since this drug program includes numerous medical specialties, patients with urticaria have gained very good access to diagnostics and potential initiation of treatment within its framework. In addition, omalizumab can be dispensed to patients for use at home, which definitely increases the safety of the therapy by limiting direct contact between the patient and medical facilities.
Explicit relations on the degenerate type 2-unified Apostol–Bernoulli, Euler and Genocchi polynomials and numbers
Authors:   Akdeniz University, Kurt Burak
Published: July 2023

The main aim of this paper is to introduce and investigate the degenerate type 2-unified Apostol–Bernoulli, Euler and Genocchi polynomials by using monomiality principle and operational methods. We give explicit relations and some identities for the degenerate type 2-unified Apostol–Bernoulli, Euler and Genocchi polynomials.
Cursos en línea abiertos y masivos: oportunidad de aprendizaje sobre salud global en Latinoamérica
Authors: Bendezu-Quispe Guido , Caira-Chuquineyra Brenda , Fernandez-Guzman Daniel , Casanova-Pérez Reggie , Bendezú-Martínez Andrés Guido
Published: July 2023

Introducción. Los cursos en línea, masivos y abiertos, brindan la oportunidad de formar profesionales e investigadores en Latinoamérica sobre salud global.Objetivos. Determinar la oferta global de los cursos en línea, masivos y abiertos, sobre salud global y conocer las características de su contenido.Materiales y métodos. Se examinaron las plataformas especializadas en cursos en línea, masivos y abiertos, para recopilar aquellos sobre salud global. La búsqueda no tuvo restricción de tiempo y se realizó por última vez en noviembre de 2021. La estrategia de búsqueda solo incluyó el descriptor “global health”. Posteriormente, se obtuvieron las características del curso, su contenido y el dominio abordado de salud global. Estos datos fueron analizados descriptivamente, y se reportaron frecuencias absolutas y relativas. Resultados. La estrategia de búsqueda identificó 4.724 cursos en línea, masivos y abiertos. De ellos, solo 92 estaban relacionados con salud global. La mayoría de estos cursos (n=44; 47,8 %) se ofrecieron mediante la plataforma Coursera. Más de la mitad de los cursos (n=50; 54,4 %) fueron realizados por instituciones de Estados Unidos y en idioma inglés (n=90; 97,8 %). La mayor parte de los cursos se centró en la “globalización de la salud y la asistencia sanitaria” (n=24; 26,1 %), seguido de los dominios “fortalecimiento de capacidades” (n=16; 17,4 %), “carga global de enfermedad” y “determinantes sociales y ambientales de la salud” (n=15; 16,3 %).Conclusiones. Se encontró una importante oferta de cursos en línea, masivos y abiertos, sobre salud global. Estos cursos abordaron las competencias de la salud global que se requieren para los profesionales sanitarios.
Bone involvement in non-congenital syphilis
Authors: Trujillo Daniela , Agudelo Carlos Andrés , Chavarriaga Andrés , Villa Pablo , Vélez Alejandro , Cardona Ricardo , Hidrón Alicia
Published: July 2023

We documented two stages of bone involvement due to syphilis in two adult patients infected with human immunodeficiency virus. Bony lesions of secondary versus tertiary syphilis cannot be differentiated on clinical or radiologic grounds alone. Given the rarity of this clinical presentation, there is no consensus on treatment duration and related outcomes.
Detection and expression of SapS, a class C nonspecific acid phosphatase with O-phospho-Ltyrosine- phosphatase activity, in Staphylococcus aureus isolates from patients with chronic osteomyelitis
Authors: Martínez-Canseco Carlos , Franco-Bourland Rebecca E. , González-Huerta Norma , Paredes-Espinosa Marco Antonio , Giono-Cerezo Silvia , Sánchez-Chapul Laura , Paniagua-Pérez Rogelio , Valdez-Mijares René , Hernández-Flores Cecilia
Published: July 2023

Introduction. The identity of Staphylococcus aureus virulence factors involved in chronic osteomyelitis remains unresolved. SapS is a class C non-specific acid phosphatase and a well-known virulence factor that has been identified in S. aureus strain 154 but in protein extracts from rotting vegetables.Objective. To identify the SapS gene and characterize the activity of SapS from S. aureus strains: 12 isolates from bone infected samples of patients treated for chronic osteomyelitis and 49 from a database with in silico analysis of complete bacterial genomes.Materials and methods. The SapS gene was isolated and sequenced from 12 S. aureus clinical isolates and two reference strains; 49 S. aureus strains and 11 coagulase-negative staphylococci were tested using in silico PCR. Culture media semi-purified protein extracts from the clinical strains were assayed for phosphatase activity with p-nitro-phenylphosphate, O-phospho-L-tyrosine, O-phospho-L-serine, and OphosphoL-threonine in conjunction with various phosphatase inhibitors.Results. SapS was detected in the clinical and in-silico S. aureus strains, but not in the in silico coagulase-negative staphylococci strains. Sec-type I lipoprotein-type N-terminal signal peptide sequences; secreted proteins, and aspartate bipartite catalytic domains coding sequences were found in the SapS nucleotide and amino acid sequence analysis. SapS dephosphorylated with p-nitro-phenyl-phosphate and ophosphoLtyrosine were selectively resistant to tartrate and fluoride, but sensitive to vanadate and molybdate.Conclusion. SapS gene was found in the genome of the clinical isolates and the in silico Staphylococcus aureus strains. SapS shares biochemical similarities with known virulent bacterial, such as protein tyrosine phosphatases, suggesting it may be a virulence factor in chronic osteomyelitis.
Asociación entre preocupación frente a la COVID-19, el apoyo social y el conocimiento sobre tuberculosis con el cumplimiento del tratamiento antituberculoso en Lima, Perú
Authors: Quiroz Yuli L. , Choqueza Susan O. , Soriano-Moreno Anderson N. , Alave Jorge L.
Published: July 2023

Introducción. En el contexto de la pandemia por la COVID-19 es escasa la información de factores asociados al cumplimiento del tratamiento antituberculoso en las zonas de alta prevalencia de tuberculosis.Objetivo. Evaluar si existe asociación entre el apoyo social, la preocupación por el contagio de COVID-19 y el conocimiento de la tuberculosis, frente al incumplimiento del tratamiento antituberculoso.Materiales y métodos. Se trata de un estudio transversal de pacientes en tratamiento antituberculoso durante los meses de enero a marzo del 2022 en centros ubicados en áreas de alta prevalencia de tuberculosis en Lima. Se utilizó el cuestionario de Morisky Green-Levine para evaluar el cumplimiento del tratamiento como variable dependiente; las variables independientes se evaluaron usando el Medical Outcomes Study Social Support Survey para determinar el apoyo social percibido y la preocupación por la infección de COVID-19, y el test de Batalla para evaluar el conocimiento del paciente sobre su enfermedad. Se utilizó la regresión de Poisson con varianza robusta para determinar la asociación entre las variables.Resultados. De un total de 101 participantes (73,3 % hombres y edad media 35,1 ± 16 años), el 51,5 % no observaron el tratamiento antituberculoso. El nivel de preocupación medio o alto de contagiarse y desarrollar COVID-19 se asoció con una mayor prevalencia de incumplimiento del tratamiento (razón de prevalencia: 1,68; intervalo de confianza del 95 %: 1,09-2,57) (ajustada por las variables de confusión consideradas).Conclusiones. El incumplimiento del tratamiento antituberculoso es una condición frecuente entre los pacientes de una zona de alta prevalencia de tuberculosis en Lima especialmente entre aquellos con mayor preocupación al contagio por el virus de SARSCoV-2, causante de la COVID-19.
Descripción del cambio en desenlaces clínicos posteriores a la implementación de un programa de gestión de antibióticos en un hospital de cuarto nivel de atención en salud
Authors: Reyes Raúl Eduardo , López María José , Pérez Jairo Enrique , Martínez Gustavo
Published: July 2023

Introducción. La inadecuada prescripción de antibióticos es un problema de salud pública, reconocido por la Organización Mundial de la Salud. Los programas de gestión de antibióticos son implementados como una herramienta para mitigar su impacto.Objetivo. Describir los cambios observados en los desenlaces clínicos después de la implementación de un programa de gestión de antibióticos en un hospital de IV nivel de atención.Materiales y métodos. Se llevó a cabo un estudio de cohorte única de pacientes hospitalizados por patologías infecciosas y tratados con antibióticos en una institución médica de alta complejidad. Inicialmente, se recolectaron las historias clínicas anteriores a a la implementación del programa de gestión de antibióticos (2013 a 2015) y luego se compararon con los datos obtenidos después de la implementación del programa de gestión de antibióticos de 2018 a 2019. Se evaluaron los cambios en los desenlaces clínicos como mortalidad y estancia hospitalaria, entre otros.Resultados. Se analizaron las historias clínicas de 1.066 pacientes: 266 con historia previa a la implementación del programa y 800 con historia posterior a la implementación. El promedio de edad fue 59,2 años y 62 % de la población era masculina. Se encontraron diferencias estadísticamente significativas en mortalidad global (29 Vs. 15 %; p<0,001), mortalidad por causa infecciosa (25 % Vs. 9 %; p<0,001) y promedio de estancia hospitalaria (45 Vs.21 días; p<0,001), con tendencia a disminuir nuevas hospitalizaciones en 30 días por patología infecciosa (14 Vs.10 %; p=0,085).Conclusiones. El desarrollo del programa de gestión de antibióticos se asoció con a una disminución en la mortalidad global, la mortalidad por causa infecciosa y la estancia hospitalaria. Esto demuestra la importancia de desarrollar intervenciones dirigidas a mitigar el impacto de la prescripción inadecuada de antibióticos.
Acoso laboral y sexual en residentes de cirugía general en Colombia
Authors: Domínguez Luis Carlos , Torregrosa Lilian , Cuevas Liliana , Peña Laura , Sánchez Sebastián , Pedraza Mauricio , Sanabria Álvaro
Published: July 2023

Introducción: El acoso laboral y el acoso sexual son preocupaciones en la formación quirúrgica.Objetivo: Exploramos la magnitud de estos problemas entre los residentes de cirugía general en Colombia.Materiales y métodos: se realizó un estudio nacional en junio de 2020. Los residentes autoevaluaron su exposición a la intimidación y el acoso sexual en forma de acoso de género, atención sexual no deseada y coerción sexual. Se analizaron variables demográficas y perpetradores entre víctimas y no víctimas.Resultados: Se incluyeron un total de 302 residentes. Las tasas de acoso laboral y sexual fueron del 49% y 14,9%, respectivamente. Las principales formas de acoso sexual correspondieron al acoso de género (47%) y la atención sexual no deseada (47%). El acoso sexual fue significativamente mayor entre las mujeres. Los cirujanos fueron los principales perpetradores.Conclusiones: El acoso laboral y el acoso sexual son frecuentes en la formación quirúrgica en Colombia. Estos hallazgos conducen a intervenciones para mejorar la cultura educativa de los departamentos quirúrgicos para disminuir la prevalencia de estos comportamientos.
Face-voice based multimodal biometric authentication system via FaceNet and GMM
Authors: Alharbi Bayan , Alshanbari Hanan S.
Published: July 2023

Information security has become an inseparable aspect of the field of information technology as a result of advancements in the industry. Authentication is crucial when it comes to dealing with security. A user must be identified using biometrics based on certain physiological and behavioral markers. To validate or establish the identification of an individual requesting their services, a variety of systems require trustworthy personal recognition schemes. The goal of such systems is to ensure that the offered services are only accessible by authorized users and not by others. This case study provides enhanced accuracy for multimodal biometric authentication based on voice and face hence, reducing the equal error rate. The proposed scheme utilizes the Gaussian mixture model for voice recognition, FaceNet model for face recognition and score level fusion to determine the identity of the user. The results reveal that the proposed scheme has the lowest equal error rate in comparison to the previous work.
Ecological indicators reveal historical regime shifts in the Black Sea ecosystem
Authors: Akoglu Ekin
Published: July 2023

Background

The Black Sea is one of the most anthropogenically disturbed marine ecosystems in the world because of introduced species, fisheries overexploitation, nutrient enrichment via pollution through river discharge, and the impacts of climate change. It has undergone significant ecosystem transformations since the 1960s. The infamous anchovy and alien warty comb jelly Mnemiopsis leidyi shift that occurred in 1989 is the most well-known example of the drastic extent of anthropogenic disturbance in the Black Sea. Although a vast body of literature exists on the Black Sea ecosystem, a holistic look at the multidecadal changes in the Black Sea ecosystem using an ecosystem- and ecology-based approach is still lacking. Hence, this work is dedicated to filling this gap.

Methods

First, a dynamic food web model of the Black Sea extending from 1960 to 1999 was established and validated against time-series data. Next, an ecological network analysis was performed to calculate the time series of synthetic ecological indicators, and a regime shift analysis was performed on the time series of indicators.

Results

The model successfully replicated the regime shifts observed in the Black Sea. The results showed that the Black Sea ecosystem experienced four regime shifts and was reorganized due to effects instigated by overfishing in the 1960s, eutrophication and establishment of trophic dead-end organisms in the 1970s, and overfishing and intensifying interspecies trophic competition by the overpopulation of some r-selected organisms (i.e., jellyfish species) in the 1980s. Overall, these changes acted concomitantly to erode the structure and function of the ecosystem by manipulating the food web to reorganize itself through the introduction and selective removal of organisms and eutrophication. Basin-wide, cross-national management efforts, especially with regard to pollution and fisheries, could have prevented the undesirable changes observed in the Black Sea ecosystem and should be immediately employed for management practices in the basin to prevent such drastic ecosystem fluctuations in the future.
Vet the journal before you submit: turnaround times of journals publishing in zoological medicine and related fields
Authors: Runde Brendan , Harms Craig
Published: July 2023

Many factors influence selection of a target journal for publishing scientific papers, including “fit” within the journal’s scope, acceptance rate, readership, open access options, submission and publication costs, journal quality, and timeliness of publication. Timeliness of publication can be a critical factor affecting career development, but many journals are not transparent about turnaround times. Here we evaluated 49 journals publishing papers in zoological medicine and related fields between 2017 and 2022, and aggregated and examined distributions of turnaround time of journals that publicly provided the requisite data, in order to aid authors in selecting target journals that best meet their needs. Of 49 journals evaluated, 39 provided necessary dates for reconstructing turnaround times. Of these, median times to acceptance ranged from 37 to 338 days, and median times to publication ranged from 41 to 403.5 days. The percentage of papers published in greater than 1 year (“slow”) ranged from 0 to 57.1%, while the percentage of papers published in under 6 months (“timely”) ranged from 0.8 to 99.8%. Acceptance rates and times to first decision were available for only 22% and 20%, respectively, of journals evaluated. Results may prove useful for authors deciding where to submit their works, depending on how they prioritize the many factors involved.