bluuebunny/crossref_metadata_2025 huggingface dataset:
Socio-psychological predictors of the development of maladjustment in foreign students of the English language
Authors: Vasylieva O.V.
Published: October 2023

The process of adaptation of higher education students is one of the pressing problems of modern society, as it directly affects academic success, personal development and the formation of a positive attitude towards the chosen profession of a future specialist. The purpose of the study: to investigate the socio-psychological predictors of maladjustment in foreign students of English-language education. A comprehensive clinical-psychological, clinical-anamnestic and psychodiagnostic examination of 372 international English-speaking students (223 men and 149 women with an average age of [19±3] years) of I–VI courses of the Kharkiv National Medical University was conducted. All subjects will be divided into three groups: Group I – 194 students from India; Group II – 96 students from Asia (Pakistan, Lebanon, Syria); Group III – 82 students from Africa (Sudan, Tunisia, Morocco, Egypt, Namibia, Israel). As a result of the study, a high level of psychological maladjustment was observed in 2.1% of students of the first group, 1.3% of students of the second group, and 2.9% of students of the third group; the expressed level of maladaptation – in 6.1%, 11.5% and 12.6%, respectively; moderate level of maladjustment – in 25.1% of students of the first group, 26.2% of the second group and 31.3% of students of the third group; an insignificant level in 31.5%, 33.9% and 35.1% of students, respectively. 35.2% of students of the first group, 27.1% of students of the second group and 18.1% of students of the third group did not show any signs of psychological maladjustment. The clinical and psychological structure of maladaptive states was represented by astheno-depressive, hypersthesic, anxious and dysphoric syndromes. It is known that an integral component of psychological maladaptation states is a violation of academic adaptation. The examined students felt their own low academic performance and insignificant educational achievements. We came to the conclusion that the formation of adjustment disorders in international English-speaking students is characterized by multifactorial conditioning and closely related social and psychological factors, which determines the specificity of the manifestations of maladaptive reactions and states.

Keywords: adaptation mechanisms, manifestations of maladjustment, adjustment disorders.
Comparison of the Effectiveness of Sleep Quality with Categories of Using and Not Using Lights while Sleeping in Students
Authors: Mulyana Hilman , Deni Wahyudi  , Yudi Supriyadi
Published: October 2023

The prevalence of sleep quality in adolescents in Indonesia in women has a high prevalence of 71.3% compared to men, which is 66.4%. One of the factors that affect sleep quality is lamp light,  the impact of poor sleep quality can cause mental and physical disturbances for someone Arief 2021. Especially for students who experience decreased concentration and morbidity at school. This study was carried out in June 2022 at Daarul Abroor Vocational School, Tasikmalaya Regency, with the aim of knowing the comparison of sleep quality using and not using light while sleeping in students. This study uses a quantitative method with a cross sectional approach with a population of 162 people. The samples taken in this study were 62 people. The number of samples is categorized by objects that use lights and do not use lights. This study uses the standard Pittsburgh Sleep Quality Index (psqi) instrument. The results of this study found that most of the students who had good sleep quality did not use lamps while sleeping as many as 14 people (45.2%), while students who used lamps when sleeping were 5 people (16.1%). Statistical analysis used in this study using the Chi-Square test and the results obtained significant differences in the quality of sleep using and not using light while sleeping in the students with (p = 0.028).
Educational Design for Adolescents Aware of Reproductive Health in an Effort to Prevent Stunting in Singkawang Public Health Center
Authors: Sulistyawati Dwi , Ernawati  , Nikki Susanti
Published: October 2023

Stunting is one of the targets of the Sustainable Development Goals (SDGs) which is included in the 2nd sustainable development goal. One of the causes of stunting is the mother's age which is too young. Interventions to prevent an increase in educational design for adolescents aware of reproductive health. as an effort to prevent stunting in health education activities. This research activity used a Quasi Experiment pre & post test with the control group. The sample in this research are 40 respondents. This research was conducted in the working area of North Singkawang Health Center I. Evaluation of the implementation of this research activity using the knowledge and attitudes of the ordinal scale. Data analysis using Wilcoxon study. The research is targeted to have met the Technology Readiness Level scale, which is when the intervention is started, the basic principles are observed, practical applications can be explored/developed. The application is still speculative and there is no detailed evidence or analysis to support the assumptions used and the examples are still limited to paper studies. The results showed an increase in knowledge about stunting prevention with a p value of 0.00 and an increase in attitude with a p value of 0.00 so that RS2R can be used as an activity that can be implemented in the wider community, especially adolescents.
Demographic Factors Of Contraception (Implants And Iud) Among Women In Lelateng
Authors: Megaputri Putu Sukma , Adnyani Ni Luh Ketut Bodi
Published: October 2023

Long-term contraceptive methods are contraception used by mothers to space out pregnancies to help mothers maintain health and have greater risks. The purpose of this study was to identify the acceptors' characteristics of IUD and implant users in the Lelateng Village. This research method is quantitative with a cross sectional approach. The sampling technique in this study was purposive sampling with a total sample of 63 respondents. The results of the study reported that the characteristics of respondents who used IUDs and implants were of reproductive age, namely 35 years, with the last education of high school, a multigravida and IUD acceptors were more ASN and implant acceptors were more IRT. The conclusion is that IUDs and implants are long-term contraceptive methods that can help mothers in the process of spacing pregnancies and avoid unwanted risks.
The Relationship Of Gadget Use With The Language Development Of 2-5 Year-Old Children In Buleleng
Authors: Sugiartini Desak Ketut , Meriyani Dewi Aprelia
Published: October 2023

The use of gadgets by toddlers can hinder their growth and development, because toddlers are the most important period in increasing optimal growth and development of children because they can influence and determine the future development of children. The purpose of this study was to determine the relationship between the intensity of gadget use and the developmental aspects of toddlers aged 2-5 years in Tinga-tinga Village. This research uses the type of analytic research in the form of observational. The experimental design used in this study is a cross-sectional research design. The sample in this study were children aged 24-60 months in Tinga-tinga Village, totaling 68 people. The sampling technique uses total sampling, the independent variable is the intensity of using gadgets and the dependent variable is the development of aspects of speech and language. The data analysis technique used is chi square analysis of the closeness of the relationship between the two variables with the Cramer's v coefficient. From the analysis results obtained a p value of 0.000 and a correlation coefficient of 0.000162. This shows p <0.05, which means that there is a significant relationship between the intensity of gadget use and delay.
The Effectiveness of Audiovisual Education on Teenager' Knowledge Levels About the Menstrual Cycle
Authors: Wahyuni Dwie Suci , Vella Yovinna Tobing  , Riau Roslita
Published: October 2023

Changes in the menstrual cycle during adolescence can be an indication of reproductive health problems. Knowing whether or not the menstrual cycle is normal will help detect reproductive health problems in the early stages; therefore, sufficient knowledge regarding the menstrual cycle is needed. It is believed that providing education will be more effective using audiovisual media as the five senses channel the needed knowledge to the brain as much as 75%-87%, while the sense of sight is only 13%-25%. The purpose of this study was to identify the effectiveness of audiovisual education on the level of knowledge of adolescents about the menstrual cycle. This research was conducted at State Junior High School (SMP) 20 Pekanbaru with the type of pre-experimental research using pre-test and post-test without a control group design. A total of 30 respondents took part in this study selected using the non-probability sampling technique, specifically the consecutive sampling technique. The analysis used was univariate analysis using frequency distribution and bivariate analysis using paired t-test. The results showed that respondents were between 14-16 years old with the average age of first menstruation being 12 years old; the distribution of respondents who had not received information on how to calculate the menstrual cycle was as many as 18 respondents (60.0%), while 16 respondents (53.3%) had not asked about this issue to their parents. The results of the majority of adolescent knowledge levels at the time of the pre-test were in the ‘poor category’ (63.3%), while after being provided with education using audiovisual post-test values, the majority of respondents were in the ‘good category’ (93.3%). The result of the paired T-tes obtained a P value of 0,001. This study recommends that schools and parents should provide education to female students about the menstrual cycle.
The Life Experience of Sirau Community in Using Post-Flood Bore Wells on Health
Authors: Zulfa Aulia , Prasetya Adhi M. Hanif
Published: October 2023

Drilled well water is one of the main sources for the people of Sirau Village in meeting their daily needs after the flood disaster. During the dry season, residents experience difficulty getting clean water for their daily needs, this is a condition that can be worrying, considering that poor water quality will threaten the health of residents who use it. The purpose of this study is to describe the life experiences of the Sirau Village community in using bore well water after the flood disaster for their health. This research method uses a qualitative descriptive research design with a population of Sirau Village people who have experience using bore well water, this research uses a purposive sampling technique for Sirau Village people who have experience in using bore well water for health for their daily needs and has appropriate criteria with the stipulated, in this case the number of informants involved was 5 people. Data collection techniques through in-depth interviews (in-depth interviews). The data analysis technique taken is the collaizi technique. The results of the study show that there are 3 themes that determine the community's life experiences in using bore well water after the flood disaster. Theme 1 is about drilled well water being the main need during floods, informants said drilled well water is the main source of daily needs during floods. Theme 2 is the lack of drilled wells in the household, the informant said that the community felt a negative impact on their household, such as household appliances becoming crusty, vehicles rusting and clothes turning yellow. Theme 3 is the impact of its use on dental health, the informant said that the teeth become tartar due to the presence of high calcium and when gargling tastes iron. And less good consumed for drinking. The Sirau Village community has life experience in using bore well water after a flood disaster for their health. Communities feel the negative impact on households and health
Effect of Distraction Therapy on Reducing Pain Levels
Authors: Winna Kurniasari  , Dini Suryani  , Sri Mulyati  , Richa Tri Septinora
Published: October 2023

Severe pain during labor causes the mother to experience psychological disorders. Therefore, interventions to reduce labor pain are needed in order to reduce complications for the mother and fetus during the process and after delivery. according to research suggests that 7-54% of mothers give birth without experiencing pain if distraction therapy is done. It turns out that through this distraction or relaxation therapy the smoothness of the birthing process naturally increases. This therapy is also very useful for creating a beautiful birthing experience for mothers giving birth. This study aims to determine the effect of distraction therapy on reducing pain perceived by mothers in the first stage of labor in the BPS Dewi delivery room, Jambi City in 2022. This study was an experimental study with a pre and post design. The research location was conducted at BPS Dewi, Jambi City. The population of this study were all mothers giving birth at BPS Dewi as many as 20 people, and all populations were used as samples. Based on the results of the analysis of the data obtained before the distraction therapy was carried out, the pain scale was obtained with a mean = 4.90 and after the distraction therapy was carried out, the mean = 3.45. So it can be seen that there is a decrease as a result of giving distraction therapy. After recapitulation, there was a mean difference between before and after giving distraction therapy 4.90 to 3.45 with a p value of .000, meaning the effect of distraction therapy on reducing pain levels. It is hoped that this research for health services can improve the quality of services for women giving birth through distraction therapy for mothers who are useful for expediting the delivery process.
Nursing Care Documentation Analysis Based on Standard Nursing Care Evaluation Instruments
Authors: Usman Sasyari  , Fitri Nurlina  , Yuyun Solihatin
Published: October 2023

The completeness of nursing care documentation has been set at a minimum standard of 85%. This is to show the patient's condition which is seen not only from the level of pain but also from the type, quality and quantity of services that have been provided by nurses in meeting patient needs. This study aims to analyze the completeness of nursing care documentation based on SAK evaluation instruments. The method used is descriptive with a documentary study using SAK. The results showed that the completeness of the assessment was 100%, the diagnosis was 90%, the intervention was 86.6%, the implementation was 100%, and the progress record was 100%. It is recommended that there be continuous and consistent evaluation by the field of nursing on nursing care documentation.
OPINION LEADERS ON THE INTERNET AND CONSUMER BEHAVIOR OF YOUNG PEOPLE
Authors: Ryabov M.A. , Khusnutdinova A.V.
Published: October 2023

The main features of the influence of opinion leaders (influencers) on the Internet on the consumer behavior of young people are revealed. Theoretical grounds for studying such influence are presented. The leading concept is Paul Lazarsfeld's theory of limited effects of media exposure, including the hypothesis of a "two-stage flow" of information. Approaches to determining the criteria for identifying opinion leaders are considered. A number of classifications are presented. Macro-, micro- and nano-influencers stand out, as well as influencers-experts and influencers-charismatics. The main interests of young people related to accessing content created by bloggers on the Internet have been identified. Entertaining, leisure motivation prevails, but there is also a cognitive, informational aspect. Advertising of goods and services carried out by bloggers has some peculiarities. A significant place is occupied by native advertising. In general, the attitude towards advertising integration of bloggers towards young people is skeptical, but not nihilistic. Young people note that advertising is necessary to support the activities of bloggers. For many of them, this is an occasion to try something new, especially in the field of beauty and self-care. Advertising of bloggers is more credible due to the “similarity of interests”, according to which young people select opinion leaders for themselves.
LEGAL REGULATION OF FOREIGN ECONOMIC ACTIVITY AS THE MOST IMPORTANT ELEMENT OF INTERNATIONAL RELATIONS
Authors: Kutsenko S.Yu. , Kutsenko I.A.
Published: October 2023

The article analyzes the legal foundations of the foreign economic activity of the Russian Federation. The genesis of legislation in the field of foreign trade activity demonstrates the improvement of the process of managing foreign trade relations as a part of international relations. Based on the data of the foreign trade turnover of the Republic of Khakassia, it is proved that regional exports tend to increase, the geographical structure of foreign trade relations is changing, the commodity structure of imports is changing as well. Under the conditions of import substitution, the role of state assistance in terms of expanding new sales markets and foreign partners for Russian manufacturers is growing. The mutual interweaving of foreign economic and interregional economic complexes is important. For a long time, the processes of globalization that took place in the world economy have affected the economy, cultural and social relations of Russia. At present, there is a need to ensure the effectiveness of foreign investment, competitiveness of Russian goods in the world economy, and foreign trade in general. These tasks will be solved with their joint understanding and mutual work of both federal authorities controlling foreign trade relations and regional support of various centers of competence, non-profit organizations, consulting agencies. The solution of the issues of increasing the efficiency of foreign trade activity of a particular regional enterprise is possible by applying a set of measures to stimulate foreign trade activity, identifying specialization and evaluation of export-oriented objects of regional industrial production. The study proves that regional enterprises possessing sufficient economic potential, with an increase in the number of foreign trade contracts are able to increase the rate of production of competitive products to the world market. Recommendations on improving the structure of foreign trade activity departments of regional enterprises are given.
Fighting Anthropogenic Forest Fires: Implications from Forest Fires in the Mediterranean Region
Authors: ORAL Vildan , TURAN Melikşah
Published: October 2023

This study aims to reveal the variables affecting forest fire response management, identify the difficulties encountered, and develop solutions. In the study, semi-structured interview technique, which is a qualitative research method, was used. The data obtained within the scope of the study were analysed by thematic analysis method. A purposeful sampling method was used within the scope of the study, and in-depth interviews were conducted with eleven firefighters who responded to the Mediterranean region fires in 2021. In the analyses made within the study's scope, four themes were revealed: coordination, source and spread factors, response reactions, and institutional roles. As a result of the study, it was seen that the participants often associated their past forest fire response experiences with the concepts of helplessness and inexperience due to a lack of training, equipment, and personnel. As a result of the analysis showed that the most common cause of forest fires in the region was the human factor, and the most serious problem encountered in the intervention was the lack of coordination. Within the scope of the study, it is recommended that professionals make the coordination the awareness of the local people, which constitutes the majority of the volunteer capacity, about forest fire precautions, and the voluntary firefighting system should be activated and included in the response system, especially in areas with high fire risk.
EVALUATION OF SUPPORT VECTOR MACHINE BASED STOCK PRICE PREDICTION
Authors: IZSÁK Tilla , MARÁK László , ORMOS Mihály
Published: October 2023

In recent years with the advent of computational power, Machine Learning has become a popular approach in financial forecasting, particularly for stock price analysis. In this paper, the authors develop a non-recurrent active trading algorithm based on stock price prediction, using Support Vector Machines on high frequency data, and compare its risk adjusted performance to the returns of a statistical portfolio predicted by the Capital Asset Pricing Model. The authors selected the three highest volume securities from a pool of 100 initially selected stock dataset to investigate the algorithmic trading strategy. The abnormal return estimates are significant and positive, and the systematic risk is lower than unity in all cases, suggesting lower risk compared to the market. Moreover, the estimated beta values for all stocks were close to zero, indicating a market independent process. The correlation analysis revealed weak correlations among the processes, supporting the potential for risk reduction and volatility mitigation through portfolio diversification. The authors tested an equally weighted portfolio of the selected three assets and demonstrated a remarkable return of 1348% during the evaluation period from July 1st, 2020, to January 1st, 2023. The results suggest that the weak form of market efficiency can be questioned, as the algorithmic trading strategy, employing a Support Vector Machine binary classification model, has consistently generated statistically significant and substantial abnormal returns using historical market data.
DATA ENGINEERING IN CRISP-DM PROCESS PRODUCTION DATA – CASE STUDY
Authors: BRZOZOWSKA Jolanta , PIZOŃ Jakub , BAYTIKENOVA Gulzhan , GOLA Arkadiusz , ZAKIMOVA Alfiya , PIOTROWSKA Katarzyna
Published: October 2023

The paper describes one of the methods of data acquisition in data mining models used to support decision-making. The study presents the possibilities of data collection using the phases of the CRISP-DM model for an organization and presents the possibility of adapting the model for analysis and management in the decisionmaking process. The first three phases of implementing the CRISP-DM model are described using data from an enterprise with small batch production as an example. The paper presents the CRISP-DM based model for data mining in the process of predicting assembly cycle time. The developed solution has been evaluated using real industrial data and will be a part of methodology that allows to estimate the assembly time of a finished product at the quotation stage, i.e., without the detailed technology of the product being known.
Characteristics Of Corn Drying Using Small Scale Dome Type Dryer
Authors: Kowimbin Meylan , Longdong Ireine A. , Tooy Dedie
Published: October 2023

This study aims to measure drying temperature, relative humidity (RH), moisture content, and drying rate versus time in small-scale dome-type dryers. The results of research on drying corn using a small-scale dome-type dryer The average air temperature on the first day of the experiment was 43.7⁰C, and on the second day was 42.8⁰C. First 2 days experiment 34⁰C, the second day 37.4⁰C third day 42.1⁰C. The average air humidity on the first 1-day experiment was 38%, and the second day was 41%. On the first 2 days of the experiment, the average air humidity was 38%, on the second day was 38%, and on the third day was 36%. The water content during the drying process of corn without husks and corn husks in experiment 1 averaged the initial moisture content of corn without husks at 22.7% and corn husks at 22.5%. Experiment 2 averaged the initial moisture content of corn without husks at 29.7% and corn husks at 30.5%. Experiment 1 with a drying time of 16 hours and experiment 2 20 hours with an average final content of 13-14%. The average drying rate in experiment 1 of corn without husk was 1.46%/hour, corn with husk was 1.15%/hour, and in the second experiment the average drying rate of corn without husk was 1.08%/hour, corn with husk was 1.00%/hour.
Keywords:  Corn Drying, Small Scale Dome.
Abstrak
Penelitian ini bertujuan untuk mengukur suhu pengeringan, kelembaban relative (RH), kadar air, serta laju pengeringan terhadap waktu pada alat pengering tipe dome skala kecil. Hasil dari penelitian pengeringan jagung menggunakan alat pengering tipe dome skala kecil Suhu udara alat rata-rata pada percobaan 1 hari pertama 43,7⁰C, hari kedua 42,8⁰C. Percobaan 2 hari pertama 34⁰C, hari kedua 37,4⁰C hari ketiga 42,1⁰C. Kelembaban udara rata-rata pada percobaan 1 hari pertama 38%, hari kedua 41%. Percobaan 2 hari pertama kelembaban udara rata-rata 38%, hari kedua 38%, dan hari ketiga 36%. Kadar air selama proses  pengeringan jagung tanpa klobot dan jagung klobot percobaan 1 rata-rata kadar air awal jagung tanpa klobot 22,7% dan jagung klobot 22.5%. Percobaan 2 rata-rata kadar air awal jagung tanpa klobot 29,7% dan jagung klobot 30,5%. Percobaan 1 dengan lama pengeringan 16 jam dan percobaan 2 20 jam dengan rata-rata kadar akhir 13-14%. Laju pengeringan rata-rata pada percobaan 1 jagung tanpa klobot sebesar 1,46%/jam, jagung klobot 1,15%/jam, dan percobaan kedua rata-rata laju pengeringan jagung tanpa klobot yaitu 1,08%/jam, jagung klobot yaitu 1,00%/jam.

Kata Kunci : Pengeringan  Jagung,  Dome Skala Kecil
The potency of mackerel scad (Decapterus macarellus) caught in WPP 716 of North Sulawesi waters by Purse Seiner landed at the coastal fishing port of Tumumpa, Manado
Authors: Gahunting Dedy , Sitanggang Effendi. P , Dien Heffry. V
Published: October 2023

The research aims to analyze the potentiality of MSY, total allowable catch (TAC), optimum effort (EMSY), and CPUE, based on the annual official report of catch and effort during 2018 - 2022 and some biological aspects of 100 fishes taken at random as samples. The results showed, the highest catch was in 2021 of 4,776,970 tons with an effort of 22,216 trips, and the lowest in 2018 of 1.610.792 tons with an effort of 14.805 trips. The MSY was 4.374.723 tons/year with a TAC of 3.499.779 tons/year and an EMSY of 20,184 trip/year. Using α 5%, it resulted in an average length of 20,64 ± 0.40 cm, and an average weight of 146.16 ± 9.98 g, with W = 0,2388 L2,1115 (W weight, L length). categorized a negative allometric growth (b < 3), with K (condition factor) 1.01 ± 0.10, and sex ratio (male and female) was 1.38: 1. The 42 female fishes had an average length of 21.09 ± 0.50 cm, average weight 154.50 ± 12.30 g, with W = 0,0061 L3.3172, categorized an isometric growth (b = 3) with K 1.00 ± 0.01, while the 58 male fishes had an average length of 20.31 ± 0.57 cm, average weight 140.12 ± 9.99 g, with W = 0,7748 L1.7313, categorized a negative allometric growth (b < 3) with K 1.02 ± 0.05.
Keywords: Decapterus macarellus, WPP 716, purse seiners, MSY, length-weight relationship, coastal fishing port, Tumumpa Manado
Abstrak
Penelitian ini bertujuan menganalisis potensi MSY dan jumlah tangkapan yang diperbolehkan (JTB), upaya pemanfaatan optimum, tingkat pemanfaatan MSY, serta menganalisis beberapa aspek biologis ikan layang biru hasil tangkapan pukat cincin ini, melalui pengambilan 100 ekor sampel acak. Hasil penelitian menunjukkan jumlah tangkapan tertinggi tahun 2021 yaitu 4.776.970 ton dengan upaya penangkapan 22.216 trip, dan terendah tahun 2018 dengan jumlah tangkapan 1.610.792 ton dengan upaya 14.805 trip. Potensi maksimum lestari (CMSY) ikan ini tercatat 4.374.723 ton/tahun dan JTB 3.499.779 ton/tahun dengan upaya maksimum lestari (EMSY) 20.184 trip/tahun. Menggunakan α 5%, diperoleh panjang rerata 20,64 ± 0.40 cm, berat rerata 146.16 ± 9.98 g dengan hubungan) yaitu W = 0,2388 L2,1115 (berat (W berat, L panjang cagak) yang terkategori alometrik negatif (b < 3), dengan K (faktor kondisi)) 1.01 ± 0.10 , dan nisbah kelamin antara jantan dan betina tercatat 1,38 : 1. Ikan layang betina (n = 42) memiliki panjang rerata 21.09 ± 0.50 cm, berat rerata 154.50 ± 12.30 g, dengan hubungan W = 0,0061 L3.3172 yang terkategori isometrik (b = 3) dengan K = 1.00 ± 0.01, sementara 58 ikan jantan memiliki panjang rerata 20.31 ± 0.57 cm, berat rerata 140.12 ± 9.99 g, dengan hubungannya W = 0,7748 L1.7313 terkategori alometrik negatif (b < 3) dengan K 1.02 ± 0.05.
Kata kunci : Ikan layang biru (Decapterus macarellus), MSY, hubungan panjang-berat, faktor kondisi, PPP Tumumpa
PDTA of Diabetes and Diabetological Network in ASL1 Abruzzo: from the ideal PDTA to the real one
Authors: Cristofaro, M.
Published: October 2023

A inizio 2022 in Abruzzo è stato approvato il Percorso Diagnostico Terapeutico Assistenziale (PDTA) per la gestione integrata del diabete mellito, finalizzato a rendere omogenea e uniforme l’offerta diabetologica su tutto il territorio regionale secondo le attuali evidenze scientifiche, in modo da garantire un’assistenza sanitaria appropriata, efficace, multidisciplinare e integrata tra Medicina Generale e intervento specialistico. In questo lavoro, riferito in particolare al diabete di tipo 2, sono state analizzate le difformità tra il PDTA regionale e lo stato dell’arte nella UOSD di Diabetologia dei Presidi Ospedalieri di Sulmona e Castel di Sangro (ASL1 Abruzzo), con l’obiettivo di rielaborare un PDTA interno contenente le misure organizzative e gestionali dirette a ottimizzare l’assistenza diabetologica in base alle risorse e alle competenze disponibili. Per verificare e monitorare l’attuazione del PDTA, sono stati proposti appositi indicatori. PAROLE CHIAVE diabete mellito; Percorso Diagnostico Terapeutico Assistenziale (PDTA); risorse, Medicina Generale; indicatori di performance.
Clinical Pathway of Diabetes in Pregnancy and Telemedicine, in Friuli Venezia Giulia Region
Authors: Petrucco, A.
Published: October 2023

La diagnosi precoce e la presa in carico della donna con diabete in gravidanza, da parte di un team multiprofessionale, hanno dimostrato di poter ridurre l’incidenza di complicanze materne e fetali. Tuttavia, il follow up delle donne con diabete gestazionale richiede frequenti rivalutazioni presso i centri diabetologici, con interventi coordinati di équipe, al fine di rispondere prontamente alle esigenze della paziente. Tale approccio “ideale” viene facilmente garantito alle donne residenti nelle città o in zone prossime ai centri diabetologici, ma risulta notevolmente più difficoltoso per donne residenti in aree più periferiche o disagiate. Difficoltà di accesso si possono presentare anche per donne con gravidanze complicate, che abbiano necessità di riposo obbligato per situazioni legate alla gravidanza stessa. In questo contesto, la creazione di nuovi modelli assistenziali con l’ausilio degli strumenti della telemedicina appare molto promettenti. Scopo del presente project work è stato quindi quello di proporre un percorso diagnostico terapeutico e assistenziale sostenibile per la presa in carico e la gestione in Telemedicina di donne affette da diabete gestazione in regione Friuli-Venezia-Giulia. PAROLE CHIAVE diabete gestazionale; telemedicina; Percorso Diagnostico Terapeutico Assistenziale (PDTA).
Proposal for the implementation and adaptation of 1DM and T2DM mellitus Clinical Pathway of the Piedmont Region Diabetes Endocrine Network to the indications of the National Decree 77/2022
Authors: Bonomo, K.
Published: October 2023

Nel 2016 la Regione Piemonte ha pubblicato un documento sul nuovo approccio diagnostico-terapeutico del paziente affetto da diabete mellito (in seguito aggiornato a PSDTA, Percorso di Salute e Diagnostico-Terapeutico-Assistenziale Diabete Mellito), basato su un modello organizzativo ospedalo-centrico, di tipo Hub and Spoke. In seguito alla pandemia da COVID-19, le istituzioni europee hanno dato vita a un nuovo programma di ripresa economica e sociale denominato PNRR (Piano Nazionale di Ripresa e Resilienza), puntando, in Sanità, all’implementazione della medicina territoriale, favorendo una rete di interconnessione tra ospedali/case di cura/ territorio. Il Decreto Ministeriale 77/2022 ha rappresentato lo strumento legislativo operativo che rendesse concreta l’attuazione di questi principi in una nuova visione della medicina territoriale. Il presente lavoro è basato su un’approfondita analisi dell’attuale modello per l’identificazione degli attori coinvolti, siano essi sanitari, socio-sanitari, amministrativi, etc. Inoltre, si sono integrate alcune nuove strutture funzionali come le Centrali Operative Territoriali (COT), vero e proprio “ganglio” strategico all’interno della gestione dei processi. Infine, è stato proposto un nuovo percorso del paziente metabolico cronico, mediante l’implementazione della telemedicina (TLM), attraverso un approccio multidisciplinare, in una visione di “presa in carico” qualitativa e non quantitativa-prestazionale del paziente cronico. PAROLE CHIAVE Percorso Diagnostico Terapeutico Assistenziale (PDTA); Percorso di Salute e Diagnostico Terapeutico-Assistenziale (PSDTA); Centrale Operativa Territoriale (COT); telemedicina (TLM).
The new organization of diabetes care in the Italian Health Houses according to Mission 6 of the PNRR
Authors: Giancaterini, A.
Published: October 2023

Le principali linee di sviluppo del PNRR Missione 6 si basano su potenziamento e riorganizzazione dei servizi sanitari territoriali attraverso reti di prossimità e sviluppo della telemedicina. L’obiettivo del lavoro proposto è quello di supportare un possibile modello organizzativo del polo diabetologico nelle Case di Comunità (CdC), adattabile alle varie realtà italiane, attraverso un nuovo percorso clinico-assistenziale territoriale multi-professionale, che preveda anche strumenti digitali. Il modello è stato elaborato su un contesto demografico di circa 500.000 abitanti, di cui 30.000 pazienti diabetici noti e 7.500 diabetici non diagnosticati. Sono stati definiti i criteri di stratificazione della popolazione diabetica, identificate le attività del team diabetologico da svolgere in presenza e da remoto, nonché il personale da dedicare al progetto. Il Business Process Reengineering ha permesso di rimodellare i processi esistenti, ridefinire i flussi e costruire la nuova organizzazione. I pazienti, suddivisi in cluster omogenei, sono stati indirizzati a differenti percorsi assistenziali. Per comprendere la sostenibilità del modello proposto è stata effettuata una valutazione di carattere economico sulla base dei costi fissi e variabili ipotizzati sul volume di attività e sul personale del team coinvolto, arrivando a calcolare il Break Even Point (BEP). Il modello del Polo Diabetologico nelle Case di Comunità prevede il mantenimento delle attività proprie del team diabetologico, per assicurare percorsi di educazione terapeutica e assistenza diabetologica, anche in contesti territoriali. Multidisciplinarietà e tecnologie digitali integrate nel progetto garantiscono al paziente, anche in contesti periferici (compreso il domicilio), la possibilità di accedere a screening e monitoraggio della patologia e delle complicanze. PAROLE CHIAVE Case di Comunità (CdC); Piano Nazionale di Ripresa e Resilienza (PNRR); telemedicina; team diabetologico; Percorso Diagnostico Terapeutico Assistenziale (PDTA).
Chronic care Management in diabetes patients: the role of telemedicine
Authors: Aricò, C.N.
Published: October 2023

Il Diabete Mellito (DM) è una delle malattie cronico-degenerative più diffuse nella popolazione, con implicazioni sanitarie e sociali di grande rilevanza. L’utilizzo delle tecnologie nel trattamento del diabete ha dimostrato di migliorare il controllo glicemico riducendo le ospedalizzazioni e i costi. La disponibilità e l’equità di accesso alle tecnologie e alle cure innovative sono quindi strumenti fondamentali per la gestione del paziente diabetico. Il presente progetto ha incluso pazienti con Diabete Mellito tipo 1 (DMT1) in terapia insulinica con sistemi integrati (sensore-microinfusore) o con sistemi Hybrid Closed-loop e pazienti DMT1 in terapia insulinica multiniettiva (MDI) con sensore Glucose Continuos Monitoring (CGM) o Flash Glucose Monitoring (FGM) o che utilizzavano ancora autocontrollo capillare (SMBG). Le prestazioni consistevano in visite ambulatoriali di controllo atte a valutare il compenso glicemico dei pazienti, rispettando un timing di follow up adeguato alle esigenze cliniche. L’obiettivo del contributo è quello di costituire un PDTA per l’erogazione dei servizi di telemedicina con particolare riferimento alla televisita e al telemonitoraggio. I dati relativi agli indicatori analizzati hanno dimostrato risultati soddisfacenti. Sebbene il periodo di analisi sia stato breve, questi dati potrebbero risultare utili per migliorare le performance dei servizi di Diabetologia, se proiettati in archi temporali più ampi. I risultati dell’analisi mostrano un miglioramento dell’accessibilità, una riduzione del tempo di visita, dei tempi di attesa, delle settimane per il completamento delle visite programmate e il miglioramento del compenso glicemico. La telemedicina, nelle sue declinazioni di televisita, teleconsulto, telemonitoraggio e teleassistenza, è uno strumento che si inserisce nello scenario dell’assistenza alla cronicità con lo scopo di fornire risposte adeguate alle domande di maggiore efficienza nella gestione del paziente cronico. Il nuovo modello di presa in carico del cittadino è costruito attorno alla parola “prossimità”, con potenziamento delle cure domiciliari affinché la casa possa diventare il luogo privilegiato dell’assistenza. PAROLE CHIAVE diabete mellito tipo 1; closed-loop; telemedicina; Percorso Diagnostico Terapeutico Assistenziale (PDTA); prossimità.
Clinical pathway for the implementation of the advanced hybrid closed loop technology in Italian diabetes units
Authors: Disoteo, O.E.
Published: October 2023

Il raggiungimento di un compenso ottimale nel diabete tipo 1 rappresenta tuttora una sfida per medici e pazienti. Tra le varie strategie di trattamento insulinico i sistemi “advanced hybrid close loop” (AHCL) si stanno rivelando quella più efficaci. L’utilizzo nel contesto dei centri diabetologici italiani risulta tuttavia non uniforme e le modalità prescrittive non omogenee. Obiettivo del progetto proposto è disegnare un percorso clinico che possa agevolare un utilizzo efficiente dei sistemi AHCL. Sono state delineate le caratteristiche di dotazione strutturale e assistenziale di un ipotetico centro Diabetologico dell’adulto che abbia in carico circa 800 persone con diabete mellito tipo 1. Nella mappa dei macro-processi si sono individuati i punti cruciali del percorso con definizione di indicazioni, obiettivi terapeutici, modalità di avvio della nuova terapia, modalità di monitoraggio e valutazione degli esiti. Sono stati definiti indicatori di popolazione, di processo e di risultato necessari per l’inquadramento del contesto organizzativo e la valutazione degli esiti. In conclusione, il percorso descritto rappresenta una guida per l’utilizzo di sistemi AHCL nel contesto di centri diabetologici di dimensioni medie e grandi. L’applicazione nei singoli centri richiede un adattamento alle singole realtà e deve avere l’obiettivo di garantire un accesso equo e appropriato a tali sistemi. PAROLE CHIAVE sistema di erogazione insulinica automatizzato composto da microinfusore integrato a CGM ed algoritmo (AHCL); monitoraggio continuo del glucosio (CGM); terapia insulinica multiiniettiva (MDI); educazione e supporto all’autogestione del diabete (DSMES); matrice di assegnazione di responsabilità (RACI)
Pathway for medical tele-consultation between Diabetes Unit and Community House
Authors: Daffra, D.
Published: October 2023

L’obiettivo di questo progetto è quello di strutturare un percorso ideale di teleconsulto e di teleconsulenza sanitaria, all’interno di quanto previsto dal DM 77/2022, tra il personale sanitario che fa capo a una Casa di Comunità (CdC) e la struttura Diabetologica Hub di riferimento per facilitare la comunicazione e l’integrazione dei percorsi terapeutici e assistenziali per i pazienti diabetici. Il progetto prevede l’utilizzo di due modalità di teleconsulto: il teleconsulto medico-medico in modalità asincrona tra medico specialista della struttura Hub e medico di medicina generale (MMG), la teleconsulenza medico-sanitaria tra Infermiere di Famiglia e Comunità (IFeC) e uno o più componenti del team diabetologico. L’obiettivo di tale progetto è quello di riuscire a supportare il percorso decisionale del MMG e l’attività dell’IFeC che gravitano su una stessa CdC, favorire l’empowerment dei pazienti attraverso l’accesso a prestazioni del team multiprofessionale diabetologico e migliorare l’appropriatezza degli invii in presenza alle strutture di diabetologia. Il progetto parte dall’ipotesi di adottare un investimento iniziale di 8 ore lavorative a settimana, per una media di 48 teleconsulti al mese, da destinare nel 50% dei casi a urgenze/richieste su pazienti che ordinariamente non utilizzano la telemedicina e nel restante 50% a pazienti che utilizzano già la telemedicina per presenza di condizioni di fragilità e/o difficoltà a raggiungere la struttura. Considerando un efficientamento delle prestazioni del 15% annuo, in circa cinque anni, l’investimento prestato potrebbe consentire una copertura del target fino al 62%. La strutturazione di un progetto pilota consentirebbe di comprendere la reale accessibilità delle cure ai pazienti nel tempo e dunque valutare il potenziale beneficio in termini organizzativi, di produttività per la struttura e di stato di benessere dei pazienti. PAROLE CHIAVE teleconsulto; pazienti diabetici ambulatoriali; cura del paziente diabetico.
On Existence of Digital Measure Constant
Authors: Ersezer Fikret
Published: October 2023

An unidentified continuous functions is an function that looks
infinitely differentiable from far away view. Here any unidentified
continuous function is assumed to have either digital continuum
(non-archimedian continuum) or archimedian continuum. Author mainly
found an method to indicate an distinction for both continuum models.
This method can be used on to unidentified continuous functions in order
to obtain a discrete unit value relation of coarse structure. An example
could be energy-frequency equation for photons.
Fusion of Global and Local Features with Multi-Inverted Indices for Efficient Image Retrieval
Authors: Weng Li
Published: October 2023

Feature fusion is an effective solution for improving image retrieval performance. Although the more feature types, the better accuracy, complexity also increases. Applications in practice typically afford a limited number of feature types. Due to the strong complementarity, global and local features form an ideal combination for many fusion applications. However, the two kinds of features are intrinsically different in nature, thus cannot be fused in a straightforward way. In this work, we propose an integrated image retrieval and feature fusion framework for global and local features. It is based on inverted index fusion, a technique for efficient image retrieval. The core idea is to rank candidates by weighted voting during candidate selection, which is named pre-ranking. This procedure takes place before re-ranking, and is potentially superior to conventional late fusion. Extensive experiments on three public datasets show that the light-weight pre-ranking stage significantly contributes to accuracy, and brings substantial improvement when used together with re-ranking. Our method is robust and versatile, and can be applied to any scenario where inverted indexing is used. It is a promising technique for multimedia retrieval in the big data era.
Pemanfaatan Teknologi Komputer untuk Pembelajaran Ilustrasi Digital pada Siswa Raudhatul Athfal Ma’had di Kota Palembang
Authors: Sanmorino Ahmad , Gustriansyah Rendra , Puspasari Shinta
Published: October 2023

Salah satu pemanfaatan teknologi komputer di era modern saat ini adalah untuk pembelajaran ilustrasi digital. Melalui kegiatan Pelayanan kepada Masyarakat (PkM) ini penulis ingin berbagi pengetahuan mengenai pemanfaatan teknologi komputer sebagai media pembelajaran ilustrasi digital untuk siswa-siswa Raudhatul Athfal pada Ma’had di Kelurahan Talang Jambe, Kota Palembang. Tujuan yang ingin dicapai dari kegiatan PkM ini adalah menumbuhkan minat siswa Raudhatul Athfal untuk mencoba teknologi berbasis komputer sebagai media pembuatan ilustrasi digital. Metode pelaksanaan kegiatan PkM ini terdiri dari dua tahap, pertama, pemaparan cara pembuatan ilustrasi digital kepada para siswa. Kedua, membimbing para siswa untuk mencoba langsung pembuatan ilustrasi digital menggunakan perangkat komputer yang telah disediakan tim PkM. Hasil dari kegiatan PkM ini memperlihatkan besarnya minat para siswa yang tertarik untuk membuat ilustrasi digital yaitu sebesar 75 persen. Adapun persentase jumlah siswa yang ingin mencoba langsung adalah sebesar 75 persen. Sedangkan jumlah siswa yang tidak tahu atau tidak memberi tanggapan hanya sebesar 25 persen. Berdasarkan feedback hasil kegiatan PkM ini dapat dilihat secara keseluruan siswa Raudhatul Athfal memiliki ketertarikan yang besar untuk mencoba dan menggunakan teknologi berbasis komputer sebagai media pembuatan ilustrasi digital.
Utilization of Computer Technology for Digital Illustration Learning for Raudhatul Athfal Students in Palembang City
 One of the uses of computer technology in the modern era is for learning digital illustrations. Through this Community Service (PkM) activity, the author wants to share knowledge about the use of computer technology as a digital illustration learning medium for Raudhatul Athfal students at Ma'had in Talang Jambe Village, Palembang City. The goal to be achieved of this PkM activity is to foster the interest of Raudhatul Athfal students to try computer-based technology as a medium for making digital illustrations. The method for implementing this PkM activity consists of two stages, first, explaining how to make digital illustrations to students, second, guiding students to try directly making digital illustrations using computer apps that have been provided by the PkM team. The results of this PkM activity show the high interest of students who are interested in making digital illustrations, namely 75 percent. The percentage of students who want to try directly is 75 percent. Meanwhile, the number of students who did not know or did not respond was only 25 percent. Based on the feedback on the results of this PkM activity, it shows that as a whole Raudhatul Athfal's students have a great interest in trying and using computer-based technology as a medium for making digital illustrations.