bluuebunny/crossref_metadata_2025 huggingface dataset:
EDUKASI SEBAYA MENINGKATKAN PENGETAHUAN TENTANG PENCEGAHAN PERILAKU SEKSUAL REMAJA
Authors: Ardina Rani
Published: July 2019

Perilaku seksual yang tidak sehat pada remaja semakin meningkat.Penelitian ini bertujuan untuk mengidentifikasi pengaruh edukasi sebaya terhadap pengetahuan dan sikap tentang perilaku seksual remaja di Pringsewu. Metode yang digunakan quasieksperimen yang terdiri dari dua kelompok; 41remaja putri sebagai kelompok intervensi dan 41 kontrol. Teknik pengambilan sampel yang digunakan adalah stratified randomsampling yang dilanjutkan dengan simplerandom sampling. Hasil penelitian menunjukkan edukasi sebaya berpengaruh secara signifikan terhadap pengetahuan (p=0,000). Edukasi sebaya dapat meningkatkan pengetahuan perilaku seksual pada remaja secara signifikan. Disarankan agar edukasi sebaya dapat digunakan sebagai salah satu upaya mengubah perilaku remaja yang bisa diintegrasikan dalam pelayanan keperawatan di sekolah.
Pengetahuan Ibu Dengan Toilet Training Pada Anak Usia Toddler (1-3 Tahun)
Authors: Kurniawati Desi
Published: July 2019

Toilet training merupakan suatu usaha untuk melatih anak agar mampu mengontrol dalam melakukan buang air kecil atau buang air besar. Penelitian ini bertujuan untuk mengetahui  hubungan tingkat pengetahuan ibu dengan toilet training pada anak usia toddler (1-3 tahun) di desa Bandung Baru Barat Kecamatan Adiluwih Kabupaten Pringsewu tahun 2015. Desain penelitian menggunakan Descriptif Analitik Korelasidengan metode pendekatan Cross Sectional. Populasi terdiri dari ibu yang memiliki anak usia toddler (1-3 tahun) yaitu 111 ibu, dan sampel yang diambil sebanyak 96 orang. Analisis dalam penelitian ini menggunakan Uji Chi Square.Hasil uji statistik diperoleh nilai p-value < α maka dapat disimpulkan bahwa ada hubungan yang bermakna antara pengetahuan dengan pelaksanaan toilet training. Bagi ibu yang memiliki anak usiatoddler (1-3 tahun) diharapkan lebih aktif dalam mencari informasi mengenai toilet training baik bertanya kepada petugas kesehatan, membaca buku atau majalah yang berkaitan dengan toilet training serta dapat mengakses informasi melalui televisi dan radio.
Faktor-Faktor Yang Berhubungan Dengan Tingkat Kecemasan Keluarga Pasien Stroke Di Rumah Sakit Mitra Husada Pringsewu
Authors: Riandini Wuri Okta , Fadhilah Nur , . Yusnita
Published: July 2019

Stroke adalah manifestasi klinis dari gangguan fungsi otak yang berlangsung cepat, lebih dari 24 jam atau sampai menyebabkan kematian tanpa penyebab lain selain gangguan vaskuler. Stroke merupakan penyebab utama kecacatan yang dapat dicegah, namun bagi sebagian masyarakat yang belum mengetahui tentang penyakit stroke hal ini akan menimbulkan kecemasan tersendiri bagi penderita maupun keluarga. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan tingkat kecemasan keluarga pasien stroke di Rumah Sakit Mitra Husada Pringsewu Tahun 2017. Penelitian ini menggunakan metode survei analitik dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah semua keluarga pasien stroke yang dirawat Rumah Sakit Mitra Husada Pringsewu dengan jumlah sampel 95 responden. Pengambilan sampel dilakukan dengan teknik purposive sampling. Analisis data menggunakan uji statistik chi square dengan tingkat kemaknaan 95% atau α = 0.05. Hasil analisis bivariat menunjukkan adanya hubungan yang signifikan antara umur (p=0.010), jenis kelamin (p=0.005) dan pendapatan (p=0.015) dengan tingkat kecemasan. Maka sangat penting dalam upaya pencegahan peningkatan kecemasan pada keluarga pasien khususnya bagi petugas kesehatan untuk lebih memperhatikan kondisi spikologis serta meningkatkan komunikasi dan informasi tanpa membedakan status pasien dan keluarga.
Analisis Perbandingan Berat Badan Akseptor Kontrasepsi Suntik 1 Dan 3 Bulan Di Bpm Yetty, S.St Sidoharjo Pringsewu
Authors: Wijayanti Yossy
Published: July 2019

Dua jeniskontrasepsi hormonal suntik yang paling banyak digunakan adalah kontrasepsi kombinasi 1 bulan dan kontrasepsi progestin 3 bulan. Kontrasepsi ini efektif dan reversible namun demikian efek sampingnya adalah peningkatan berat badan. Penelitian ini bertujuan untuk mengetahui perbandingan berat badan akseptor kontrasepsi suntik 1 dan 3 bulan.Penelitian ini menggunakan desain survey analitik dengan pendekatan crossectional. Sample yang digunakan adalah total sampling 43 akseptor suntik yang berkunjung bulan Januari 2016 dan pada akhir tahun Desember 2016 diukur kembali. Analisis menggunakan uji T Paired. Hasil berdasarkan data univariat didapatkan ada peningkatan berat badan pada kedua akseptor. Pada kontrasepsi 1 bulan 55,4(9,3) kg menjadi 56,9(10,7) kg. Kontrasepsi 3 bulan51,3 (9,8) kg menjadi 53,3(9,3) kg. Namun demikian analisis menunjukkan tidak ada perbedaan bermakna berat badan pada akseptor suntik 1 bulan (ρ=0.313), hal yang sama juga pada akseptor suntik 3 bulan yaitu (ρ=0,064). Kesimpulan pada penelitian ini terdapat kenaikan berat badan selama 1 tahun penggunaan kontrasepsi suntik 1 bulan dan 3 bulan namun tidak bermakna
Faktor Risiko Aspek Perilaku Berhubungan Dengan Diabetes Militus Tipe II
Authors: Yulianto Andri
Published: July 2019

Jumlah penderita diabetes militus semakin bertambah, terutama di negara ­maju sehingga berdampak terhadap penderita diabetes militus juga semakin meningkat di dunia. Diketahui faktor risiko aspek perilaku yang berhubungan dengan diabetes militus Tipe II terkontrol. Jenis penelitian dengan ­analitik kuantitatif. Penelitian dilakukan ­di Puskesmas Kota Dalam dengan Populasi sebanyak 854 ­penderita DM, dan sampel sebanyak 90 responden ­dengan simpel random sampling. Jenis data yang digunakan ­data primer. Analisa data yang digunakan yaitu analisis bivariat dengan Chi square. Distribusi frekuensi diabetes militus Tipe II dalam kategori tidak terkontrol sebanyak 51 (56,7%),  penderita diabetes militus Tipe II dalam kategori gemuk (IMT > 25 Kg) sebanyak 63 (70 %), ­pola makan penderita diabetes militus Tipe II dalam kategori ­risiko (pola makan tidak sesuai jadwal) ­sebanyak 49 (54,4%), aktivitas fisik penderita diabetes militus Tipe II dalam kategori ­­­­­tidak aktif (­­­­­­­­­­­­­olahraga < 5 kali perminggu dengan durasi 30 menit) ­sebanyak 52 (57,8%). Hasil uji statistic didapatkan ada hubungan pola makan, obesitas, dan aktifitas fisik  dengan kejadian diabetes militus Tipe II dengan pola makan (p – value = 0,026 dan OR = 3,168), obesitas (p – value = 0,000 dan OR = 5,425), dan aktifitas fisik  (p – value = 0,000 dan OR = 6,5) Peneliti menyarankan kepada ­pernderita DM yang mengalami obesitas di Wilayah Kerja Puskesmas Kota Dalam ­diharapkan untuk melakukan aktifitas fisik yang rutin seperti berolahraga (jogging, dan bersepeda), mengikuti senam DM yang diadakan Puskesmas ­dan mengatur pola makan.
hubungan pencemaran udara rumah tangga dengan kejadian infeksi saluran pernapasan akut (ispa) pada balita
Authors: Indarti Siti , . Istikomah
Published: July 2019

Penyakit Infeksi Saluran Pernapasan Akut (ISPA) merupakan salah satu penyebab utama kematian pada anak di bawah 5 tahun. World Health Organization (WHO) memperkirakan insiden ISPA di negara berkembang di atas 40 per 1000 kelahiran hidup. Pada tahun 2000 terdapat 1,9 juta (95%) anak-anak di seluruh dunia meninggal karena ISPA, 70 % diantaranya berasal dari Afrika dan Asia Tenggara (WHO, 2002). Penyakit ISPA dipengaruhi oleh berbagai faktor, salah satunya yaitu pencemaran udara dalam rumah (asap hasil pembakaran bahan bakar memasak, asap rokok, dan asap penggunaan obat anti nyamuk). Tujuan penelitian ini adalah untuk mengetahui hubungan pencemaran udara rumah tangga dengan kejadian ISPA pada balita. Penelitian ini merupakan penelitian observasional dengan pendekatan cross sectional dilakukan di Desa Way Ngison wilayah kerja puskesmas Pagelaran. Subjek yang diteliti yaitu seluruh ibu yang memiliki anak balita di Desa Way Ngison Pagelaran sebanyak 40 responden. Hasil penelitian dengan  menggunakan uji chi square didapatkan nilai p value= 0,007. Hasil penelitian menunjukkan bahwa ada hubungan pencemaran udara rumah tangga dengan kejadian ISPA pada balita di desa Way Ngison wilayah kerja puskesmas Pagelaran kabupaten Pringsewu Lampung tahun 2017 dengan nilai p=0,007.
Efektifitas Penggunaan Electricblanketpada Pasien Yang Mengalami Hipotermi Post Operasi Di Instalasi Bedah Sentral (Ibs) Rumah Sakit Umum Daerah Palembang Bari Tahun 2018
Authors: Suswita Dessy
Published: July 2019

Perubahan fisiologis pada tubuh pasien yang menjalani pembedahan menurut Brunner & Suddarth(2002) dapat berupa penurunan suhu tubuh atau hipotermi. Hipotermi merupakan keadaan suhu tubuh berada dibawah batas normal fisiologis, yaitu 36,6oC – 37,5oC.Hipotermi dapat terjadi pada pasien yang mengalami pembedahan dan disebabkan oleh beberapa faktor. Penanganan yang bisa diberikan untuk mengatasi permasalah hipotermi tersebut diantaranya dengan pemberian selimut hangat elektrik. Tujuan penelitian ini adalah untuk mengetahuiefektifitaspenggunaan electricblanketdalam mengatasi hipotermi pada pasien post operasi. Penelitian di laksanakan di Instalasi Bedah Sentral RSUD Palembang BARIpada tanggal 15 Juni – 27 Juni 2018.Penelitian ini merupakan quasi eksperimen dengan Posttest Only Control Group Design, dan menggunakan sampel sebanyak 22 responden yang terdiri dari 11 responden sebagai kelompok intervensi dan 11 responden sebagai kelompok kontrol.Metode analisisyang digunakan adalah uji parametric dengan independen t-tes. Hasil penelitian menunjukkan rata-rata waktu yang diperlukan untuk mencapai suhu normal pada kelompok intervensi dengan electric blanketadalah 15,9 menit dan dengan selimutbiasa26,7 menit. Berdasarkan uji statistikdiperoleh pvalue yang sangat jauh dibawah 0,05 (nilai signifikasi output 0,000)sehingga dapat disimpulkan electricblanket lebih efektif untuk meningkatkan suhu tubuh dibandingkan selimut biasa. Sehingga peneliti menyarankan pihak rumah sakit agar menjadikan electricblanketsebagaiselimut alternatif pada pasien pasca operasi dalam upaya untuk meningkatkan keselamatan pasien dan meningkatkan mutu pelayanan Rumah Sakit.
Perancangan Dan Implementasi Sistem Informasi Pembayaran Pada Perguruan Tinggi Menggunakan Web Services Metode H2H Dari Perbankan
Authors: Pradesan Iis
Published: July 2019

Teknologi telah berpengaruh besar di segala aspek kehidupan manusia dari kebutuhan komersial, hingga dimanfaatkan sebagai alat hiburan semata. Teknologi tersebut juga telah mempengaruhi aktivitas perbankan, nasabah tidak lagi harus bertatap muka dengan teller, cukup dengan smartphone dan koneksi internet maka semua aktivitas perbankan terselesaikan saat itu juga. Salah satu bentuk perkembangan teknologi perbankan yang telah dirilis saat ini adalah sistem pembayaran Host to Host (H2H), sistem ini akan terhubung melalui jaringan internet langsung dengan server (host) yang dimiliki sebuah institusi, sehingga request yang dilakukan terhadap data trasaksi perbankan dapat diresponse secara realtime. Salah satu institusi yang dapat memanfaatkan H2H antara lain perguruan tinggi terkait aktivitas pembayaran yang dilakukan mahasiswa. Namun H2H harus dijembatani sebuah interface/aplikasi yang berfungsi sebagai web services yang tentunya mempermudah dalam melakukan komunikasi dengan H2H. Untuk itu penelitian ini bertujuan melakukan perancangan dan pengimplementasian Web Service dengan metode H2H dari perbankan, adapun metode penelitian yang digunakan adalah deskriptif dengan metodologi pengembangan sistem informasi RUP dan UML sebagai tool dalam pemodelannya dan berbasis web application menggunankan framework Laravel dalam tahap pengembangannya
Street Food: A Tool for Promoting Tradition, Territory, and Tourism
Authors: Alfiero Simona , Bonadonna Alessandro , Cane Massimo , Lo Giudice Agata
Published: July 2019

Around 2.5 billion people worldwide consume street food every day, thanks to it being low cost, easily available, and convenient. Street food also has high socioeconomic value, as it fosters preservation of the local cultural and food heritage, resulting in increased benefits from tourism
and strengthened links with the territory. Two street food operators were reviewed, using the Business Model Canvas (BMC), to investigate street food in Italy and draw public attention to the current situation, highlighting what is needed to counteract flattening of flavors, to promote tourism
and safeguard local identity. This initial study aims to identify the unique aspects of the street food business and to describe its close links to its surroundings.
Should Laparoscopic Lymph Node Biopsy Be the Preferred Diagnostic Modality for Isolated Abdominal Lymphadenopathy?
Authors: Gilbert R.W.D. , Bird B.H. , Murphy M.G. , O’Boyle C.J.
Published: July 2019

Background: Isolated abdominal lymphadenopathy is frequently detected, but often challenging to diagnose. To obtain a tissue diagnosis, percutaneous biopsy (PB) or laparoscopic biopsy (LB) is often undertaken. The safety profiles and diagnostic accuracy of PB and LB within the abdomen are both poorly defined. Methods: In this retrospective analysis, we identified all patients who underwent LB or PB for isolated abdominal lymphadenopathy at our institute during 2008–2016. Results: Of 62 patients who underwent nodal biopsy for isolated abdominal lymphadenopathy, 33 underwent LB and 29 underwent PB. For the 33 patients who underwent LB, the procedure was diagnostic in 100% of cases; for the 29 who underwent PB, the procedure was diagnostic in 18 cases (62.1%). Both procedures were safe, with similar complication rates (6.0% for LB; 7.0% for PB). Conclusions: Our results establish that LB and PB are both safe and reliable in the setting of isolated abdominal lymphadenopathy. We also demonstrate that each procedure has situational advantages. A PB should be considered to be the upfront diagnostic modality, particularly when anatomic or disease factors favour its success. In situations in which it is felt that PB cannot safely access the lymphadenopathy or in disease states in which the yield of a core biopsy will be insufficient, LB should be strongly considered. Examples include extra-retroperitoneal lymphadenopathy and cases of suspected lymphoma.
Position Statement on Defining and Standardizing an Oncoplastic Approach to Breast-Conserving Surgery in Canada
Authors: Arnaout A. , Ross D. , Khayat E. , Richardson J. , Kapala M. , Hanrahan R. , Zhang J. , Doherty C. , Brackstone M.
Published: July 2019

Although mastectomy is an effective procedure, it can have a negative effect on body image, sense of attractiveness, and sexuality. As opposed to the combination of breast oncologic surgery and plastic surgery, whose primary focus is on replacing lost volume, breast-conserving oncoplastic surgery (OPS) redistributes remaining breast tissue in a manner that requires vision, anatomic knowledge, and an appreciation of esthetics, symmetry, and breast function. Modern surgical treatment of breast cancer can be realized only with breast and plastic surgeons working together using oncoplastic techniques to deliver superior cosmetic and cancer outcomes alike. Using this collaborative approach, oncologic and plastic surgeons in Canada have a significant opportunity to improve the care of their breast cancer patients. We propose a tri-level classification for volume displacement procedures to act as a rubric for the training of general surgeons and oncologic breast surgeons in oncoplastic breast-conserving therapy techniques. It is our position that OPS enhances outcomes for many women with breast cancer and should become part of the standard repertoire of procedures used by Canadian oncologic surgeons treating breast cancer.
Prognostic Factors in Asian and White American Patients with Cervical Cancer, Considering Competing Risks
Authors: Hou Y. , Guo S. , Lyu J. , Lu Z. , Yang Z. , Liu D. , Chen Z.
Published: July 2019

Background: Cervical cancer is the 2nd most common malignant tumour in women worldwide. Previous research studies have given little attention to its prognostic factors in the rapidly growing Asian American population. In the present study, we explored prognostic factors in Asian and white American patients with cervical cancer, considering competing risks. Methods: The study included 58,780 patients with cervical cancer, of whom 54,827 were white and 3953 were Asian American, and for all of whom complete clinical information was available in the U.S. Surveillance, Epidemiology, and End Results database. Death from cervical cancer was considered to be the event of interest, and deaths from other causes were defined as competing risks. The cumulative incidence function and the Fine–Gray method were applied for univariate and multivariate analysis respectively. Results: We found that, for all patients (white and Asian American combined), the cumulative incidence function was associated with several factors, such as age at diagnosis, FIGO (Fédération internationale de Gynécologie et d’Obstétrique) stage, registry area, and lymph node metastasis. Similar results were found when considering white patients only. However, for Asian American patients, registry area was not associated with the cumulative incidence function, but the other factors (for example, FIGO stage) remained statistically significant. Similarly, in multivariate analyses, we found that age at diagnosis, figo stage, lymph node metastasis, tumour histology, treatment method, and race were all associated with prognosis. Conclusions: Survival status differs for white and Asian American patients with cervical cancer. Our results could guide the treatment of, and facilitate prognostic judgments about, white and Asian American patients with cervical cancer.
Stereotactic Image-Guided Neoadjuvant Ablative Single-Dose Radiation, then Lumpectomy, for Early Breast Cancer: The Signal Prospective Single-Arm Trial of Single-Dose Radiation Therapy
Authors: Guidolin K. , Yaremko B. , Lynn K. , Gaede S. , Kornecki A. , Muscedere G. , BenNachum I. , Shmuilovich O. , Mouawad M. , Yu E. , Sexton T. , Gelman N. , Moiseenko V. , Brackstone M. , Lock M.
Published: July 2019

Background and Purpose: Adjuvant whole-breast irradiation after breast-conserving surgery, typically delivered over several weeks, is the traditional standard of care for low-risk breast cancer. More recently, hypofractionated, partial-breast irradiation has increasingly become established. Neoadjuvant single-fraction radiotherapy (RT) is an uncommon approach wherein the unresected lesion is irradiated preoperatively in a single fraction. We developed the SIGNAL (Stereotactic Image-Guided Neoadjuvant Ablative Radiation Then Lumpectomy) trial, a prospective single-arm trial to test our hypothesis that, for low-risk carcinoma of the breast, the preoperative single-fraction approach would be feasible and safe. Methods: Patients presenting with early-stage (T < 3 cm), estrogen-positive, clinically node-negative invasive carcinoma of the breast with tumours at least 2 cm away from skin and chest wall were enrolled. All patients received prone breast magnetic resonance imaging (MRI) and prone computed tomography simulation. Treatable patients received a single 21 Gy fraction of external-beam rt (as volumetric-modulated arc therapy) to the primary lesion in the breast, followed by definitive surgery 1 week later. The primary endpoints at 3 weeks, 6 months, and 1 year were toxicity and cosmesis (that is, safety) and feasibility (defined as the proportion of mri-appropriate patients receiving RT). Results: Of 52 patients accrued, 27 were successfully treated. The initial dosimetric constraints resulted in a feasibility failure, because only 57% of eligible patients were successfully treated. Revised dosimetric constraints were developed, after which 100% of patients meeting mri criteria were treated according to protocol. At 3 weeks, 6 months, and 1 year after the operation, toxicity, patient- and physician-rated cosmesis, and quality of life were not significantly different from baseline. Conclusions: The SIGNAL trial presents a feasible method of implementing single-dose preoperative rt in early-stage breast cancer. This pilot study did not identify any significant toxicity and demonstrated excellent cosmetic and quality-of-life outcomes. Future randomized multi-arm studies are required to corroborate these findings.
Renal Cell Carcinoma in the Canadian Indigenous Population
Authors: Wong E. C. L. , Breau R. H. , Mallick R. , Wood L. , Pouliot F. , Basappa N. S. , Tanguay S. , Soulières D. , So A. , Heng D. , Lavallée L. T. , Drachenberg D. , Kapoor A.
Published: July 2019

Background: Diagnosis and treatment of renal cell carcinoma (RCC) might be different in Indigenous Canadians than in non-Indigenous Canadians. In this cohort study, we compared RCC presentation and treatments in Indigenous and non-Indigenous Canadians. Methods: Patients registered in the Canadian Kidney Cancer Information System treated at 16 institutions between 2011 and 2018 were included. Baseline patient, tumour, and treatment characteristics were compared between Indigenous and non-Indigenous Canadians. The primary objective was to determine if differences in RCC stage at diagnosis were evident between the groups. The secondary objective was to determine if treatments and outcomes were different between the groups. Results: During the study period, 105 of the 4529 registered patients self-identified as Indigenous. Those patients were significantly younger at the time of clinical diagnosis (57.9 ± 11.3 years vs. 62.0 ± 12.1 years, p = 0.0006) and had a family history prevalence of RCC that was double the prevalence in the non-Indigenous patients (14% vs. 7%, p = 0.004). Clinical stage at diagnosis was similar in the two groups (p = 0.61). The disease was metastatic at presentation in 11 Indigenous Canadians (10%) and in 355 non-Indigenous Canadians (8%). Comorbid conditions that could affect the management of RCC—such as obesity, renal disease, diabetes mellitus, and smoking—were more common in Indigenous Canadians (p < 0.05). Indigenous Canadians experienced a lower rate of active surveillance (p = 0.01). Treatments and median time to treatments were similar in the two groups. Conclusions: Compared with their non-Indigenous counterparts, Indigenous Canadian patients with RCC are diagnosed at an earlier age and at a similar clinical stage. Despite higher baseline comorbid conditions, clinical outcomes are not worse for Indigenous Canadians than for non-Indigenous Canadians.
Effect of Obesity, Dyslipidemia, and Diabetes on Trastuzumab-related Cardiotoxicity in Breast Cancer
Authors: Kosalka P. , Johnson C. , Turek M. , Sulpher J. , Law A. , Botros J. , Dent S. , Aseyev O.
Published: July 2019

Background: Clinical trials have demonstrated an increased risk of cardiotoxicity in patients with breast cancer (BCA) receiving trastuzumab-based therapy. Diabetes, dyslipidemia, and obesity are known risk factors for cardiovascular disease. Studies have yielded conflicting results about whether those factors increase the risk of cardiotoxicity in patients with BCA receiving trastuzumab. Methods: In this retrospective cohort study, data were collected for 243 patients with BCA positive for HER2 (the human epidermal growth factor receptor 2) who were receiving trastuzumab and who were referred to The Ottawa Hospital Cardio-oncology Referral Clinic between 2008 and 2013. The data collected included patient demographics, reason for referral, cardiac function, chemotherapy regimen (including anthracycline use), and 3 comorbidities (diabetes, dyslipidemia, obesity). Rates of symptomatic cancer treatment–related cardiac dysfunction (SCTCD) and asymptomatic decline in left ventricular ejection fraction (adLVEF) were calculated for patients with and without the comorbidities of interest. Results: Of the 243 identified patients, 104 had either diabetes, dyslipidemia, or obesity. In that population, the most likely reason for referral to the cardio-oncology clinic was adLVEF. Conclusions: The combination of 2 or 3 comorbidities significantly increased the incidence of sctcd in our population, reaching a rate of 67% for patients with obesity and dyslipidemia [relative risk (RR): 2.2; p = 0.04], 69% for patients with obesity and diabetes (RR: 2.3; p = 0.02), and 72% for patients with all 3 risk factors (RR: 2.4; p = 0.08). The combination of 2 or 3 comorbidities significantly increases the incidence of symptomatic cancer treatment–related cardiotoxicity. Patients with BCA experiencing cancer treatment–related cardiotoxicity who have a history of diabetes, dyslipidemia, and obesity might require more proactive strategies for prevention, detection, and treatment of cardiotoxicity while receiving trastuzumab-based treatment.
Testing E-mail Content to Encourage Physicians to Access an Audit and Feedback Tool: A Factorial Randomized Experiment
Authors: Vaisson G. , Witteman H. O. , Chipenda-Dansokho S. , Saragosa M. , Bouck Z. , Bravo C. A. , Desveaux L. , Llovet D. , Presseau J. , Taljaard M. , Umar S. , Grimshaw J. M. , Tinmouth J. , Ivers N. M.
Published: July 2019

Background: In Ontario, an online audit and feedback tool that provides primary care physicians with detailed information about patients who are overdue for cancer screening is underused. In the present study, we aimed to examine the effect of messages operationalizing 3 behaviour change techniques on access to the audit and feedback tool and on cancer screening rates. Methods: During May–September 2017, a pragmatic 2×2×2 factorial experiment tested 3 behaviour change techniques: anticipated regret, material incentive, and problem-solving. Outcomes were assessed using routinely collected administrative data. A qualitative process evaluation explored how and why the e-mail messages did or did not support Screening Activity Report access. Results: Of 5449 primary care physicians randomly allocated to 1 of 8 e-mail messages, fewer than half opened the messages and fewer than 1 in 10 clicked through the messages. Messages with problem-solving content were associated with a 12.9% relative reduction in access to the tool (risk ratio: 0.871; 95% confidence interval: 0.791 to 0.958; p = 0.005), but a 0.3% increase in cervical cancer screening (rate ratio: 1.003; 95% confidence interval: 1.001 to 1.006; p = 0.003). If true, that association would represent 7568 more patients being screened. No other significant effects were observed. Conclusions: For audit and feedback to work, recipients must engage with the data; for e-mail messages to prompt activity, recipients must open and review the message content. This large factorial experiment demonstrated that small changes in the content of such e-mail messages might influence clinical behaviour. Future research should focus on strategies to make cancer screening more user-centred.
Countercurrents: Is Now the Right Time to Pull the Plug on Mammography?
Authors: Narod S. A.
Published: July 2019

In their report of 10 December 2018, the Canadian Task Force on Preventive Health Care gave a lukewarm endorsement of screening mammography.[...]
Fulfilling the Potential of Real-World Evidence for Lung Cancer in Canada
Authors: Cheema P.K. , Kuruvilla S.
Published: July 2019

The use of real-world evidence (rwe) through real-world data (rwd) is becoming increasingly prevalent in health care around the globe. [...]
Patient Perspectives on Renal Replacement Therapy Modality Choice: A Multicenter Questionnaire Study on Bioethical Dimensions
Authors: Balzer Michael S. , Clajus Christian , Eden Gabriele , Euteneuer Frank , Haller Hermann G. , Martin Heike , Patecki Margret , Schmitt Roland , Hiss Marcus , Fuerholzer Katharina
Published: July 2019

Background

Peritoneal dialysis (PD) incidence and prevalence in Germany are low compared with hemodialysis (HD), an underachievement with multifactorial causes. Patient perspectives on renal replacement therapy (RRT) choice play a growing role in research. To date, and to the best of our knowledge, the importance of bioethical dimensions in the context of RRT choice has not been analyzed. The aim of this multicenter questionnaire study was to delineate differences in patient perspectives of PD vs HD in terms of bioethical dimensions, thus helping nephrologists target potential PD candidates more efficiently.

Methods

A total of 121 stable outpatients from 2 tertiary care hospitals and 4 dialysis clinics were surveyed for bioethical dimensions (“autonomy,” “beneficence,” “non-maleficence,” “justice,” and “trust”) with ranking and Likert scale items. Inclusion criteria were RRT > 3 months, age ≥ 18 years, and sufficient cognitive and language skills.

Results

A surprisingly high percentage of patients felt excluded from the RRT choice process. Peritoneal dialysis patients were more critical of RRT. They used more versatile information sources on RRT, whereas HD patients were mainly informed by their nephrologist. Peritoneal dialysis patients felt more often dissatisfied with RRT than HD patients and had less trust in their co-patients. However, PD patients felt less autonomy impairment regarding body integrity, fluid balance, and dialysis in general.

Conclusions

Our study demonstrates that PD patients showed more scrutiny of their situation as patients, especially their co-patients. Their treatment empowered them toward feeling more autonomous than HD patients. These new insights into patient perspectives on RRT choice might facilitate modality choice for nephrologists.
Hierarchically structured 3D carbon nanotube electrodes for electrocatalytic applications
Authors: Wang Pei , Kulp Katarzyna , Bron Michael
Published: July 2019

Hierarchically structured 3-dimensional electrodes based on branched carbon nanotubes (CNTs) are prepared on a glassy carbon (GC) substrate in a sequence of electrodeposition and chemical vapor deposition (CVD) steps as follows: Primary CNTs are grown over electrodeposited iron by CVD followed by a second Fe deposition and finally the CVD growth of secondary CNTs. The prepared 3-dimensional CNT structures (CNT/CNT/GC) exhibit enhanced double-layer capacitance and thus larger surface area compared to CNT/GC. Pt electrodeposition onto both types of electrodes yields a uniform and homogeneous Pt nanoparticle distribution. Each preparation step is followed by scanning electron microscopy, while the CNTs were additionally characterized by Raman spectroscopy. In this way it is demonstrated that by varying the parameters during the electrodeposition and CVD steps, a tuning of the structural parameters of the hierarchical electrodes is possible. The suitability of the hierarchical electrodes for electrocatalytic applications is demonstrated using the methanol electro-oxidation as a test reaction. The Pt mass specific activity towards methanol oxidation of Pt-CNT/CNT/GC is approximately 2.5 times higher than that of Pt-CNT/GC, and the hierarchical electrode exhibits a more negative onset potential. Both structures demonstrate an exceptionally high poisoning tolerance.
Flexible freestanding MoS2-based composite paper for energy conversion and storage
Authors: Zoller Florian , Luxa Jan , Bein Thomas , Fattakhova-Rohlfing Dina , Bouša Daniel , Sofer Zdeněk
Published: July 2019

The construction of flexible electrochemical devices for energy storage and generation is of utmost importance in modern society. In this article, we report on the synthesis of flexible MoS2-based composite paper by high-energy shear force milling and simple vacuum filtration. This composite material combines high flexibility, mechanical strength and good chemical stability. Chronopotentiometric charge–discharge measurements were used to determine the capacitance of our paper material. The highest capacitance achieved was 33 mF·cm−2 at a current density of 1 mA·cm−2, demonstrating potential application in supercapacitors. We further used the material as a cathode for the hydrogen evolution reaction (HER) with an onset potential of approximately −0.2 V vs RHE. The onset potential was even lower (approximately −0.1 V vs RHE) after treatment with n-butyllithium, suggesting the introduction of new active sites. Finally, a potential use in lithium ion batteries (LIB) was examined. Our material can be used directly without any binder, additive carbon or copper current collector and delivers specific capacity of 740 mA·h·g−1 at a current density of 0.1 A·g−1. After 40 cycles at this current density the material still reached a capacity retention of 91%. Our findings show that this composite material could find application in electrochemical energy storage and generation devices where high flexibility and mechanical strength are desired.
KELT-23Ab: A Hot Jupiter Transiting a Near-solar Twin Close to the TESS and JWST Continuous Viewing Zones
Authors: Johns Daniel , Reed Phillip A. , Rodriguez Joseph E. , Pepper Joshua , Stassun Keivan G. , Penev Kaloyan , Gaudi B. Scott , Labadie-Bartz Jonathan , Fulton Benjamin J. , Quinn Samuel N. , Eastman Jason D. , Ciardi David R. , Hirsch Lea , Stevens Daniel J. , Stevens Catherine P. , Oberst Thomas E. , Cohen David H. , Jensen Eric L. N. , Benni Paul , Villanueva Steven , Murawski Gabriel , Bieryla Allyson , Latham David W. , Vanaverbeke Siegfried , Dubois Franky , Rau Steve , Logie Ludwig , Rauenzahn Ryan F. , Wittenmyer Robert A. , Zambelli Roberto , Bayliss Daniel , Beatty Thomas G. , Collins Karen A. , Colón Knicole D. , Curtis Ivan A. , Evans Phil , Gregorio Joao , James David , Depoy D. L. , Johnson Marshall C. , Joner Michael D. , Kasper David H. , Khakpash Somayeh , Kielkopf John F. , Kuhn Rudolf B. , Lund Michael B. , Manner Mark , Marshall Jennifer L. , McLeod Kim K. , Penny Matthew T. , Relles Howard , Siverd Robert J. , Stephens Denise C. , Stockdale Chris , Tan Thiam-Guan , Trueblood Mark , Trueblood Pat , Yao Xinyu
Published: July 2019

We announce the discovery of KELT-23Ab, a hot Jupiter transiting the relatively bright (V = 10.3) star BD+66 911 (TYC 4187-996-1), and characterize the system using follow-up photometry and spectroscopy. A global fit to the system yields host-star properties of

K,

,

,

,

(cgs), and

. KELT-23Ab is a hot Jupiter with a mass of

, radius of

, and density of

g cm−3. Intense insolation flux from the star has likely caused KELT-23Ab to become inflated. The time of inferior conjunction is

and the orbital period is

days. There is strong evidence that KELT-23A is a member of a long-period binary star system with a less luminous companion, and due to tidal interactions, the planet is likely to spiral into its host within roughly a gigayear. This system has one of the highest positive ecliptic latitudes of all transiting planet hosts known to date, placing it near the Transiting Planet Survey Satellite and James Webb Space Telescope continuous viewing zones. Thus we expect it to be an excellent candidate for long-term monitoring and follow up with these facilities.
Peculiar Velocities of Galaxies Just Beyond the Local Group
Authors: Anand Gagandeep S. , Tully R. Brent , Rizzi Luca , Shaya Edward J. , Karachentsev Igor D.
Published: July 2019

The Milky Way lies in a thin plane, the Local Sheet, a part of a wall bounding the Local Void lying toward the north supergalactic pole. Galaxies with accurate distances both above and below this supergalactic equatorial plane have systematically negative peculiar velocities. The interpretation of this situation is that the Local Void is expanding, giving members of the Local Sheet deviant velocities toward the south supergalactic pole. The few galaxies within the void are evacuating the void. Galaxies in a filament in the supergalactic south are not feeling the expansion so their apparent motion toward us is mainly a reflex of our motion. The model of the local velocity field was uncertain because the apex of our motion away from the Local Void lies in obscurity near the Galactic plane. Here, results of Hubble Space Telescope infrared observations are reported that find tip of the red giant branch distances to four obscured galaxies. All the distances are ∼7 Mpc, revealing that these galaxies are part of a continuous filamentary structure passing between the north and south Galactic hemispheres and sharing the same kinematic signature of peculiar velocities toward us. A fifth galaxy nearby in projection, GALFA-DW4, has an ambiguous distance. If nearby at ∼3 Mpc, this galaxy has an anomalous velocity away from us of +348 km s−1. Alternatively, perhaps the resolved stars are on the asymptotic giant branch and the galaxy is beyond 6 Mpc whence the observed velocity would not be unusual.
The Evolution and Origin of Ionized Gas Velocity Dispersion from z ∼ 2.6 to z ∼ 0.6 with KMOS3D
∗
Authors: Übler H. , Genzel R. , Wisnioski E. , Schreiber N. M. Förster , Shimizu T. T. , Price S. H. , Tacconi L. J. , Belli S. , Wilman D. J. , Fossati M. , Mendel J. T. , Davies R. L. , Beifiori A. , Bender R. , Brammer G. B. , Burkert A. , Chan J. , Davies R. I. , Fabricius M. , Galametz A. , Herrera-Camus R. , Lang P. , Lutz D. , Momcheva I. G. , Naab T. , Nelson E. J. , Saglia R. P. , Tadaki K. , Dokkum P. G. van , Wuyts S.
Published: July 2019

We present the 0.6 < z < 2.6 evolution of the ionized gas velocity dispersion in 175 star-forming disk galaxies based on data from the full

integral field spectroscopic survey. In a forward-modeling Bayesian framework including instrumental effects and beam-smearing, we fit simultaneously the observed galaxy velocity and velocity dispersion along the kinematic major axis to derive the intrinsic velocity dispersion σ
0. We find a reduction of the average intrinsic velocity dispersion of disk galaxies as a function of cosmic time, from σ
0 ∼ 45 km s−1 at z ∼ 2.3 to σ
0 ∼ 30 km s−1 at z ∼ 0.9. There is substantial intrinsic scatter (

) around the best-fit σ
0–z relation beyond what can be accounted for from the typical measurement uncertainties (δσ
0 ≈ 12 km s−1), independent of other identifiable galaxy parameters. This potentially suggests a dynamic mechanism such as minor mergers or variation in accretion being responsible for the scatter. Putting our data into the broader literature context, we find that ionized and atomic+molecular velocity dispersions evolve similarly with redshift, with the ionized gas dispersion being ∼10–15 km s−1 higher on average. We investigate the physical driver of the on average elevated velocity dispersions at higher redshift and find that our galaxies are at most marginally Toomre-stable, suggesting that their turbulent velocities are powered by gravitational instabilities, while stellar feedback as a driver alone is insufficient. This picture is supported through comparison with a state-of-the-art analytical model of galaxy evolution.
Four new species of the sac spider genus Planochelas Lyle & Haddad, 2009 (Araneae, Trachelidae) from central and southern Africa
Authors: Khoza Thembile T. , Lyle Robin
Published: July 2019

The genus Planochelas Lyle & Haddad, 2009 is endemic to the Afrotropical region. Members of the genus are very small, arboreal sac spiders. They are mainly collected by canopy fogging in tropical forest and savanna. In this study, four new species of Planochelas are described: P.brevissp. nov., P.jocqueisp. nov. (Democratic Republic of the Congo) and P.haddadisp. nov., P.neethlingisp. nov. (South Africa). An updated key to the genus is provided, and the new species are illustrated by photographs and drawings. A distribution map for the genus is provided. This paper increases the number of species in the genus to seven.
Le rapporteur et la contrainte du temps
Authors: Ach Nelly
Published: July 2019

L’activité du rapporteur revêt classiquement trois dimensions : relecture et, au besoin, réécriture des jugements à l’issue des audiences, mise au point des dossiers en état d’être enrôlés, traitement de fond des dossiers dont l’imminence de l’enrôlement est moindre. Ce travail du rapporteur le confronte à la question du temps et la célérité à laquelle il est enjoint ne doit pas le conduire à la précipitation. Pour le rapporteur, la satisfaction du besoin de célérité suppose, après l’avoir adoptée, de s’en tenir à une stratégie lui autorisant une meilleure maîtrise du temps. Le code de justice administrative lui octroie des pouvoirs lui permettant d’accroître la vitesse de l’instruction, ou d’éviter, autant que possible, que le respect du principe du contradictoire ne le ralentisse à l’excès. La lenteur de l’instruction n’est d’ailleurs pas due exclusivement au respect du principe du contradictoire. La confrontation de la position du rapporteur à celle du rapporteur public ou à celle des autres membres de la formation de jugement, ses propres hésitations, la nécessité de recourir à des mesures d’instruction supplémentaires ou de formuler des demandes d’avis sont autant d’exemples de motifs de retardement du jugement de l’affaire qu’il convient pour autant de préserver dès lors qu’ils sont susceptibles de renforcer la qualité de la décision juridictionnelle. En revanche, et même s’il peut être encouragé en tant qu’il autorise une alternative à la résolution purement juridique du litige, mais parce qu’il en retarde notamment l’issue, le recours à la médiation reste, aux yeux de nombreux magistrats, un outil difficile à exploiter. A ces considérations s’ajoutent celles, plus particulières et en relation avec des hypothèses spécifiques, qu’il s’agisse par exemple de la demande d’aide juridictionnelle, de l’intervention d’une note en délibéré, de l’existence de délais difficiles compressibles dans certains types de contentieux. Autant de facteurs, ici encore, pouvant expliquer que la propension du rapporteur à la célérité puisse être contrariée. Le rapporteur ne peut donc se hâter qu’avec lenteur.
Faut-il tendre vers une mise en état ?
Authors: de la Burgade Denis
Published: July 2019

La mise en état n’existe pas officiellement en contentieux administratif. La réalité montre toutefois que les outils permettant au juge de mettre une affaire en état d’être jugés sont nombreux dès lors qu’il lui est loisible de faire usage des pouvoirs qu’il tient du code de justice administrative et qui lui permettent, non seulement d’ordonner des mesures d’instruction mais également d’agir sur le calendrier de la procédure. Il convient pour autant de s’interroger sur le sens à donner à la mise en état dans le procès administratif. La mise en état, en procédure administrative, correspond à une phase de l’instruction se manifestant par un corps de règles procédurales destinées à organiser la contradiction. Les évolutions textuelles récentes confèrent à cet égard au rapporteur ce statut de cheville ouvrière de la mise en état quand le greffe de la juridiction sert de plaque tournante. Et en tant que processus de régulation du procès administratif, la mise en état concourt à l’efficacité et à la célérité du travail du juge. Mais la tentation d’une procédure d’ordre à laquelle s’expose la mise en état dans le procès administratif n’est pas la panacée, eu égard aux spécificités de la procédure administrative. Des réformes sont envisageables, lesquelles permettraient une adaptation de la mise en état au contentieux administratif, sans que celle-ci ne lui soit indispensable.
L’écrit, vecteur suffisant de l’instruction ?
Authors: Azouaou Philippe
Published: July 2019

Le contentieux administratif est organisé de telle manière qu’il accorde une place essentielle à l’écrit, autant dans le cadre de la procédure ordinaire que dans celui des procédures de référé. Pour autant, le praticien ne peut que nuancer l’affirmation suivant laquelle l’écrit serait un vecteur suffisant de l’instruction. Le code de justice administrative lui-même crée les conditions d’épanouissement de l’oralité, que ce soit dans le cadre de l’enquête, de la visite sur les lieux, ou encore de l’expertise. Et l’expérience montre que l’oralité est le moyen, pour le justiciable, d’exprimer avec plus de clarté son sentiment sur l’affaire qui le concerne et cela pourrait d’ailleurs expliquer sa préférence pour le renforcement de l’oralité. Il n’en demeure pas moins que le caractère traditionnellement écrit du contentieux administratif doit être préservé et que l’oralité de la procédure, même si elle devait être renforcée, ne pourrait être qu’un complément sans jamais ne pouvoir se substituer à l’écrit comme vecteur de l’instruction.
L’apport des tiers à l’instruction
Authors: Ciaudo Alexandre
Published: July 2019

L’analyse de l’intervention des tiers au cours de l’instruction permet d’éclairer la teneur de l’office du juge dans la réunion des éléments nécessaires à la résolution du litige. En premier lieu, c’est au rétablissement, volontaire, de l’équité entre les parties que le juge parvient. Il y parvient, d’une part, au moyen de procédés classiques que sont l’expertise (très fréquente) et l’enquête (plus exceptionnelle). Il y parvient, d’autre part, au moyen de procédés nouveaux que sont l’avis technique (que le contentieux administratif ne découvre d’ailleurs pas totalement) et l’ amicus curiae (qui n’est pas sans générer de difficulté eu égard aux problèmes d’impartialité pouvant se poser). En second lieu, c’est à la garantie de l’équité de la solution juridictionnelle que le juge s’oblige. Le contrôle de l’authenticité des pièces du requérant, à la faveur de ses pouvoirs inquisitoriaux, autant que la détermination de l’exact préjudice du requérant, question à laquelle la juridiction administrative se montre aujourd’hui plus sensible qu’hier, en témoignent. De l’analyse des situations, il ressort que le juge administratif n’hésite pas à sortir du débat contentieux délimité par les parties en recourant à l’assistance de tiers détenant les éléments de nature à l’éclairer.
L’Espagne : le chemin vers la Chine passe par l’Europe
Authors: Esteban Mario , Armanini Ugo
Published: July 2019

Depuis 1973, l’Espagne a maintenu de bonnes relations politiques avec la Chine menant à l’établissement d’un Partenariat stratégique global en 2005. Leurs relations économiques ont quant à elles connu un développement significatif à partir des années 2000. Les deux pays ont récemment promu un approfondissement de leurs relations, mais l’Espagne a refusé d’adhérer à l’initiative des nouvelles routes de la soie. En effet, malgré de nombreuses opportunités économiques portées par la demande et la transition économiques chinoises, tant en matière de relations bilatérales que sur les marchés tiers, un rééquilibrage et une plus grande réciprocité semblent nécessaires. Par conséquent, l’Espagne s’en remet à l’UE pour négocier dans un rapport plus égal un engagement plus réciproque avec la Chine.
Preferences for Truth‐Telling
Authors: Abeler Johannes , Nosenzo Daniele , Raymond Collin
Published: July 2019

Private information is at the heart of many economic activities. For decades, economists have assumed that individuals are willing to misreport private information if this maximizes their material payoff. We combine data from 90 experimental studies in economics, psychology, and sociology, and show that, in fact, people lie surprisingly little. We then formalize a wide range of potential explanations for the observed behavior, identify testable predictions that can distinguish between the models, and conduct new experiments to do so. Our empirical evidence suggests that a preference for being seen as honest and a preference for being honest are the main motivations for truth‐telling.
Inference in Group Factor Models With an Application to Mixed‐Frequency Data
Authors: Andreou E. , Gagliardini P. , Ghysels E. , Rubin M.
Published: July 2019

We derive asymptotic properties of estimators and test statistics to determine—in a grouped data setting—common versus group‐specific factors. Despite the fact that our test statistic for the number of common factors, under the null, involves a parameter at the boundary (related to unit canonical correlations), we derive a parameter‐free asymptotic Gaussian distribution. We show how the group factor setting applies to mixed‐frequency data. As an empirical illustration, we address the question whether Industrial Production (IP) is still the dominant factor driving the U.S. economy using a mixed‐frequency data panel of IP and non‐IP sectors. We find that a single common factor explains 89% of IP output growth and 61% of total GDP growth despite the diminishing role of manufacturing.