bluuebunny/crossref_metadata_2025_split huggingface dataset:
Baseline assessment of cervical cancer screening and treatment capacity in 25 counties in Kenya, 2022
Authors: Mwenda Valerian , Murage David , Kilonzo Catherine , Bor Joan-Paula , Njiri Patricia , Osiro Lance , Nyangasi Mary , Arbyn Marc , Tummers Philippe , Temmerman Marleen 
Published: July 2024

BackgroundCervical cancer is the leading cause of cancer deaths among women in Kenya. In the context of the Global strategy to accelerate the elimination of cervical cancer as a public health problem, Kenya is currently implementing screening and treatment scale-up. For effectively tracking the scale-up, a baseline assessment of cervical cancer screening and treatment service availability and readiness was conducted in 25 priority counties. We describe the findings of this assessment in the context of elimination efforts in Kenya.MethodsThe survey was conducted from February 2021 to January 2022. All public hospitals in the target counties were included. We utilized healthcare workers trained in preparation for the scale-up as data collectors in each sub-county. Two electronic survey questionnaires (screening and treatment; and laboratory components) were used for data collection. All the health system building blocks were assessed. We used descriptive statistics to summarize the main service readiness indicators.ResultsOf 3,150 hospitals surveyed, 47.6% (1,499) offered cervical cancer screening only, while 5.3% (166) offered both screening and treatment for precancer lesions. Visual inspection with acetic acid (VIA) was used in 96.0% (1,599/1,665) of the hospitals as primary screening modality and HPV testing was available in 31 (1.0%) hospitals. Among the 166 hospitals offering treatment for precancerous lesions, 79.5% (132/166) used cryotherapy, 18.7% (31/166) performed thermal ablation and 25.3% (42/166) performed large loop excision of the transformation zone (LLETZ). Pathology services were offered in only 7.1% (17/238) of the hospitals expected to have the service (level 4 and above). Only 10.8% (2,955/27,363) of healthcare workers were trained in cervical cancer screening and treatment; of these, 71.0% (2,097/2,955) were offering the services. Less than half of the hospitals had cervical cancer screening and treatment commodities at time of survey. The main health system strength was presence of multiple screening points at hospitals, but frequent commodity stock-outs was a key weakness.ConclusionTraining, commodities, and diagnostic services are major gaps in the cervical cancer program in Kenya. To meet the 2030 elimination targets, the national and county governments should ensure adequate financing, training, and service integration, especially at primary care level.
Depressive symptoms of older adults with chronic diseases: the mediating roles of activities of daily living and economic burden of diseases
Authors: Ni Zihan , Zhu Xiuyuan , Tian Kan , Chen Qing , Yang Yi , Xie Shiyu 
Published: July 2024

ObjectiveTo explore the mediating roles of activities of daily living (ADL) and economic burden of diseases in the relationship between chronic diseases and depressive symptoms of older adults.MethodsThe data were sourced from China Health and Retirement Longitudinal Study (CHARLS). The number of chronic diseases, ADL, out-of-pocket medical expenses and the Center for Epidemiological Studies Depression Scale (CES-D) were selected as measuring indexes. Mediation analysis was conducted to explore the potential mediating roles of ADL and economic burden of diseases in the association between chronic diseases and depressive symptoms.ResultsThe number of chronic diseases, ADL, economic burden of diseases and depressive symptoms of older adults were significantly correlated with each other. ADL and economic burden of diseases individually mediated the relationship between the number of chronic diseases and depressive symptoms, accounting for 31.460% and 5.471% of the total effect, respectively. Additionally, ADL and economic burden of diseases demonstrated a chain mediating effect in this relationship, contributing to 0.759% of the total effect.ConclusionThe chain-mediated model effectively elucidated the mediating roles of ADL and economic burden of diseases in the association between chronic diseases and depressive symptoms among older adults. The study underscores the need for policymakers to focus attentively on the mental health of older adults with chronic diseases. Enhancing the capacity for ADL and strengthening social security to mitigate the economic burden of diseases are recommended strategies to alleviate depressive symptoms in older adults.
Treatment of bipolar depression: clinical practice vs. adherence to guidelines—data from a Bavarian drug surveillance project
Authors: Kriner Paul , Brieger Peter , Pogarell Oliver , Schüle Cornelius , Mußmann Lisa , Korbmacher Julie , Seemüller Florian 
Published: July 2024

ObjectivesPharmacotherapy of bipolar depression (BPD) is confronted with major clinical challenges, like limited evidence-based treatment options, regular cases of treatment resistance, and risk of treatment-emergent affective switches. Medical guidelines can support practitioners to make decisions based on current scientific evidence. The objective of this study is to evaluate to what extent recommendations of the 2019 German S3 guidelines “Diagnosis and Treatment of Bipolar Disorders” are reflected in clinical practice in inpatient treatment.MethodsWe conducted a descriptive analysis of prescription numbers in 2,627 patients with BPD in a naturalistic inpatient setting analyzing data from the ongoing Bavarian multicenter drug safety project Pharmaco-Epidemiology and Vigilance (Pharmako-EpiVig) from the years 2014–2022.ResultsOf the patients, 38% were not administered any drug explicitly recommended for treatment of BPD, that is, quetiapine, lamotrigine, carbamazepine, or olanzapine. Only 6% of the patients received monotherapy with one of those drugs. Of the patients, 34% were administered ≥4 psychotropic drugs simultaneously. Patients received 912 different therapy regimens of mono or combination therapy with mood stabilizers (MS), atypical antipsychotics (AAP), and antidepressants. Of the patients, 72% received an antidepressant and 6% without concomitant prescription of an AAP or MS. Prescription rates of venlafaxine (21% to 14%) and tricyclic antidepressants (9% to 6%) decreased significantly from the first (2014–2016) to the last (2020–2022) observed time period. Of the patients, 60% received an MS. Prescription rate of valproate (22% to 14%) decreased significantly, while lithium prescription increased significantly (29% to 35%). Of the patients, 71% were administered an AAP. Quetiapine was the most prescribed drug overall (43%). Only two patients were administered a combination of olanzapine and fluoxetine.ConclusionOur results demonstrate a substantial gap between guideline recommendations and current clinical practice. The remarkable heterogeneity in treatment regimens, with no discernible dominant treatment approach, is in part a reflection of the complexity of bipolar disorder but also substantiates the need of comprehensive recommendations regarding combination therapies. Increase in lithium prescription is an encouraging development due to its unique efficacy in maintenance treatment. To improve the quality of clinical practice guideline implementation, more randomized controlled trials should be conducted in the future to prospectively investigate different implementation strategies.
Outcome in acute ischemic stroke patients with large-vessel occlusion and initial mild deficits
Authors: Kazmi Jacob S. , O'Hara Joseph , Gandomi Amir , Wang Jason J. , Sanmartin Maria X. , Yang Bo , Sanelli Pina C. , Katz Jeffrey M. 
Published: July 2024

BackgroundThe management of patients with initially mild acute ischemic stroke (AIS), defined by the National Institutes of Health Stroke Scale (NIHSS) scores 0–5, remains ambiguous despite advances in stroke treatment. The early identification of patients likely to deteriorate is critical in preventing lasting disability.AimsWe investigated the frequency and early predictors of poor functional outcomes in AIS patients with large-vessel occlusion (LVO) and initial mild deficits.MethodsWe performed a retrospective observational study of consecutive AIS patients admitted to a single comprehensive stroke center between 2018 and 2021. The inclusion criteria were a diagnosis of AIS, an arrival NIHSS score of 0–5, imaging-confirmed LVO, and arrival within 24 h of the last-known-well time. The primary outcome was the change in the discharge-modified Rankin Score (ΔmRS) from baseline, categorized as 0–1 (stable outcome) or &gt;1 (poor outcome). Early neurological deterioration was defined as a mean NIHSS score increase of &gt;1 in the first 24-h period. Univariate and multivariable regression analyses were performed. The mean daily NIHSS scores were compared between groups using an analysis of variance (ANOVA).ResultsOf 4,410 stroke admissions, 120 patients met the study inclusion criteria, with 71 (59.2%) patients having a ΔmRS of 0–1 and 49 (40.8%) patients having a ΔmRS of &gt; 1. The mean arrival NIHSS score was similar between groups. However, the mean first-24-h NIHSS score was significantly higher in the poor outcome group vs. the stable outcome group (2.13 vs. 0.95, p &lt; 0.001). A demographic-adjusted multivariable logistic regression revealed that a higher mean first-24-h NIHSS score was the sole early predictor of poor outcome (odds ratio [OR] of 1.65 and a 95% confidence interval [CI] of [1.18, 2.48]). The only association with early neurological deterioration was vertebral artery occlusion, with an OR of 0.35 and a 95% CI of [0.14, 0.81]. The trending mean daily NIHSS scores revealed that patients with poor outcomes deteriorate within 24 h, a significant difference from the stable group (p &lt; 0.001).ConclusionPoor outcomes occurred in a significant proportion of LVO patients with initial mild deficits. The only association was early neurological deterioration. To prevent poor outcomes, rapid identification of any clinical deterioration should prompt consideration of thrombectomy.
Is Night Surgery a Nightmare for Lung Transplantation?
Authors: Tanaka Sébastien , De Tymowski Christian , Dupuis Erevan , Tran-Dinh Alexy , Lortat-Jacob Brice , Harpan Adela , Jean-Baptiste Sylvain , Boudinet Sandrine , Tahri Chahra-Zad , Salpin Mathilde , Castier Yves , Mordant Pierre , Mal Hervé , Girault Antoine , Atchade Enora , Montravers Philippe ,   the Bichat Lung Transplant Group
Published: July 2024

Night work is frequently associated with sleep deprivation and is associated with greater surgical and medical complications. Lung transplantation (LT) is carried out both at night and during the day and involves many medical healthcare workers. The goal of the study was to compare morbidity and mortality between LT recipients according to LT operative time. We performed a retrospective, observational, single-center study. When the procedure started between 6 AM and 6 PM, the patient was allocated to the Daytime group. If the procedure started between 6 PM and 6 AM, the patient was allocated to the Nighttime group. Between January 2015 and December 2020, 253 patients were included. A total of 168 (66%) patients were classified into the Day group, and 85 (34%) patients were classified into the Night group. Lung Donors’ general characteristics were similar between the groups. The 90-day and one-year mortality rates were similar between the groups (90-days: n = 13 (15%) vs. n = 26 (15%), p = 0.970; 1 year: n = 18 (21%) vs. n = 42 (25%), p = 0.499). Daytime LT was associated with more one-year airway dehiscence (n = 36 (21%) vs. n = 6 (7.1%), p = 0.004). In conclusion, among patients who underwent LT, there was no significant association between operative time and survival.
Sofosbuvir-based Antiviral Treatment in Patients with HCV and Chronic Kidney Disease
Authors: Козаченко М.Г. , Литвинчук Д.В. , Карпов И.А. , Данилов Д.Е. , Захарченко Т.С. , Карабань А.А. 
Published: July 2024

Введение. Противовирусное лечение хронического гепатита С имеет важное значение для системы здравоохранения. Большинство схем лечения включают противовирусный препарат софосбувир, по применению которого у пациентов со сниженной функцией почек длительное время имелись ограничения. Цель. Оценить эффективность и безопасность противовирусного лечения ВГС-инфекции препаратами прямого действия с включением софосбувира у пациентов с хронической болезнью почек. Материалы и методы. В исследование включено 116 пациентов, у которых проводилось противовирусное лечение гепатита С на базе УЗ «ГКИБ» г. Минска в период с 2019 по 2023 г., в том числе 16 пациентов с хронической болезнью почек и 100 пациентов без хронической болезни почек. Использовались схемы: софосбувир + даклатасвир, софосбувир/велпатасвир, софосбувир/ледипасвир. Результаты. Частота достижения устойчивого вирусологического ответа у пациентов с хронической ВГС-инфекцией и хронической болезнью почек составила 100% (15/15) как через 12 недель, так и через 24 недели после завершения противовирусного лечения и была сопоставима с эффективностью лечения у пациентов без почечной патологии. Ни у одного из пациентов с хронической болезнью почек как в процессе противовирусного лечения хронической ВГС-инфекции, так и после его завершения не отмечалось статистически значимых изменений уровня креатинина и мочевины по сравнению с пациентами без хронической патологии почек. Заключение. Применение софосбувирсодержащих схем противовирусного лечения хронической ВГС-инфекции с хронической болезнью почек, включая пациентов на программном гемодиализе, характеризуется высокой эффективностью и безопасностью.
Introduction. Access to the antiviral treatment for chronic hepatitis C is essential for public health. Most antiviral regimens include sofosbuvir, which has been restricted for a long time in patients with renal insufficiency. Purpose of the study. To evaluate the efficacy and safety of HCV treatment with sofosbuvir-based antiviral regimens in patients with chronic kidney disease. Materials and methods. The study included 116 patients with antiviral treatment for hepatitis C in Minsk City Hospital for Infectious Diseases from 2019 to 2023, including 16 patients with chronic kidney disease and 100 patients without chronic kidney disease. The following regimens were used: sofosbuvir + daclatasvir, sofosbuvir/velpatasvir, sofosbuvir/ledipasvir. Results. All patients with chronic HCV infection and chronic kidney disease (15/15; 100%) achieved sustained virologic response both at 12 weeks and 24 weeks. Treatment results were comparable to those of patients without renal pathology. Both during and after antiviral treatment, none of the patients with chronic kidney disease had statistically significant changes in creatinine and urea levels. Sofosbuvir-based regimens are effective and safe in patients with chronic HCV infection and chronic kidney disease, including patients on hemodialysis.
RESPUESTA DE GRUPOS DE MAIZ DE DIFERENTE PRECOCIDAD A ETAPAS DE SEQUIA CONTROLADA
Authors: Martín del Campo-Valle Salvador , Luna-Flores Maximino 
Published: July 2024

Nueve variedades de maíz (Zea mays L.) de temporal, clasificadas en tres grupos de precocidad con 3 variedades por grupo, fueron sometidas a cuatro períodos únicos de sequía en las siguientes cuatro etapas fenológicas: de emergencia a 30 días, de 30 a 60 días, de 60 a 90 días y de 90 a 120 días después de la siembra. Cada etapa de sequía consistió en suspender el riego por aproximadamente 30 días, excepto en los tratamientos control los cuales se mantuvieron con humedad edáfica aprovechable durante todo el ciclo. Se observaron diferencias altamente significativas entre los efectos debidos a las etapas de sequía, a la precocidad y a las variedades dentro de grupos, pero las interacciones entre las etapas de sequía y grado de precocidad y de éstas con variedades no fueron significativas. Las correlaciones fenotípicas entre días a floración, rendimiento de grano y biológico, índice de cosecha y otros ocho caracteres fueron positivas y altamente significativas. No hubo correlación entre los índices de área foliar y de cosecha.
ESTIMACION DE LA VARIANZA AMBIENTAL INTRAPARCELAR EN EL DISEÑO I DE CAROLINA DEL NORTE
Authors: Sahagún-Castellanos Jaime 
Published: July 2024

La variación de origen ambiental que se produce entre las plantas de una misma parcela es de importancia teórica y aplicada en el mejoramiento genético de los cultivos. El problema de contar con un estimador de la varianza asociada a este tipo de variabilidad no ha sido totalmente resuelto puesto que de los estimadores existentes unos se basan en materiales genéticos y/o condiciones diferentes de las que se tienen en un programa de mejoramiento particular, en tanto que otros que si bien no adolecen de este problema no han sido caracterizados en términos de sus bondades como estimadores. En este estudio, utilizando el diseño I de Carolina del Norte, mediante la solución de un sistema de ecuaciones entre cuadrados medios y sus valores esperados, éstos en términos de varianzas aditiva, de dominancia y de variación ínter e intraparcelar, se identificó un estimador de la varianza ambiental intraparcelar que no tiene los problemas antes mencionados. Adicionalmente, se determinó la varianza de este estimador y la manera de estimarla.
Experience in implementing a preventive disinfection department in a large multidisciplinary hospital. development prospects
Authors: Salakhetdinova Elvira Kharisovna ,   St. Petersburg State Budgetary Healthcare Institution «Elizavetinskaya Hospital», Shirai Olga Vladimirovna , Savintseva Elena Ivanovna ,   St. Petersburg State Budgetary Healthcare Institution «Elizavetinskaya Hospital»,   St. Petersburg State Budgetary Healthcare Institution «Elizavetinskaya Hospital»
Published: July 2024

The flock was prepared on the basis of a report made at the scientific and practical conference «Organization of deratization measures in modern conditions, topical issues of disinfection activities in the conditions of medical organizations of various profiles,» held May 15–16, 2024 in St. Petersburg. The interaction between the medical and non-medical units of the hospital, their well-coordinated work is one of the most important factors in the provision of high-quality medical care in a large multidisciplinary hospital. The implementation of preventive and anti-epidemic activities is often distributed among departments, and non-medical specialists do not always understand the need for these measures. To improve the quality of medical care and improve the interaction between services, a new department was introduced into the staff of a large multidisciplinary hospital – the department of preventive disinfection. Keywords: multidisciplinary hospital, preventive disinfection department, linen regime, disinfectants, disinfection, deratization, medical waste management, disinfection chamber, preventive activities, anti-epidemic measures, interaction between medical and non-medical units.
La réflexivité au cœur du droit constitutionnel comparé
Authors: Buixan Alexis 
Published: July 2024

Réfléchir à l’émergence du concept de « culture de constitution » dans le débat académique pose la question de l’intériorisation par les acteurs politiques et juridiques des formes constitutionnelles dans leurs pratiques politiques. Inscrit dans une démarche comparatiste, ce phénomène permet de mettre en évidence des trajectoires nationales singulières, déterminées par l’histoire, les mœurs, les contextes sociaux et les règles de droit. Ce concept devient ainsi un étalon pour éprouver la légitimité et l’adhésion ressenties à l’égard de la Constitution. Une telle méthode juridico-culturelle nous informe plus largement sur la fonction réflexive du droit constitutionnel comparé : « connaître l’autre pour mieux se connaître soi-même ».
L’État administratif aux États-Unis
Authors: Michaut Maud 
Published: July 2024

Qu’implique l’étude d’un droit administratif étranger ? Inscrire une recherche dans le champ disciplinaire du « droit étranger » soulève d’abord la question de la manière dont il convient d’envisager la relation de ce dernier avec celui du « droit comparé ». À bien des égards, la distinction généralement établie semble devoir être nuancée, notamment parce qu’un droit étranger ne peut être compris et présenté que par rapport au droit national. Quant au droit administratif étranger, le constat majoritaire a longtemps été celui d’une certaine indifférence des comparatistes à l’égard du droit administratif, et des administrativistes à l’égard du droit comparé. Pourtant, outre que l’étude d’un droit administratif étranger présente un grand intérêt pour la compréhension du système de gouvernement considéré, elle permet également d’envisager son droit administratif national avec un regard renouvelé et critique.
Représenter la doctrine publiciste britannique : essai de comparaison juridique critique
Authors: Padilla Marie 
Published: July 2024

Dans sa conférence donnée en 1983, The Search for Principle, Lord Goff reconnaît le rôle joué par les professeurs de droit dans la construction des normes juridiques pour le système britannique. À rebours d’une représentation anglaise et française de l’« anti-modèle » doctrinal britannique, cette reconnaissance judiciaire ouvre la possibilité de (re)penser le rôle des professeurs de droit britannique comme répondant à une définition fonctionnelle de la notion de doctrine. Néanmoins, la saisie de l’objet doctrinal dans une démarche comparative suppose au préalable de discuter les cadres méthodologiques et théoriques, permettant non pas d’étudier le droit positif, mais, au contraire, le discours sur le droit. L’approche comparée ici proposée est celle d’un double regard critique, à la fois du droit comparé classique, mais aussi de l’épistémologie juridique.
Ensino Musical e Enriquecimento Curricular
Authors: Cordeniz Vera Inácio 
Published: July 2024

Este artigo aborda os contornos da política de ação pública - “Escola a Tempo Inteiro” (ETI), compreendendo a operacionalização, passados cerca de 15 anos desta implementação, em Portugal Continental, numa interligação à possível igualdade de oportunidades a outras atividades - ensino da música (1.º ciclo Ensino Básico), assinalando o papel de poder do Estado. A metodologia analisa um conjunto de documentação legislativa/especializada e estudos científicos e procuramos compreender as implicações do ensino musical no enriquecimento curricular (AEC), em articulação com a nossa experiência. Assinalamos a aplicação desta política na Região Autónoma da Madeira, por terem sido os pioneiros, no contexto português e fazemos um paralelo com a Escola a Tempo Integral brasileira, de modo a percecionar diferenças e semelhanças na educação artístico-musical. Concluímos com uma abordagem da transposição da ETI a outros ciclos de estudo questionando o tempo/ludicidade das AEC, aliados a ferramentas de poder das políticas de ação pública.