bluuebunny/crossref_metadata_2025_split huggingface dataset:
Providing “a beam of light to see the gaps”: determinants of implementation of the Systems Analysis and Improvement Approach applied to the pediatric and adolescent HIV cascade in Kenya
Authors: Beima-Sofie Kristin , Wagner Anjuli D. , Soi Caroline , Liu Wenjia , Tollefson Deanna , Njuguna Irene N. , Ogutu Emily , Gaitho Douglas , Mburu Nancy , Oluoch Geoffrey , Mwaura Peter , Cherutich Peter , Oyiengo Laura , John-Stewart Grace C. , Nduati Ruth , Sherr Kenneth , Gimbel Sarah 
Published: July 2022

Abstract
Background
Children and adolescents living with HIV have poorer rates of HIV testing, treatment, and virologic suppression than adults. Strategies that use a systems approach to optimize these multiple, linked steps simultaneously are critical to close these gaps.

Methods
The Systems Analysis and Improvement Approach (SAIA) was adapted and piloted for the pediatric and adolescent HIV care and treatment cascade (SAIA-PEDS) at 6 facilities in Kenya. SAIA-PEDS includes three tools: continuous quality improvement (CQI), flow mapping, and pediatric cascade analysis (PedCAT). A predominately qualitative evaluation utilizing focus group discussions (N = 6) and in-depth interviews (N = 19) was conducted with healthcare workers after implementation to identify determinants of implementation. Data collection and analysis were grounded in the Consolidated Framework for Implementation Research (CFIR).

Results
Overall, the adapted SAIA-PEDS strategy was acceptable, and the three tools complemented one another and provided a relative advantage over existing processes. The flow mapping and CQI tools were compatible with existing workflows and resonated with team priorities and goals while providing a structure for group problem solving that transcended a single department’s focus. The PedCAT was overly complex, making it difficult to use. Leadership and hierarchy were complex determinants. All teams reported supportive leadership, with some describing in detail how their leadership was engaged and enthusiastic about the SAIA-PEDS process, by providing recognition, time, and resources. Hierarchy was similarly complex: in some facilities, leadership stifled rapid innovation by insisting on approving each change, while at other facilities, leadership had strong and supportive oversight of processes, checking on the progress frequently and empowering teams to test innovative ideas.

Conclusion
CQI and flow mapping were core components of SAIA-PEDS, with high acceptability and consistent use, but the PedCAT was too complex. Leadership and hierarchy had a nuanced role in implementation. Future SAIA-PEDS testing should address PedCAT complexity and further explore the modifiability of leadership engagement to maximize implementation.
Intervention, individual, and contextual determinants to high adherence to structured family-centered rounds: a national multi-site mixed methods study
Authors: Knighton Andrew J. , Bass Ellen J. , McLaurin Elease J. , Anderson Michele , Baird Jennifer D. , Cray Sharon , Destino Lauren , Khan Alisa , Liss Isabella , Markle Peggy , O’Toole Jennifer K. , Patel Aarti , Srivastava Rajendu , Landrigan Christopher P. , Spector Nancy D. , Patel Shilpa J. 
Published: July 2022

Abstract
Background
Effective communication in transitions between healthcare team members is associated with improved patient safety and experience through a clinically meaningful reduction in serious safety events. Family-centered rounds (FCR) can serve a critical role in interprofessional and patient-family communication. Despite widespread support, FCRs are not utilized consistently in many institutions. Structured FCR approaches may prove beneficial in increasing FCR use but should address organizational challenges. The purpose of this study was to identify intervention, individual, and contextual determinants of high adherence to common elements of structured FCR in pediatric inpatient units during the implementation phase of a large multi-site study implementing a structured FCR approach.

Methods
We performed an explanatory sequential mixed methods study from September 2019 to October 2020 to evaluate the variation in structured FCR adherence across 21 pediatric inpatient units. We analyzed 24 key informant interviews of supervising physician faculty, physician learners, nurses, site administrators, and project leaders at 3 sites using a qualitative content analysis paradigm to investigate site variation in FCR use. We classified implementation determinants based on the Consolidated Framework for Implementation Research.

Results
Provisional measurements of adherence demonstrated considerable variation in structured FCR use across sites at a median time of 5 months into the implementation. Consistent findings across all three sites included generally positive clinician beliefs regarding the use of FCR and structured rounding approaches, benefits to learner self-efficacy, and potential efficiency gains derived through greater rounds standardization, as well as persistent challenges with nurse engagement and interaction on rounds and coordination and use of resources for families with limited English proficiency.

Conclusions
Studies during implementation to identify determinants to high adherence can provide generalizable knowledge regarding implementation determinants that may be difficult to predict prior to implementation, guide adaptation during the implementation, and inform sustainment strategies.
Empowerment resources, decision-making and gender attitudes: which matter most to livestock keepers in the mixed and livestock-based systems in Ethiopia?
Authors: Kinati Wole , Baker Derek , Temple Elizabeth C. , Najjar Dina , Mulema Annet Abenakyo 
Published: July 2022

Abstract
Background
Women's empowerment constitutes an important aspect of the development agenda. Although it is highly contextual in nature, empowerment literature so far has focussed on identifying factors associated with empowerment, neglecting the importance of understanding which empowerment resources and agency dimensions are more important for whom and under what contexts. This is important, because we cannot talk of empowerment for those who are not in a disempowered condition or who do not value it. We examine the gender differences in the relative valuations of empowerment resources and decision-making areas across different farming systems, and examine the most valued empowerment resources.

Methods
Using a mixed methods approach, data on major household decisions, empowerment resources, and their relative importance were collected. Pairwise ranking methods were used to assess their gendered relative importance. Individual interviews using Ryff’s psychological well-being (PWB) items were conducted to obtain quantitative data on the key empowerment resource, which emerged as an important aspect of empowerment from the pairwise ranking exercises. Drawing on the empowerment framework and self-determination theory, we analysed the data.

Results
Our results show that the major empowerment resources and decision-makings that are valuable to men and women vary across gender and farming systems. In general, men place a greater importance on decisions about livestock, crop and finances. The women valued decisions regarding crop, livestock and social relations. Regarding empowerment resources, psychological well-being was found to be one of the most important resources, for women as well as men. Assessment of the basic psychological needs―autonomy, self-acceptance, and positive relations―statistically yielded no significant differences between the gender groups. However, the effects of location and the intersection of location with gender were both found to be statistically significant, suggesting that being men and from Horo is associated with higher scores on self-acceptance and personal relation subscales.

Conclusions
We conclude that gender and location play important roles in forming contextual conditions for empowerment and agency implying that empowerment efforts need to consider both. More specifically, policies and intervention efforts to empower individuals or groups must begin by first building their psychological assets and consider contextual gendered perceptions of resources.
Results of transanal endoscopic resections in rectal cancer
Authors: Nikitenko R. , Vorotyntseva K. , Degtiarenko S. , Mishchenko V. , Stepanovichus E. 
Published: July 2022

Introduction. Rectal cancer is the most widespread form of cancer in different countries of the world, without regard to gender, and reaches 8–9% of the total number of all cancers. It is necessary to further improve and study modern methods of both surgical and combined integrated approach to the treatment of patients with rectal cancer. Lymphatic cancer spread is one of the most important causes of local recurrence of rectal cancer and an unfavorable prognostic.
Aim of the study: to study and improve the results of treatment of patients with rectal cancer during transanal endoscopic microsurgery with staining “sentinel” lymph nodes.
Materials and methods. In the period from 2009 to 2021, 92 patients with rectal cancer were operated on at the Odessa Regional Clinical Hospital using transanal endoscopic resections. All 92 patients were divided into 2 groups. In group I, 45 patients were diagnosed stage I rectal cancer (T1-2N0M0. In group II, 47 patients were diagnosed stage II rectal cancer (T3N0M0) before surgery. In group I, a standard TEM procedure was performed. In group II, taking into account the presence of stage II RC in patients, and the high possibility of recurrence and metastasis, after performing local excision of tumors using the TEM method, we improved this method.
Results. The average time of the hospital stay was (3.4±1.7) days (from 2 to 6 days). The lower edge of the tumor was at the average height of (9.5±4.2) cm from the anal canal (from 5 to 18 cm), the average size of the tumor was from (2.8±1.7) cm (from 1.5 to 4 cm). The average follow-up period ranged from 12 to 60 months. Recurrence of rectal cancer was found in 6 (6.5%) patients, group I.
Conclusions. One of the most important prognostic factors of the development of the RC local recurrence is the regional lymph nodes involvement. Identification and target study of the “sentinel” LN in patients with RC most likely make it possible to assess the stage of the disease and apply an adequate scheme of the complex treatment.
Imeglimin: features of the mechanism of action and potential benefits
Authors: Kuznetsov K. O. , Saetova A. A. , Mahmutova E. I. , Bobrik A. G. , Bobrik D. V. , Nagaev I. R. , Khamitova A. D. , Arapieva A. M. 
Published: July 2022

Imeglimin is the first drug in a new class of tetrahydrotriazine-containing oral hypoglycemic agents called «glimines». Its mechanism of action is aimed at achieving a double effect, firstly, to improve the function of beta cells of the pancreas, and secondly, to enhance the action of insulin in key tissues, including the liver and skeletal muscles. At the cellular level, imeglimin modulates mitochondrial function, which leads to an improvement in cellular energy metabolism, as well as to the protection of cells from death in conditions of excessive accumulation of reactive oxygen species. It is important to note that the mechanism of action of imeglimin differs from existing drugs used for the treatment of type 2 diabetes mellitus. Like glucagon-like peptide-1 receptor agonists, imeglimin enhances insulin secretion in an exclusively glucose-dependent manner, but their mechanism of action at the cellular level diverges. Sulfonylureas and glinides function by closing ATP-sensitive potassium channels to release insulin, which is also different from imeglimin. Compared with metformin, the effect of imeglimine is also significantly different. Other major classes of oral antihypertensive agents, such as sodium-glucose transporter-2 inhibitors, thiazolidinediones and α glucosidase inhibitors mediate their action through mechanisms that do not overlap with imeglimine. Given such differences in the mechanisms of action, imeglimin can be used as part of combination therapy, for example with sitagliptin and metformin. The imeglimine molecule is well absorbed (Tmax-4), and the half-life is 5–6 hours, is largely excreted through the kidneys, and also has no clinically significant interactions with either metformin or sitagliptin.
Evaluation of FreeStyle Libre in pediatric t1dm: improved glycemic control, reduction in diabetic ketoacidosis and severe hypoglycemia
Authors: Laptev D. N. , Bezlepkina O. B. , Demina E. S. , Malievskiy O. A. , Nikitina I. L. , Samoilova I. G. , Peterkova V. A. 
Published: July 2022

BACKGROUND: Self-monitoring of blood glucose (SMBG) with glucometers provides only a snapshot of the glycemic profile and is accompanied by significant psychological discomfort and pain, especially in children. Flash Glucose Monitoring System — FreeStyle Libre (FSL) overcomes many of the barriers associated with glucose measurement and improves metabolic control.AIM: To evaluate the efficacy of FSL in children with type 1 diabetes mellitus (T1DM) in terms of glycemic control, episodes of severe hypoglycemia (SH) and diabetic ketoacidosis (DKA).MATERIALS AND METHODS. A multicenter, prospective, observational study in real clinical practice was carried out. A total of 469 subjects (258 boys and 211 girls) aged 4–18 were included in the study. The median age was 11.3 (8.4–14.6) years, duration of T1DM — 4.2 (2.1–7.1) years. After FSL start, patient was followed up for 6 months.RESULTS: After 3 and 6 months of FSL use, HbA1c significantly decreased from 7.4% to 7.1% and 7.2%, respectively (p<0.001). The number of children with HbA1c ><7.5% increased from 51% to 60% and 58% at 3 and 6 months, respectively (p><0.001). The incidence of DKA and SH, as well as the proportion of patients experiencing at least one episode of DKA and SH, were significantly reduced after 6 months of FSL use compared with baseline (p><0.001).CONCLUSION: The Study demonstrated a significant improvement in metabolic control in children with T1DM 6 months after FSL start: decrease in HbA1c, accompanied by reduction in incidence of DKA and SH.
The dual role of the menopausal hormonal therapy as the enhancer of pleiotropic telomere rejuvenation and the silencer of cellular aging (literature review)
Authors: Grigoryan O. R. , Frolova T. M. , Mikheev R. K. , Sheremetyeva E. V. , Absatarova Yu. S. , Uzhegova Z. A. , Andreeva E. N. , Mokrysheva N. G. 
Published: July 2022

Present worldwide healthcare researches prove that female patients are more sensitive to the population aging. Menopause or climacteria (climax) — is not as ageing itself, but a physiological unstoppable process. The main task for a physician is to improve life quality for female despite of ageing problems. Menopausal hormone therapy (MHT) due to the estrogen component has an anti-inflammatory, antioxidant effect and promotes the expression of telomerase, which together changes the homeostasis and integrity of telomeres. The use of MHT for five years or more can not only significantly change the quality of life, but also increase its duration. Literature search was carried out in national (eLibrary, CyberLeninka.ru) and international (PubMed, Cochrane Library) databases in Russian and English. The priority was free access to the full text of articles. The choice of sources was prioritized for the period from 2019 to 2021. However, taking into account the insufficient knowledge of the chosen topic, the choice of sources dates back to 1989.
Hypophysitis and reversible hypopituitarism developed after COVID-19 infection — a clinical case report
Authors: Gorbova N. Yu. , Vladimirova V P. , Rozhinskaya L. Y. , Belaya Zh. Y. 
Published: July 2022

AIM. To present a clinical case of reversible hypopituitarism due to hypophysitis developed after COVID-19 infection.MATERIALS AND METHODS. A patient with residual clinical manifestations of hypopituitarism underwent clinical evaluation at the time of symptoms of hypopituitarism and in follow-up. Morning serum cortisol (171–536 nmol/l) was measured by electrochemiluminescence immunoassay. Morning ACTH (7.2–63.3 pg/ml), prolactin (66–436 mU/l), TSH (0.25–3.5 mIU/L), fT4 (9–19 pmol/l) and fT3 (2.6–5.7 pmol/l) were measured by chemiluminescence immunoassay. Data were analyzed throughout the course of the disease.RESULTS. A 35-year-old female developed clinical symptoms of hypopituitarism two months after recovery from a confirmed COVID-19 infection. Laboratory investigation confirmed hypocorticism, hypothyroidism, hypogonadism and the patient was prescribed appropriate hormonal therapy in January 2021. Four months later the symptoms were alleviated (April 2021) and there were signs of recovery shown by imaging and hormonal: morning serum cortisol 227 nmol/l, morning ACTH 33.96 pg/ml, prolactin 68.3 mU/l, TSH 2.626 mIU/L, fT4 10.75 pmol/l, fT3 3.96 pmol/l. Thyroid hormone was discontinued, but hypogonadism and hypocorticism persisted with estradiol — 51.48 pmol/l, 24h urine cortisol level — 41.8 nmol/day. MRI results showed that the signs of hypophysitis were alleviated in comparison with MRI from January 2021. Full recovery of pituitary axis was reported in October 2021, with recovery of normal menstrual cycle. Furthermore, hormonal profile was likewise normal.CONCLUSION. This report provides evidence of delayed damage to the pituitary gland after infection with the COVID-19, with recovery of its function and structure. To date, the mechanisms of such an impact are not entirely clear; further collection of data on such cases and analysis is required.
Clinical and demographic analysis of telemedicine «doctor-patient» consultations at the Endocrinology Research Centre
Authors: Gorbacheva A. M. , Logvinova O. V. , Mokrysheva N. G. 
Published: July 2022

BACKGROUND: The COVID-19 pandemic has accelerated the development of telemedicine technologies. Today there is evidence of the successful use of telemedicine in various fields of health care, in particular in endocrinology. At the same time, there is not enough information for effective integration of telemedicine into the management of patients with various endocrinopathies.AIM: The aim of this study is a clinical and demographic assessment of the structure of telemedicine consultations (TMC) conducted at the Endocrinology Research Centre in 2020–2021.MATERIALS AND METHODS: A single-stage, single-center retrospective study was conducted. The study included all patients who received at least one TMC at the Endocrinology Research Centre in 2020–2021. Clinical and demographic information was analyzed (gender, age of patients, region of residence, ICD-10 code). All patients signed voluntary informed consent for TMC. The obtained data were processed using the Microsoft Office 2013 software package.RESULTS: In 2020, 1,548 TMC were held, in 2021 — 4180 TMC. Among adults, women predominated in the structure of referrals (83–86%), among children there is a tendency towards equivalent referrals for boys and girls (in 2021 — 45% and 55%, respectively). The median age of adult patients in 2021 was 38 years [31; 53], among children — 11 years [7; 14]. In 2020, residents of 74 regions of the Russian Federation applied for TMC, in 2021 — of 82 regions. There is a tendency towards the prevalence of patients from the Central, Volga, Southern and North Caucasian federal districts in the TMC structure. Diseases of the thyroid gland predominated in the nosological structure of TMC.CONCLUSION: TMC turned out to be in demand in patients with a wide variety of endocrinopathies. It is important to conduct further analysis of both the TMC market and the effectiveness of remote counseling for various nosologies to determine the place of telemedicine in the modern healthcare structure and to introduce TMK into the system of clinical guidelines and programs of territorial compulsory medical insurance funds.
Prevention of iodine deficiency diseases: focus on regional targeted programs
Authors: Dedov I. I. , Platonova N. M. , Troshina E. A. , Makolina N. P. , Belovalova I. M. , Senyushkina E. S. , Melnichenko G. A. 
Published: July 2022

The strategy for the elimination of diseases associated with iodine deficiency throughout the Russian Federation is based on the adoption of a federal law providing for the use of iodized salt as a means of mass (population) iodine prophylaxis. Chronic iodine deficiency that exists in Russia leads to dramatic consequences: the development of mental and physical retardation in children, cretinism, thyroid diseases, and infertility. Under conditions of iodine deficiency, the risk of radiation-induced thyroid cancer in children in the event of nuclear disasters increases hundreds of times. By definition, all iodine deficiency diseases (IDDs) can be prevented, while changes caused by iodine deficiency during fetal development and in early childhood are irreversible and practically defy treatment and rehabilitation. The actual average consumption of iodine by a resident of Russia is only 40–80 mcg per day, which is 3 times less than the established norm (150–250 mcg). Every year, more than 1.5 million adults and 650 thousand children with various thyroid diseases turn to medical institutions. The cause of 65% of cases of thyroid disease in adults and 95% in children is insufficient intake of iodine from the diet. At the stage of preparing the relevant legislative act, the development and implementation of regional programs for the prevention of IDD is of utmost importance. A typical draft of such a program is proposed in this article for its adaptation and use at the regional level.
Combination of a global-search method with model selection criteria for the ellipsometric data evaluation of DLC coatings
Authors: Dorywalski K. , Lupicka O. , Grundmann M. , Sturm C. 
Published: July 2022

Abstract
A method for the evaluation of experimental data from spectroscopic ellipsometry is proposed which combines the global-search optimization algorithm with statistical model selection criteria. The hybrid genetic-gradient search algorithm (HGGA) is applied to find the optical parameters and thickness of a diamond-like carbon (DLC) coating deposited on SW7M stainless steel. Akaike and Bayesian information criteria are used to evaluate the different dielectric function models. The method is able to find optical model parameters even in case of a limited initial knowledge about the material optical constants. At the same time, the optimal dielectric function model for the description of the material optical properties can be selected unambiguously from the set of candidate models.