bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical considerations for the management of psoriasis in women with disorders of the menstrual cycle
Authors: Dyulmesova-Bilash Olga 
Published: November 2021

Introduction. Psoriasis in women of reproductive age is one of the most pressing medical and social problems. The consequence of psoriasis disease is a significant decrease in the quality of life, disability of patients, difficulties in creating a family and deterioration of family relations, significant psychological discomfort.
Objective of the study: to increase the effectiveness of treatment of women with psoriasis with menstrual irregularities by means of pathogenetically substantiated therapy based on the study of hormonal changes.
Materials and research methods. The study included 130 women who were divided into three groups: the main group – 75 women with psoriasis with menstrual irregularities, who were randomized into 3 subgroups: 1a – 25 patients who will receive standard psoriasis therapy; 1b – 25 patients, in addition to the standard treatment of psoriasis, will receive gestagens for 3 months; 1c – 25 patients, in addition to the standard treatment of psoriasis, will receive a preparation of an dry extract of herb of creeping anchors for 3 months. The comparison group consisted of 25 women with psoriasis without hormonal disorders, comparable in age and social status with the study group. The control group – 30 apparently healthy women, comparable in age and social status with the study group.
Research results. In patients of the main group who received standard psoriasis therapy (1a); who received progestogens for 3 months in addition to standard psoriasis treatment (1b) and, in addition to the standard treatment of psoriasis, who received the preparation of an dry extract of herb of anchors creeping for 3 months (1c), before the start of the treatment, the ratio of LH / FSH – luteinizing hormone (LH) and follicle-stimulating hormone (FSH) was below normal, which indicates a certain deficit in LH production relative to FSH values. In parallel, in these cohorts, the production of prolactin was increased, which suppresses the formation of FSH and LH in the pituitary gland. Changes in the production of gonadotropic hormones are a reaction to the existing deficiency or excess of sex hormones. In the main 1a, 1b and 1c in groups, estradiol values ​​were within the normal range with progesterone deficiency in the luteal phase. The testosterone value in all study groups did not deviate from the standard values.
Conclusions. The obtained results of the survey indicate the need to increase the effectiveness of treatment of women with psoriasis with menstrual irregularities by involving measures aimed at correcting hormonal status in complex therapy.
Biological medicinal products: reference and biosimilar products – selected issues
Authors: Kobuszewski Bartosz 
Published: November 2021

Biological therapies are being used in many chronic conditions. Development of biosimilar medicines gives chances for wider access to biological treatment. The aim of the review was to present legal regulations of the marketing authorisation of biological medicines in the context of biosimilars medicines. The article focuses on the legislation of the European Union, which was established on the beginning of the XXI century and is very complex and strict. In the first part of the article were described basic terms in this field, such as biological medicine, biosimilar medicine, reference medicine and generic medicie. It also shows differnces between biosimilar and generic medicines. Main difference concerns the manufacturing process, because of which biosimilar will never be identical to the reference medicine. Next part concentrates on the proces of registration of new biological medicines, especially in the area of medicines’ indications to use and controversies related to them. The last part presents issues of the safety monitoring of biological medicines on european level. The purpose of european law in that field is to guarantee every registred biologic therapy is safe for the patients.
Features of the intestinal microbiota functional status in early-aged children with rotavirus infection
Authors: Vorobiova N. , Usachova O. 
Published: November 2021

The aim is to assess the intestinal microflora functional and structural disorders in early-aged children in the dynamics of rotavirus infection by studying intestinal metabolites in faeces – short-chain fatty acids (SCFA).
Materials and methods. The study included 60 breastfed children aged 1-24 months with rotavirus infection (the study group) and 30 healthy children, representative by age and sex (the comparison group). Determination of SCFA (acetate, propionate, butyrate) in faeces was carried out in all children of the study group three times in the dynamics of the disease (on the 3rd, 5th and 10th day) and in healthy children once.
Results. The total concentration of SCFA in children with rotavirus infection was 3 and 2.2 times lower than in healthy children in the acute period of the disease (p<0.01 on the 3rd and 5th day, respectively), increasing on the 10th day (p<0.05), however, not reaching the normal level (p<0.01). The decrease in the total pool of SCFA occurred due to all volatile acids (C2, C3, C4), the concentrations of which were lower than in healthy children (p<0.01). Violation of the volatile acids ratio in their general pool was observed from the first days of rotavirus gastroenteritis in the form of an increase in the C2 relative concentration (p˂0.05) and a decrease in C3 and C4 profiles (p˂0.05). Correspondingly, a decrease in anaerobic index was noted. It was equal to 0.04 [0.01; 0.11] on the 3rd and 5th day of the disease, constituting only 1/5 of the healthy children values (p˂0,01), increasing on the 10th day to 0,09 [0,02; 0.17], however, remaining twice as lower than in children of the comparison group (p˂0,01).
Conclusions. There is a violation of the intestinal microflora functional condition in early-aged children from the first days of rotavirus infection, which is expressed by depletion of the total pool of SCFA and concentrations of each of them, as well as structural disorders of intestinal microbiocinosis in the form of reducing its anaerobiosis. These changes are most pronounced during the first five days of rotavirus gastroenteritis and last up to 10th day of illness.
Osmotically volumetric urine index in early recognition and evaluation of the central diabetes insipidus correction efficiency
Authors: Hnativ Yu. 
Published: November 2021

Purpose of the work: to develop an information criterion for early recognition and evaluation of the homeostasis correction efficiency in central diabetes insipidus.
Materials and methods. 48 neurosurgical patients who underwent traumatic brain injury (21), surgery for a brain tumor (14) and stroke (13), whose course of the disease was complicated by central diabetes insipidus, have been examined. The diuresis rate and urine density (refractometrically) were studied in each of its portions excreted out of the body within an hour. According to the indicator of osmotic density and the range of urine output, an information criterion for the diagnosis of diabetes insipidus and the dynamics of its course was developed – the osmotically volumetric urine index (OVUI).
Results and discussion. With physiological water input, 0.8-1.0 ml∙kg-1of urine is usually excreted from the human body within an hour. Concurrently, its specific gravity (urine density, UD) is 1012-1025. In 12 patients of the comparison group without diabetes insipidus, the OVUI index was 8.0-12.0. Central diabetes insipidus is characterized by significant homeostasis disorders: blood hypohydration and hyperosmolarity due to violation of hypothalamic-pituitary regulation of antidiuretic hormone secretion. In these conditions the osmotically volumetric urine index decreases to indicators ˂ 1.0. The criterion for the intensive therapy efficiency for homeostasis disorders in diabetes insipidus is OVUI increase above 1.0. The article presents a clinical case of timely recognition and successful correction of homeostasis in a patient with traumatic brain injury complicated by central diabetes insipidus.
Conclusions. The osmotically volumetric urine index – is an indicator that allows diagnosing diabetes insipidus in its early manifestations and timely preventing a violation of homeostasis. With the norm of OVUI at 8.0-12.0, its decrease to ˂ 1.0 indicates the presence of diabetes insipidus in the patient. Timely and adequate correction of disorders of hydration, blood osmolarity and the use of desmopressin lead to the OVUI normalization, which is a dynamic marker of the efficiency of intensive therapy of diabetes insipidus. The simplicity of the study (the possibility of carrying it out directly at the patient’s bedside), as well as the informativeness of the OVUI diagnostic and prognostic values deserve to be used in clinical practice.
Kluczowe czynniki konkurencyjności podmiotów leczniczych
Authors: Sikora Tomasz , Kanecki Krzysztof , Sikora Agnieszka , Bogdan Magdalena 
Published: November 2021

Wstęp: Rynek ochrony zdrowia, podobnie jak inne sektory gospodarki oparty jest o konkurencyjność. Z uwagi na unikalność świadczonych usług (polegających na ratowaniu ludzkiego zdrowia i życia), konkurencyjność podmiotów leczniczych różni się od typowego wolnego rynku.

Cel: Celem pracy była identyfikacja czynników konkurencyjności podmiotów leczniczych w czterech wyróżnionych obszarach konkurencyjności przedsiębiorstw – czynników zewnętrznych (makro- i mikrootoczenie) oraz czynników wewnętrznych (zasoby i aktywa).

Wyniki: Czynniki makrootoczenia zostały pogrupowane na: polityczno-prawne, ekonomiczne, społeczne, technologiczne i demograficzne. Mikrootoczenie zostało podzielone na: konsumentów i konkurentów, uwzględniając ich intensywność oraz bariery wejścia na rynek oraz dostawców. Zasoby podzielono na: aktywa finansowe, infrastrukturę pomieszczeń oraz wyposażenie w sprzęt. Natomiast aktywa zostały scharakteryzowane w oparciu o elementy systemu organizacji, warunkujące ich sprawczość – strategię, style, kompetencje, pracowników, strukturę oraz kulturę organizacji.

Podsumowanie: Dokonany przegląd i systematyzacja czynników wpływających na konkurencyjność podmiotów leczniczych umożliwia ocenę ich potencjału konkurencyjności w kontekście poszczególnych obszarów i scharakteryzowanych w nich kluczowych czynników sukcesu.
On-chip all-optical quantizer based on the cross polarization modulation effect in a double-ridge a-Si:H-Si3N4 waveguide
Authors: Hui Zhanqiang , Pan Deng , Wen Xijian 
Published: November 2021

The on-chip all-optical quantizer is a key functional module to realize all-optical analog-to-digital conversion. It has important applications in future optical communication and ultrafast all-optical signal processing systems. To the best of our knowledge, a novel all-optical quantization scheme based on the cross-polarization modulation effect in a double-ridge

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waveguide is proposed. For the optimized waveguide, the maximum nonlinear coefficient and transmission loss at the probe wavelength are

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and 2.246 dB/cm, respectively. The simulation results of the proposed all-optical quantizer show that a nonlinear phase shift of 8 can be generated in the 8.79 mm long waveguide when the peak pump light power is 0.8 W. A 16-level quantization and a 4-bit quantization resolution are obtained. The effective number of bits is 3.79-bit, which is only 0.21-bit away from the ideal resolution.
Periodontitis, dental plaque, and atrial fibrillation in the Hamburg City Health Study
Authors: Struppek Julia , Schnabel Renate B. , Walther Carolin , Heydecke Guido , Seedorf Udo , Lamprecht Ragna , Smeets Ralf , Borof Katrin , Zeller Tanja , Beikler Thomas , Börschel Christin S. , Karakas Mahir , Gosau Martin , Aarabi Ghazal 
Published: November 2021

Background/Aim
Atrial fibrillation (AF) is a major health problem and causes heart failure and stroke. Pathophysiological mechanisms indicate a link with oral health including periodontitis (PD), but supporting data are scarce. The aim was to investigate the link between features of oral health and the prevalence of AF.

Methods
This cross-sectional analysis of the Hamburg City Health Study included 5,634 participants with complete data on their PD and AF status. AF was assessed via self-reported questionnaire or medically diagnosed by standard 12-lead resting ECG. The oral health examination included full-mouth measurements of the dental plaque index (PI), the clinical attachment loss (CAL) at 6 sites per tooth, the bleeding on probing (BOP) and the decayed, missing and filled teeth (DMFT) index. Descriptive analyses for all variables stratified by the status of PD were performed. To test for an association between prevalent PD and prevalent AF, multivariable logistic regression models were used. Mediation analysis was used to test if interleukin-6 (IL-6) and/or C-reactive protein (CRP) mediated the association between PD and AF.

Results
Atrial fibrillation (prevalence: 5.6%) and the severity of PD (prevalence: moderate: 57.7%, severe: 18.9%) increased with age in men and women. Prevalent severe PD, CAL ≥3 mm, PI, and BOP were all associated with prevalent AF in unadjusted regression analysis. However, no association except for PI (odds ratio (OR): 1.22, 95% confidence interval (CI): 1.1–1.35, p<0.001) could be observed after adjusting for age, sex, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), body mass index, diabetes, smoking, and educational level. Participants brushing their teeth at least twice daily had a lower AF prevalence compared with those brushing only once daily. Hs-CRP, IL-6, and the odds of AF increased as a function of PD severity grades in unadjusted analysis. However, neither the DMFT index nor IL-6 or CRP was associated with AF after adjusting for age and sex. Mediation analyses could not provide support for the hypothesis that IL-6 or CRP acted as mediator of the association between prevalent PD and prevalent AF.

Conclusion
The study shows an association between prevalent AF and increased dental plaque levels indicated by a higher PI. In contrast, an association of prevalent PD with prevalent AF after adjustments for several confounders could not be demonstrated. Further studies are necessary to investigate the mechanisms underlying poor oral hygiene and AF as well as the influence of improved oral hygiene on AF onset.
Barriers and facilitators to the integration of digital technologies in mental health systems: A protocol for a qualitative systematic review
Authors: Berardi Chiara , Hinwood Madeleine , Smith Angela , Melia Adrian , Paolucci Francesco 
Published: November 2021

Introduction
Digital technology has the potential to improve health outcomes and health system performance in fragmented and under-funded mental health systems. Despite this potential, the integration of digital technology tools into mental health systems has been relatively poor. This is a protocol for a synthesis of qualitative evidence that will aim to determine the barriers and facilitators to integrating digital technologies in mental health systems and classify them in contextual domains at individual, organisational and system levels.

Methods and analysis
The methodological framework for systematic review of qualitative evidence described in Lockwood et al. will be applied to this review. A draft search strategy was developed in collaboration with an experienced senior health research librarian. A systematic search of Medline, Embase, Scopus, PsycInfo, Web of Science and Google Scholar, as well as hand searching of reference lists and reviews will identify relevant studies for inclusion. Study selection will be carried out independently by two authors, with discrepancies resolved by consensus. The quality of selected studies will be assessed using JBI Critical Appraisal Checklist for Qualitative Research. Data will be charted using JBI QUARI Data Extraction Tool for Qualitative Research. Findings will be defined and classified both deductively in a priori conceptual framework and inductively by a thematic analysis. Results will be reported based on the Enhancing transparency in reporting the synthesis of qualitative research. The level of confidence of the findings will be assessed using GRADE-CERQual.

Ethics and dissemination
This study does not require ethics approval. The systematic review will inform policy and practices around improving the integration of digital technologies into mental health care systems.
Changes in physical activity levels and mental health during COVID-19: Prospective findings among adult twin pairs
Authors: Duncan Glen E. , Avery Ally R. , Tsang Siny , Williams Bethany D. , Seto Edmund 
Published: November 2021

BackgroundPhysical distancing and other COVID-19 pandemic mitigation strategies have negatively impacted physical activity (PA) levels and mental health in cross-sectional studies. The purpose of this study was to investigate associations between changes in PA and mental health outcomes during the COVID-19 pandemic, following implementation of mitigation strategies, in a sample of adult twins.MethodsThis was a prospective study of 3,057 adult twins from the Washington State Twin Registry. Study participants completed online surveys in 2020, at baseline (March 26 –April 5), and three follow-up waves (W1: April 20 –May 3; W2: Jul 16 –Aug 2; W3: Sept 16 –Oct 1). Physical activity was operationalized as self-reported moderate-to-vigorous PA (MVPA) and neighborhood walking (minutes/week), and mental health outcomes, operationalized as self-reported anxiety and perceived stress were assessed in the three waves of follow-up. Latent growth curve models (LGCMs) were used to assess changes in PA and mental health outcomes over time. Parallel LGCMs were used to estimate the cross-sectional, parallel, and prospective associations between PA and mental health over time. All models took into within-pair correlations and adjusted for age, sex, and race.ResultsIndividuals’ amount of MVPA and walking decreased over time, whereas levels of anxiety remained stable, and stress increased slightly. Cross-sectional associations observed between both PA predictors and mental health outcomes were weak. After taking into account cross-sectional associations between PA and mental health outcomes, changes in PA over time were not associated with changes in mental health outcomes over time.ConclusionsOver a time period aligned with COVID-19 mitigation strategies and social restrictions, changes in physical activity was not associated with changes in anxiety or stress levels in the current sample. Nonetheless, the average decline in PA over time is worrisome. Public health resources should continue to promote PA as a means to improve physical health during the pandemic.
Impacts of body composition parameters and liver cirrhosis on the severity of alcoholic acute pancreatitis
Authors: Jang Dong Kee , Ahn Dong-Won , Lee Kook Lae , Kim Byeong Gwan , Kim Ji Won , Kim Su Hwan , Kang Hyoun Woo , Lee Dong Seok , Yoon Soon Ho , Park Sang Joon , Jeong Ji Bong 
Published: November 2021

AimLiver cirrhosis and features of muscle or adipose tissues may affect the severity of acute pancreatitis (AP). We aimed to evaluate the impact of body composition parameters and liver cirrhosis on the severity of AP in patients with alcohol-induced AP (AAP).MethodsPatients with presumed AAP who underwent CT within one week after admission were retrospectively enrolled. L3 sectional areas of abdominal fat and muscle, and mean muscle attenuations (MMAs) were quantified. The presence of liver cirrhosis was determined using clinical and CT findings. Factors potentially associated with moderately severe or severe AP were included in the multivariable logistic regression analysis.ResultsA total of 242 patients (47.0 ± 12.6 years, 215 males) with presumed AAP were included. The mild and moderately severe/severe (MSS) groups included 137 (56.6%) and 105 patients (43.4%), respectively. Patients in the MSS group had higher rates of liver cirrhosis, organ failure, and local complications. Among body composition parameters, mean MMA (33.4 vs 36.8 HU,P<0.0001) and abdominal muscle mass (126.5 vs 135.1 cm2,P= 0.029) were significantly lower in the MSS group. The presence of liver cirrhosis (OR, 4.192; 95% CI, 1.620–10.848) was found to be a significant risk factor for moderately severe or severe AP by multivariable analysis.ConclusionThe results of this study suggest that liver cirrhosis has a significant impact on the severity of AAP. Of the body composition parameters examined, MMA and abdominal muscle mass showed potential as promising predictors.
Prevalence and determinants of early initiation of breastfeeding (EIBF) and prelacteal feeding in Northern Ghana: A cross-sectional survey
Authors: Dubik Stephen Dajaan , Amegah Kingsley E. 
Published: November 2021

Background
There is suboptimal early initiation of breastfeeding (EIBF) with widespread prelacteal feeding in Ghana. However, studies exploring the determinants of EIBF and prelacteal feeding are limited in Ghana. The study was conducted to assess the prevalence and determinants of EIBF and prelacteal feeding in Northern Ghana.

Methods
This cross-sectional study was conducted among 508 mothers with infants aged 0–24 months in the Sagnarigu Municipality of Northern Ghana. The quantitative data were collected using a structured questionnaire adapted from Ghana’s demographic and health survey. Multivariate logistic regression was used to identify the independent determinants of EIBF and prelacteal feeding.

Results
The prevalence of EIBF and prelacteal feeding was 72% and 21%, respectively. The independent positive determinants of EIBF were partner support to breastfeed [adjusted Odds ratio (AOR): 1.86, 95% Confidence interval (CI): 1.09–3.17] and exposure to breastfeeding information during pregnancy (AOR = 1.63 (95% CI: 1.01–2.64). Lower odds of EIBF were observed among mothers from extended family (AOR = 0.62, 95% CI: 0.41–0.95). Regarding prelacteal feeding, negative determinants were having a normal weight baby (AOR: 0.50, 95% CI: 0.27–0.90), exposure to breastfeeding information during pregnancy (AOR: 0.54, 95% CI: 0.31–0.92), while experiencing delayed onset of lactation was a risk factor for prelacteal feeding practice (AOR: 2.35, 95% CI: 1.41–3.94).

Conclusion
In this study, EIBF was slightly higher than the 2030 global target on EIBF with widespread prelacteal feeding practice. Health programs aimed at improving EIBF should focus on the women partners, nutrition counselling, and support to mothers from the extended family. In the same vein, programs aimed at discouraging prelacteal feeding practice should also target women at risk, such as those with low birthweight babies and women experiencing delayed lactation onset.