bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing and Implementing a Framework for System Level Measures: lessons from New Zealand
Authors: Doolan-Noble Fiona , Lyndon Mataroria , Hill Andrew G , Gray Jonathon , Gauld Robin 
Published: May 2020

Background: Measuring performance is now the norm in health systems. System Level Measures (SLMs), implemented at New Zealand’s Counties Manukau Health (CMH) are designed to support quality improvement activities undertaken across the health system using only a small set of measures. While the healthcare and performance measurement literature contains information regarding the facilitators and barriers to quality improvement initiatives, there is an absence of studies into whether these factors are germane to the establishment and implementation of a SLM framework.
Methods: A purposive sample of thirteen senior managers and clinicians involved in the construction and implementation of SLMs were invited to participate. Semi-structured telephone interviews were completed and recordings transcribed verbatim. Transcriptions were thematically analysed using a general inductive approach.
Findings: In total, ten interviews took place. Six facilitative themes were identified including: dispersed and focused leadership; communication; data; alignment of the measures with organisational strategic data; alignment of the measures with organisational strategic plans and values; stakeholder engagement; and a dedicated project team. Conversely, five themes were identified that hindered the process. These were: reaching consensus; perfection versus pragmatism; duplication and process burden; achieving buy-in and workload.
Discussion: The factors that facilitate and hinder establishing and implementing a framework of SLMs are common to other quality improvement approaches. However, this study demonstrated that these factors were also germane to SLMs. These findings are of particular relevance as researchers and policy makers elsewhere increasingly aim to adopt measurement arrangements for health systems that address equity, safety, quality, access and cost.
Abbreviations: CMH – Counties Manukau Health; DHB – District Health Board; IHI – Institute for Healthcare Improvement; QI – Quality Improvement; SLM – System Level Measure.
Addressing Health Insurance Deductions through an Interventional Study: the Case of a Large Central Hospital
Authors: Kharazmi Erfan , Salehi Asiyeh , Hashemi Neda , Ghaderi Shekufe , Hatam Nahid 
Published: May 2020

Objective: A large proportion of hospitals’ private income is provided by insurance organisations. Hospitals in Iran face various problems in terms of insurance deductions from insurance organisations resulting from inefficient performance by both the hospitals and the insurers. These problems necessitate more specific cost control in this area. This research assesses the causes of insurance deductions by using the Failure Mode Effects Analysis (FMEA) technique, and addresses the issues resulting in deductions by providing some interventions through the Pareto technique.
Design: The 10-step pattern of FMEA was implemented for assessing the main causes of insurance deduction in this study.
Setting: Data was collected from deduced amounts by three main/largest contracting party insurance organisations (e.g. the Social Security Insurance Organisation, Medical Services Insurance Organisation and Armed Forces Medical Services Insurance Organisation of Namazi Hospital, a large healthcare provider in the South of Iran, in 2014.
Findings: Sixty-five potential failure causes were identified, of which 26 were related to the anaesthesia unit, 23 were related to the surgery room unit and 16 were related to the hospitalisation unit. Deductions in the anaesthesia and hospitalisation units and the surgery room were reduced after intervention programs by 14.42%, 57.76%, and 51.52%, respectively.
Conclusions: Using the FMEA technique in a large healthcare provider in Iran resulted in identifying the main causes of insurance deductions and provided intervention programs in order to increase the efficiency and productivity of healthcare services.
Abbreviations: FMEA – Failure Mode Effects Analysis; RPN – Risk Priority Number.
MANAGING CONSUMER COOPERATIVES IN THE TRANSITION TO A DIGITAL ECONOMY
Authors: Shamsutdinova Marina , Zhilina Nadezhda , Rayner Yulia 
Published: May 2020

The term "digital economy" was coined by Nicholas Negroponte in 1995.this concept includes the development of digital technologies, acceleration of scientific and technological progress, and changes in the communication paradigm. The demassification of production, the need for continuous innovation, and the transition to horizontal relationships within the organization lead to one of the largest economic revolutions of recent times.
The transition of society to the digital economy determines the transformation of the management mechanism of consumer cooperation organizations in order to ensure their competitiveness in the current and long-term perspective. The use of the latest technologies, based on traditional cooperative values, opens up wide opportunities for the formation and active development of a new generation of cooperation.
OPPORTUNITIES FOR THE DEVELOPMENT OF A RISK MANAGEMENT SYSTEM AND CONTROL FOR THE EVALUATION OF VALUE-EXPERT EXAMINATION
Authors: Demina Tat'yana 
Published: May 2020

Considering the author’s experience gained as a result of the review of appraisal and cost assessments conducted by both qualified appraisers and current experts, the following questions are proposed in the article for consideration:
•	We consider “gaps” in the legislation regulating expert activity;
•	We accumulate errors in the conclusions of experts of the appraisal and value examination, which allow them to be “broken up" in court;
•	We develop recommendations for avoiding the risks of making mistakes in the production of valuation and valuation expertise;
•	We are considering the possibility of developing a risk management system and monitoring the production of cost-based expertise.
Roles for Health Sciences Librarians at College and University Libraries
Authors: Reed Jason B , Carroll Alexander J. 
Published: May 2020

ABSTRACT

Objectives: To meet the changing priorities of researchers and funding agencies, U.S. college and university libraries (C&ULs) that are not Association of Academic Health Sciences Libraries (AAHSL) members may want to hire librarians capable of supporting interdisciplinary health sciences research. This study sought to identify whether such roles are emerging by examining advertised position descriptions.

Methods: We collected position advertisements posted to job boards and mailing lists between September 1 2018 and March 1 2019. Positions that included one of these terms in the title, qualifications, or responsibilities were eligible for inclusion: medic*, health, life, nursing, veterinary, bio*, pharma*. We categorized postings by institution type, geographic region, and position type. We used grounded theory to identify themes within the data, and NVivo to quantify how often each theme appeared within the data.

Results: 104 job postings met our inclusion criteria: 60 at AAHSL institutions and 44 at C&UL institutions. Despite some minor variations among specific roles and responsibilities, we found substantial overlap in the qualifications listed for positions at both types of institution. Qualifications more often prioritized traditional librarian competencies rather than emerging areas, such as data science, grant support, and research impact.

Conclusions: Both AAHSL and C&UL institutions show an interest in hiring librarians capable of supporting health and life sciences teaching and research. Competition for a similar pool of applicants may create challenges for hiring officials, and librarians interested in these positions will likely seek out professional development opportunities in emerging areas of practice.
Abordagem etnozoológica sobre o uso do tejo (<em>Salvator merianae</em>) por moradores rurais do município de Aparecida, PB, Brasil
Authors: Sá Tatiane Pontes de , Medeiros Paulo Roberto de 
Published: May 2020

<p>O tejo<em> Salvator merianae </em>é uma importante espécie para moradores rurais do Nordeste do Brasil. Analisar como a espécie é utilizada e o quão frequente ocorre sua captura são aspectos fundamentais para compreender seu status de conservação. Deste modo, o presente trabalho teve por objetivo avaliar o conhecimento etnozoológico de moradores rurais do Município de Aparecida (Paraíba), em relação ao uso e a importância do tejo (<em>S. merianae</em>). A obtenção dos dados ocorreu através de entrevistas semiestruturadas com a aplicação de questionários aos moradores da região que possuem um maior potencial de conhecimento sobre o uso do animal para fins terapêuticos e alimentícios. Observou-se claramente que <em>S. merianae</em> é utilizada para tratamentos anti-inflamatórios e sua carne é altamente consumida pelos moradores locais, sendo a caça a principal atividade realizada para obtenção de subprodutos do animal. Os resultados mostram a necessidade de novos estudos que aprofundem a importância da zooterapia e avaliem a real eficácia dos produtos de origem animal e os impactos da caça na diversidade zoológica local. </p><p><strong>Palavras chave</strong>: Etnoherpetologia, Zooterapia, Caatinga, Conservação.</p>
Retrospective Comparison of the Efficiency of Sperm Preparation Methods in Intrauterine Insemination in Unexplained Infertility Cases
Authors: YAYLALI Asli 
Published: May 2020

Aim: To compare the effects on pregnancy rates of the sperm preparation methods used in intrauterine insemination (IUI) treatment in couples diagnosed with unexplained infertility.Method: The study included 112 couples who presented at the Assisted Reproductive Techniques Clinic with no gynaecological problem observed in the female and semen analysis in the male showing features suitable for insemination, who were then diagnosed with unexplained infertility. The patients were evaluated in three groups according to the sperm preparation methods as Group 1 (Swim-Up), Group II (Gradient) and Group III (Microchip). The results were analyzed statistically and discussed in light of the relevant literature. Results: No statistically significant difference was determined between the groups in respect to the age of the couples, duration of infertility, female basal FSH values, number of dominant follicles formed with ovulation induction, endometrium thickness during IUI, total number of motile sperm before sperm preparation, ratio of sperm with normal morphology (Kruger), motility rate after sperm preparation, and number of inseminated sperm (p&gt;0.05 for all). The mean number of IUI attempts was 3.68 in the Microchip group, 1.86 in the Swim-Up group and 1.82 in the Gradient group. A statistically significantly higher number of IUI attempts was made in the Microchip group than in the other groups (p&lt;0.01). In the comparison of the pregnancy rates, the highest rate of 22.73% was determined in the Microchip group, followed by 17.39% in the Gradient group and 15.91% in the Swim-Up group, with no statistically significant difference determined between the groups (p=0.064). Conclusion: Although there was no apparent difference in success between the two methods most frequently used in sperm preparation in IUI cycles (Swim-Up, Gradient), the method of sperm selection with Microchip, which is being increasingly used, seems to be a promising alternative. There is a need for further
Can portal vein pulsatility index be used as predictive parameter with hepatic artery resistive index for liver fibrosis in nonalcoholic hepatosteatosis?
Authors: DİLEK Okan , KAYA Ömer 
Published: May 2020

Aim: Nonalcoholic fatty liver disease (NAFLD) is a clinical entity with a broad spectrum of isolated liver steatosis, steatohepatitis and even cirrhosis. In the development of hepatitis or cirrhosis, flow changes in the hepatic artery and portal vein may be detected. The aim of this study was to investigate the significance of the changes in hemodynamic findings according to the steatosis grade in patients with nonalcoholic hepatosteatosis. Materials and Methods: the study was performed with B-mode and Doppler ultrasonographic (US) measurements of patients who applied to the radiology department for abdominal ultrasonography examination between February and September 2018. Hepatic artery resistive index (HARI) and portal vein pulsatility index (PVPI) were evaluated. Thirty patients without steatosis and 30 patients from each 3 hepatosteatosis grade were included into the study. As the criteria for inclusion of patients in the study, there was no history of additional disease. p&lt;0.05 values were considered statistically significant. Results: HARI was significantly lower in grade 3 steatosis than the control group, grade 1 and 2 steatosis (p&lt;0.05). In grade 3 steatosis, portale vein diameter was significantly wider than the control group, grade 1 and 2 steatosis (p&lt;0.05). PVPI was significantly lower in grade 2 steatosis than the control group and grade 1 steatosis (p&lt;0.05). Significant hemodynamic changes were detected in the hepatic artery and portal vein when compared with control and patients groups. Conclusion: The evaluation of PVPI is considered as a noninvasive valuable method as if HARI in the evaluation of liver parenchymal damage in NAFLD.
Change of anthropometric indicators in qualified young women volleyball players during the annual training macrocycle
Authors: Sarafyniuk L.A. , Khapitska O.P. , Sarafyniuk P.V. , Koliadenko S.V. , Cherkasova L.A. 
Published: May 2020

Determining the indicators of the external body structure, which are inherent in highly qualified athletes of a particular sport during the annual training macrocycle, can be reliable markers in sports selection. The aim of the work is to determine the differences of anthropometric dimensions in qualified young women volleyball players at the beginning of the preparatory period and at the end of the competitive period of the annual training cycle. We examined 36 young women volleyball players of the section of sports improvement of National Pirogov Memorial Medical University, Vinnytsya and the women’s volleyball team of the Super League of Ukraine “Bilozgar – Medical University”. All volleyball players belonged to a juvenile age (from 16 to 20 years) and had a high level of sportsmanship. We conducted two surveys of volleyball players during the 2018-2019 study year: the first – in September 2018, which corresponded to the beginning of the preparatory period of the annual training cycle; the second – in May 2019, which was at the end of the competitive period of the annual training cycle. Anthropometric measurement was performed by the method of V.V. Bunak (1941). The analysis of the obtained results was performed in the license package “Statistica 5.5” using non-parametric methods of evaluation of indicators. At the end of the competition period, compared to the preparatory training period, volleyball players of high level of sportsmanship in adolescence showed a statistically significant decrease in body weight with a significant increase in shoulder width, chest circumference on inspiration, thighs and crus in the upper third, and a tendency to larger values of the height of the suprasternal and shoulder points, torso length and transverse mid-chest diameter. Certain somatometric features of volleyball players can be considered from two aspects: first, as a consequence of qualified prognostic sports selection, and secondly, as a result of training and competitive sports activities. Analysis of external body parameters in volleyball players during the annual macrocycle can be used as criteria for ascertaining sports selection, because when selecting at the stages of advanced specialization it is necessary to identify athletes capable of achieving high sports results, effective sports improvement in subsequent stages of training.
Submicroscopic changes in the liver of young rats with hyperhomocysteinemia
Authors: Halahan Yu.V. 
Published: May 2020

To date, it has been established that hyperhomocysteinemia plays a significant role in the development and progression of many diseases. The accumulation of homocysteine occurs due to a violation of the relationship between its production and excretion from the body. The liver plays an important role in the metabolism of homocysteine, because it undergoes most of the reactions of its transmethylation, and, therefore, it is the first to be adversely affected. The aim of the study is to identify the features of electron microscopic changes in the liver structure of young rats with hyperhomocysteinemia. The experimental study was performed on 22 white nonlinear young (1-2 months) male rats, which were divided into a control group and an experimental group. A model of persistent hyperhomocysteinemia was created by administering to rats the experimental group of thiolactone homocysteine at a dose of 200 mg/kg body weight intragastrically for 60 days. The study of ultrastructural changes in the liver of rats was performed using an electron microscope PEM-125K. It was found that the introduction of thiolactone homocysteine at a dose of 200 mg/kg in rats led to the development of degenerative changes in hepatocytes. Changes in the structure of liver cells manifested themselves in the form of edema of the cytoplasm and mitochondria, destruction of mitochondrial cristae, dilation of the tubules of the granular endoplasmic reticulum and tanks of the Golgi complex. The activity of fat-accumulating liver cells and stellate macrophages is characteristically. In the lumens of the sinusoidal capillaries found sweeter shaped blood elements, the cytoplasm of endothelial cells had signs of edema. Thus, in experimental hyperhomocysteinemia revealed changes at the ultrastructural level in all structural components of the liver of young rats. The identified changes are compensatory-adaptive in nature and are reversible.
Effects of implantation of a deep brain stimulation device on patient weight in Parkinson’s disease and essential tremor
Authors: Monteferrante Nikolas R. , Wilhelmi Brian G. , Lambert Margaret , Ponce Francisco A. 
Published: May 2020

OBJECTIVE
Deep brain stimulation (DBS) is a well-established therapy for treating neurological movement disorders. Some patients who have received DBS therapy have noticed significant weight gain. Further investigation into correlations between patient characteristics and weight gain following DBS device implantation, which the authors here have done, will provide physicians with useful clinical information.

METHODS
The authors performed a retrospective study of patients with Parkinson’s disease (PD) and essential tremor (ET) who had received DBS therapy in the period from 2012 to 2017. Patient weights had been recorded preoperatively and at 3, 6, and 12 months postoperatively. These data were used to compare patient characteristics, including diagnosis, body mass index (BMI), sex, levodopa equivalent dose (LED), and change in Unified Parkinson’s Disease Rating Scale (UPDRS) score. For PD patients, a quantile multivariate regression analysis was used to examine whether significant correlations existed between several of these patient characteristics, as well as age and weight gain following implantation.

RESULTS
PD patients had gained a significant amount of weight at 3 months (mean [SE] 2.66 [0.428] kg, p < 0.001), 6 months (3.64 [0.492] kg, p < 0.001), and 12 months (4.18 [0.540] kg, p < 0.001) after DBS placement. Patients who had undergone subthalamic nucleus (STN) DBS device placement gained, on average, more weight than the patients with globus pallidus internus (GPi) placement at both 6 months (mean 2.558 [1.020] kg, p = 0.01) and 12 months (2.358 [1.130] kg, p = 0.04). BMI in the STN cohort was greater than that in the GPi cohort at 6 months (mean difference [SE] 2.60 [1.127] kg/m2, p = 0.02) and at 12 months (2.36 [1.112] kg/m2, p = 0.04). A reduction in LED was negatively correlated with weight change at 6 months (r = −0.33, p < 0.001) and 12 months (r = −0.41, p < 0.001). There was no weight gain correlated with DBS therapy for ET.

CONCLUSIONS
PD patients experienced a significant change in weight over time after DBS therapy, whereas ET patients did not. PD patients with an STN target site experienced greater weight gain, on average, than those with a GPi target site. Furthermore, there was a significant increase in BMI at 6 and 12 months in patients with an STN target compared to that in patients with a GPi target. PD patients whose LED was reduced after DBS gained more weight at 6 and 12 months after surgery than the patients whose LED was kept at the same level or increased.
Analysis of risk factors and clinical sequelae of direct electrical cortical stimulation–induced seizures and afterdischarges in patients undergoing awake mapping
Authors: Abecassis Zachary A. , Ayer Amit B. , Templer Jessica W. , Yerneni Ketan , Murthy Nikhil K. , Tate Matthew C. 
Published: May 2020

OBJECTIVE
Intraoperative stimulation has emerged as a crucial adjunct in neurosurgical oncology, aiding maximal tumor resection while preserving sensorimotor and language function. Despite increasing use in clinical practice of this stimulation, there are limited data on both intraoperative seizure (IS) frequency and the presence of afterdischarges (ADs) in patients undergoing such procedures. The objective of this study was to determine risk factors for IS or ADs, and to determine the clinical consequences of these intraoperative events.

METHODS
A retrospective chart review was performed for patients undergoing awake craniotomy (both first time and repeat) at a single institution from 2013 to 2018. Hypothesized risk factors for ADs/ISs in patients were evaluated for their effect on ADs and ISs, including tumor location, tumor grade (I–IV), genetic markers (isocitrate dehydrogenase 1/2, O
6-methylguanine-DNA methyltransferase [MGMT] promoter methylation, chromosome 1p/19q codeletion), tumor volume, preoperative seizure status (yes/no), and dosage of preoperative antiepileptic drugs for each patient. Clinical outcomes assessed in patients with IS or ADs were duration of surgery, length of stay, presence of perioperative deficits, and postoperative seizures. Chi-square analysis was performed for binary categorical variables, and a Student t-test was used to assess continuous variables.

RESULTS
A total of 229 consecutive patients were included in the analysis. Thirty-five patients (15%) experienced ISs. Thirteen (37%) of these 35 patients had experienced seizures that were appreciated clinically and noted on electrocorticography simultaneously, while 8 patients (23%) experienced ISs that were electrographic alone (no obvious clinical change). MGMT promoter methylation was associated with an increased prevalence of ISs (OR 3.3, 95% CI 1.2–7.8, p = 0.02). Forty patients (18%) experienced ADs. Twenty-three percent of patients (9/40) with ISs had ADs prior to their seizure, although ISs and ADs were not statistically associated (p = 0.16). The presence of ADs appeared to be correlated with a shorter length of stay (5.1 ± 2.6 vs 6.1 ± 3.7 days, p = 0.037). Of the clinical features assessed, none were found to be predictive of ADs. Neither IS nor AD, or the presence of either IS or AD (65/229 patients), was a predictor for increased length of stay, presence of perioperative deficits, or postoperative seizures.

CONCLUSIONS
ISs and ADs, while commonly observed during intraoperative stimulation for brain mapping, do not negatively affect patient outcomes.