bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of missing Electronic Medical Record (EMR) discharge summaries: A retrospective study on data from a large Canadian cohort
Authors: Wiebe Natalie , Xu Yuan , Shaheen Abdel Aziz , Eastwood Catherine , Boussat Bastien , Quan Hude
Published: September 2019

Background: Healthcare systems worldwide have adopted the electronic medical record (EMR). EMRs are an efficient method of interprofessional communication, and can improve data availability for secondary research purposes. The discharge summary (DS) is a crucial document for both interprofessional communication, and coding of data for research purposes. We aimed to assess the completeness of our EMRs by assessing the presence of a DS in the EMR. Additionally, we evaluated the presence of predictors for a missing DS. Method: A retrospective chart review was conducted on 3,011 inpatient charts from 3 hospitals in Calgary, Alberta Canada. 893 charts were found to be missing an electronic DS. A 10% sample was drawn to assess for presence of a paper DS. A list of variables was compiled to assess for association between patient and hospital characteristics, patient comorbidities, and the absence of an electronic DS. A Chi-square test, Fisher’s test and logistic regression were conducted to assess for associations. Results: The univariate analyses showed that age, being a surgical patient, a Charlson Comorbidity Index (CCI) of </1, as well as patients with myocardial infarctions, congestive heart failure, cerebrovascular disease, dementia, chronic pulmonary disease, diabetes, and renal disease were associated with a missing DS. The multivariate logistic regression showed that those that were middle aged, surgical patients, or with fewer comorbidities were more likely to have a missing DS. Within the 10% sample, approximately 50% of all patients were from a surgical department, all of which were missing both electronic and paper discharge summaries. Conclusion: Our study is the first to describe predictors associated with missing electronic discharge summaries. There is a modern day propensity for adoption of the EMR across healthcare systems worldwide. The EMR, especially the DS, is used for the improvement of interprofessional communication, patient outcomes, and data quality. Therefore, the implications of an incomplete EMR are widespread. Our findings will caution future researchers using EMR data about the potential for incomplete data, particularly for patients who are surgical, middle aged, and have fewer comorbidities. Additionally, our study highlights the need for further investigation into the lack of discharge summaries in surgical units.
Effect of Two Major Health Reforms on Health Care Cost and Utilization in Iran: Family Physician Program and Health Transformation Plan
Authors: Bayati Mohsen , Keshavarz Khosro , Lotfi Farhad , KebriaeeZadeh Abbas , Barati Omid , Zareian Shahram , Amiri Akbar , Delavari Sajad
Published: September 2019

Background: Family physician program (FPP) and health transformation plan (HTP) are two major reforms that have been implemented in Iran's health system in recent. The present study aimed at evaluating the impact of these two reforms on the level of service utilization and cost of health care services. Methods: This longitudinal study was conducted on people insured by social security organization in Fars province during 2009-2016. The data on the utilization of services and costs of general practitioner visits, specialist visits, medications, imaging, laboratory tests, and hospitalization were collected. Interrupted time series analysis was used to analyze the effect of the two mentioned reforms. Results: FPP resulted in a significant reduction in the number of specialist visits, imaging, and laboratory tests in the short term, and in the number of radiology services, laboratory tests, and hospitalization in the long term. In contrast, HTP significantly increased the utilization of radiology services and laboratory tests both in the short term and long term. Concerning the costs, FPP resulted in a reduction in costs in the short term, but in an increase in costs in the long term. However, HTP resulted in an increase in health care costs in both of the studied time periods. Conclusions: FPP has been successful in rationalizing the utilization of services. On the other hand, HTP has improved people’s access to services by increasing the utilization; but it has increased health care costs. Therefore, policy makers must adopt an agenda to revise and re-design the plan.
Central line bundle including split-septum device and single use prefilled flushing syringes for prevention of port associated bloodstream infections: A cost and resource utilization analysis
Authors: Devrim Ilker , Ozkul Mustafa T , Çağlar İlknur , Oruç Yeliz , Demiray Nevbahar , Tahta Neryal , Vergin Canan
Published: September 2019

Background: Central line bundle programs were found to be effective in decreasing central line–associated bloodstream infection rates in pediatric cancer patients with ports. However cost-effectiveness studies of central line bundle programs in pediatric cancer patients are limited and most available data are from intensive care unit or adult studies. Methods: In this 6 years cross-sectional study, comprehensive assessment of total health care costs attributable to CLABSI’s associated with ports between two periods including 3 years of pre-bundle period and bundle period. Results: This cross-sectional study was carried out in the pediatric hematology-oncology ward of Dr. Behçet Uz Children’s Hospital from 1 August November 2011 to 31 July 2017. The CLABSI rates decreased significantly from 8,31 CLABSIs to 3.04 per 1000 central line days ( p <0.0001). In the prebundle period, total attributable costs spent for of patients with CLABSI were $130661,68 and in the bundle period, total attributable costs spent for patients with CLABSI were $116579,05.Within bundle implantation, 71 potential CLABSI were prevented which saved an additional $208977,81. In other words, for one dollar spent for bundle program, $ 6,54 was saved by decreasing the expected CLABSI. Conclusion: our study shows that central line bundles decreases not only the CLABSI rate, but also decreases attributable costs due to CLABSI. Expenses spent for bundle elements, were covered by savings by preventing CLABSI with higher costs
Development of the Prototype Concise Safe Systems Checklist Tool for General Practice
Authors: Litchfield Ian J , Spencer Rachel , Bell Brian , Avery Anthony , Perryman Katherine , Marsden Kate , Greenfield Sheila , Campbell Stephen
Published: September 2019

Background We identified a need for a concise safe-systems checklist designed to address areas of patient safety which are under-represented in mandatory requirements and existing tools. The process of development is described from initial expert consensus of a long list of items suitable for inclusion on the checklist through their refinement following staff feedback to the nine items included on the prototype checklist. We then present the results of the pilot of the prototype checklist and a qualitative exploration of staff attitudes to its utility and usability. Methods An extensive narrative review and a survey of world-wide general practice organisations were used to identify existing primary care patient safety issues and tools. A RAND panel of international experts rated the resulting statements summarising the findings for importance and relevance. The checklist was created to include areas that are not part of established patient safety tools or mandatory and legal requirements. Four main themes were identified: information flow, practice safety information, prescribing and use of IT systems. A 13 item checklist was trialled in 16 practices resulting in a 9 item prototype tool, which was tested in 8 practices. Qualitative data on the utility and usability of the prototype checklist was collected with a series of semi-structured interviews. Results In testing the prototype 4 of 9 items on the checklist were achieved 100% of the time, 3 items 87% of the time and 2 items 75% of the time. Participants expressed concern about the utility and implementation of checklists in general. However, the prototype was praised for its brevity and its use as a learning tool and ‘final check’ on elements of safety that the practices considered important. Conclusions The concise patient safety checklist tool, specifically designed for general practice, has been made available as part of an online Patient Safety Toolkit hosted by the Royal College of General Practitioners. Practice managers/GP partners should find it a useful tool to monitor safety within the practice.
Cost of inappropriate antimicrobial use for upper respiratory infection in Japan
Authors: Tsuzuki Shinya , Kimura Yuki , Ishikane Masahiro , Kusama Yoshiki , Ohamagari Norio
Published: September 2019

Background : Antibiotics are often prescribed inappropriately to patients with upper respiratory infection (URI) in ambulatory care settings; however, the economic burden of such prescription has not been quantitatively assessed. Here, we aimed to evaluate the additional cost of antimicrobial prescription for URI at the population level in Japan. Methods : We conducted a retrospective observational survey using longitudinal claims data between 2013 and 2016 obtained from the Japan Medical Data Center (JMDC) Claims Database, which contains data from 5·1 million corporate employees and family members aged <65 years. Appropriateness of antibiotic prescription was assessed by a panel of six infectious disease physicians according to ICD-10 code in JMDC Claims Database. Total additional cost of antibiotic prescription for URI at the national level was estimated by weighting of age-structured population data Results : The total annual cost of antibiotic prescription for URI was estimated at 423·6 (95% CI: 416·8–430·5) million USD in 2013, 340·9 (95% CI: 335·7–346·2) million USD in 2014, 349·9 (95% CI: 344·5–355·3) million USD in 2015, and 297·1 (95% CI: 292·4–301·9) million USD in 2016. Three classes of broad-spectrum oral antibiotics (third-generation cephalosporins, macrolides, and fluoroquinolones) accounted for >90% of the total annual cost. Conclusions : Although a decreasing trend was observed, annual costs of antibiotic prescriptions for URI could be a substantial economic burden in Japan. Appropriately prescribing broad-spectrum oral antibiotics might be an important issue to reduce unnecessary medical costs in Japanese ambulatory care.
Prognostic value of a four-level Chinese emergency triage for an Emergency Department: A prospective cohort study
Authors: Huang Wenlong , Xie Xiaohua , Xiong Haiyan , Liu Qiongling , Wei Tan , Zeng Yingchun
Published: September 2019

Background In order to assign treatment priorities of patients who presenting to emergency departments (ED), various triage scales have been developed around the world. In china, four-tier triage scale was recommended by a national triage guideline that published by the central Chinese government. After that a four-tier triage system, used only in tertiary hospitals in Shenzhen, was published by the Public Hospital Administration of Shenzhen Municipalitfy in August, 2013 (Shenzhen Triage System, SZTS). But the ability in predicting admission and in-hospital mortality with the four-level triage scale for patients presented in emergency department was unclear. This research aimed to assess the prognostic value of the SZTS by examining the association between triage levels and clinical outcomes in adult patients.Methods Patients 18 years of age or older, who were triaged category 1, 2 or 3 in the emergency department (ED) from May 17, 2017 until September 27, 2017, were enrolled. This study evaluated an association between triage level and in-hospital mortality, ICU admission and general ward admission by using multivariable logistic regression analysis. Receiver operating characteristic curves were used to assess the predictive ability of SZTS in determining in-hospital mortality, ICU admission and general ward admission.Results There were 383 patients enrolled in the study. More urgent triage level were significantly related to a higher proportion of in-hospital mortality, ICU admission and general ward admission. The OR for in-hospital mortality (OR 11.6, 95% CI 5.8-22.9, p<0.001), ICU admission (OR 14.4, 95% CI 7.4-27.7, p<0.001) and general ward admission (OR 10.6, 95% CI 1.4-79.2, p=0.022) were greater at triage level 1 compared to triage level 2 and level 3. The AUC for in-hospital mortality, ICU admission and general ward admission prediction of SZTS was 0.838, 0.830 and 0.792, respectively.Conclusions This study suggests that triage levels were associated with general ward admission, ICU admission and in-hospital mortality, and SZTS showed good performance for clinical outcomes prediction.
Acute suppurative thyroiditis with thyroid abscess in adults: clinical presentation, treatment and outcomes
Authors: Falhammar Henrik , Wallin Göran , Calissendorff Jan
Published: September 2019

Background

Abscess in the thyroid gland is a rare but severe infectious disease. The condition can have anatomic or iatrogenic underlying causes. If untreated it could be fatal. Pathogens vary considerably. Treatment is intravenous antibiotics, drainage, and sometimes surgery.

Methods

The electronic medical records of all adult patients with acute thyroiditis 2003–2017 treated at the Karolinska University Hospital (catchment area 2 million) in Sweden were systematically reviewed.

Results

Five patients were found in the catchment area. One patient from another region but known to us was also included. Thus, six patients (aged 28-73 years) were included in the study. Median length of hospital stay was 7.5 days (4-79 days). All were treated with antibiotics (intravenous n=5, oral n=1). Total antibiotic treatment duration was 13.5 days (10-41 days). Blood cultures were positive in three (streptococcus pneumonia, streptococci sanguineous, pepto streptococci), deep tissue culture in three (escherichia coli, candida, hemophilic influenza) and no positive culture at all in two. Drainage was used in three patients. All patients recovered without recurrences. Surgery was performed twice in the acute phase in one. There was no recurrence during 7 years (3-12) of follow-up, but one patient died after three years (severe heart failure and pneumonia).

Conclusion

Thyroid abscess in adults is extremely rare nowadays in the developed world. With prompt antibiotic therapy, drainage and in some cases thyroidectomy the prognosis seems favourable.
Perinatal outcomes of infants with congenital limb malformations: an observational study
Authors: Farr Alex , Wachutka Eva , Bettelheim Dieter , Windsperger Karin , Farr Sebastian
Published: September 2019

Background: Congenital limb malformations are rare and their perinatal outcomes are not well understood. This study analyzed the perinatal outcomes of infants with congenital limb malformations. Methods: All infants with congenital limb malformations who underwent prenatal assessment and delivery at our tertiary referral center from 2004 through 2017 were retrospectively identified. Neonatal outcome parameters were assessed and the predictors of worse perinatal outcomes were determined. Results: One hundred twenty-four cases with congenital limb malformations were identified, of which 104 (83.9%) were analyzed. The upper limb was affected in 15 (14.4%), the lower limb in 49 (47.1%), and both limbs in 40 cases (38.5%). A fetal syndrome was identified in 66 cases (63.5%); clubfoot and longitudinal reduction defects were the most frequent malformations. In total, 38 cases (36.5%) underwent termination, 7 (6.7%) resulted in stillbirth, and 59 (56.7%) in live-born delivery. Rates of preterm delivery and NICU-transfer were 42.4% and 25.4%, respectively. Localization of the malformation was a determinant of the perinatal outcome and preterm delivery ( P = .006). Conclusions: Congenital limb malformations frequently occur bilaterally, and are associated with poor perinatal outcomes, including high rates of stillbirth and preterm delivery. Multidisciplinary care and referral to a perinatal center are warranted.
Remarriage after Divorce and Health in Later Life: Findings from CHARLS in China
Authors: li xiaomin , Jiang Quanbao , Ge Tingshuai , Cheng Xinfeng
Published: September 2019

Background : Marriage has a positive effect on health. After the dissolution of a marriage, the health of divorcees worsens. The focus of this paper is on whether remarriage can help a person regain the health benefits that comes with marriage. Methods: This study used the national baseline data from the China Health and Retirement Longitudinal Study (CHARLS), a survey conducted from 2011 to 2012, this article applies instrumental variables to deal with the endogenous problems and to investigate the association between remarriage after divorce and late-life health. Result: According to descriptive statistics, among the 235 middle-aged and elderly respondents with a history of divorce, 46% remarried, 75% of them thought their SRH was fair or bad, 15% of them suffered from ADL impairment and the scale score for depression averaged 9.33 ( SD =7.1). According to the regression results, compared with divorcees who have not remarried, those who remarry suffer less from depression and have better self-rated health. There are gender differences reflected in the relationship between remarriage after divorce and mental health. Remarriage can promote the mental health of men, but there is no significant correlation between remarriage and the mental health of women. Conclusion: Marriage has a protective effect on health, and remarriage can help people regain the health benefits. Key words: ADL ; Depression; Self-rated health ; Instrumental variable; Remarriage after divorce
Development of a “Perceived Stress Scale" Based on Classical Test Theory and Graded Response Model
Authors: YAŞAR Metin
Published: September 2019

The
main purpose of this study is to develop a perceived stress scale based on
Classical Test Theory (CTT) and Graded Response Model (GRM); to compare the
parameters of the items in the scale that are tried to be developed according
to both models, and to determine under which theory the measurement tool
produces more reliable and valid results according to these compared item
parameters. The item discrimination parameter value calculated according to CTT
ranges from 0.472 to 0.735. On the other hand, item discrimination parameter
values calculated under GRM vary between 1.062 (Item 15) and 2.606 (Item 2).
Correlations between item thresholds were tested and the calculated correlation
coefficients were; r =0.840 for β1 (p<0.01), r = 0.947 for β2 (p<0.01), r
= 0.713 for β3 (p<0.05), and r = 0.559 for β4 (p<0.05) respectively. It
can be assumed that these values not only support the item invariance of the
items in the scale, but also show that the GRM is suitable for the data used
for the scaling of the items. The reliability coefficient of the scale, in
terms of internal consistency, was calculated as 0.919 according to the CTT,
while the marginal reliability coefficient calculated as 0.931 according to
GRM. Both reliability coefficients are quite high. In conclusion, there is a
high correlation between the item parameters calculated according to both
approaches, and the perceived stress scale (PSS) that is being developed can
measure the desired features.
Modeling of state socio-economic systems in the countries of the European region
Authors: Hrysenko Maryna , Pryiatelchuk Olena , Shvorak Liudmila
Published: September 2019

Recent global economic and social challenges confirm the existence of a number of systemic problems in socio-economic relations. Thus, the spread of the concept of sustainable development, which combines social, environmental and economic aspects, became a characteristic feature of the global development trend in recent decades. Highly developed world countries are currently implementing the principles of social economy (a special state management model for socio-economic development) in their policies with the aim to overcome abovementioned challenges and to reach the millennium development goals. The implementation of these principles, realized by the state management in these countries during the last decades, enables us to evaluate the available results and highlight the characteristics of individual national business models of social economy. The study of the most important social and economic global indicators by means of modeling, clustering and regression analysis made it possible not only to emphasize the most important indicators characterizing socio-economic development, but also, taking into account the establishment of interrelationships between social and economic parameters, to single out separate groups of countries (exclusively the European region has been selected for the research) united by common principles and methods of social and economic policy and its implementation outcomes. The obtained results allow us to predict further trends of socio-economic development of separate groups of countries taking into account the available material and technical resources, the situation on the labor market and the level of competitiveness of national labor resources, the features of the functioning of the monetary and tax systems, etc. Given the results of clustering, it was possible to identify both specific models for socio-economic development specific to certain groups and their inherent tendencies of functioning. Besides, a set of specific methods and mechanisms of government control which are common and the best suitable for these systems is determined.
What Do Turkish Pre-Service Teachers Think About Artificial Intelligence?
Authors: Haseski Halil Ibrahim
Published: September 2019

The aim of the present study was to determine the views of pre-service teachers on artificial intelligence. In the present qualitative study, conducted with the phenomenology design, that data were collected from 94 pre-service teachers attending different departments at Manisa Celal Bayar University, Faculty of Education during the 2018-2019 academic year fall semester in Turkey. Data were collected with semi-structured interview form and written interview form, developed by the author. Collected data were analyzed by using content analysis method and classified under themes. Analyses demonstrated that pre-service teachers assigned different meanings to artificial intelligence, felt basically negative emotions for artificial intelligence, and did not want to live in a world ruled by artificial intelligence. Furthermore, it was found that pre-service teachers considered that artificial intelligence could have both several benefits and risks, and it might have both positive and negative effects on education. Based on the study findings, various recommendations were presented for future studies and implementations on the topic.
The Bell Jar_ Shattered: Exploration of creativity through a psychiatric lens
Authors: Khan Romesa Qaiser , Asnia Latif  , Hashmi Ali Madeeh
Published: September 2019

Aristotle’s theory of melancholia hypothesized for the first time that individuals who possess any form of genius are prone to depression more than the average person. The list of examples supplementing Aristotle’s theory is by no means exhaustive. Extensive medical research has also been done to establish this connection. We will briefly review our understanding of the relationship between creativity and mental illness. We will discuss the insights provided by the life and works of American poet, novelist and short story writer Sylvia Plath. Sylvia Plath extensively chronicled her struggle with lifelong depression in her semi-autobiographical novel 'The Bell Jar'.
Characteristics of wastewater treatment by Chlorella sorokiniana and comparison with activated sludge
Authors: Fan Jie , Cao Liang , Gao Cheng , Chen Yue , Zhang Tian C.
Published: September 2019

Characteristics of Chlorella sorokiniana treating wastewater with consideration of HRT (6 d, 16 h, 8 h), hydraulic conditions, light or dark culture were evaluated and compared with activated sludge. Results showed that optimal HRT was 8 h; if longer, effluent chemical oxygen demand (COD) and NH4+-N in the dark began to rebound. Mixing was beneficial to COD removal of algae, while aeration was suitable for nutrient removal. Growth of C. sorokiniana in the light was mixotrophic growth and 1.3–1.7 times more than that of dark heterotrophic growth. The maximum specific growth rate (µmax), productivity, and biomass yields on COD (YCOD), N (YNH4), P (YP) of algae were higher in the light than that in the dark. COD assimilation capacity of algae was similar to activated sludge but with different dynamics. N and P assimilation capacity of algae was 1.4, 1.2–2.5 times more than activated sludge; N and P removal efficiency of algae was 5%–10%, 10%–55% respectively higher than activated sludge. This study confirmed the advantage of algae over activated sludge and reveal why algae could assist the activated sludge process.
Okul Yöneticilerinin Yönetsel ve Sanal Kaytarma Davranışları Arasındaki İlişki
Authors: Kurun Mehmet , Çobanoğlu Fatma
Published: September 2019

Okulların amaçlarına
ulaşabilmesi, okul yöneticilerinin kendilerine verilen görevleri yerine
getirebilmelerini sağlayacak yönetsel davranışları sergilemelerine bağlıdır.
Ancak teknolojide yaşanan gelişmeler, okul yöneticilerinin yönetsel
davranışları sergilemelerini kolaylaştırmanın yanı sıra bu davranışları
engelleyebilecek sanal kaytarma davranışlarına da neden olabilmektedir. Bu
araştırmada, okul yöneticilerinin yönetsel davranışları ve sanal kaytarma
davranışlarını gösterme düzeyleri arasındaki ilişkinin belirlenmesi
amaçlamıştır. İlişkisel tarama modelinde yürütülen araştırmanın örneklemini,
Denizli ili Tavas ilçesinde görev yapan 41 okul müdürü ve 433 öğretmen
oluşturmuştur. Sanal Kaytarma Ölçeği ve Uluslararası Öğretme ve Öğrenme
Araştırmasında  (TALIS) geliştirilen
Yönetsel Davranışlar Ölçeği ile toplanan verilerin analizinde, normal dağılım
göstermesi nedeniyle parametrik test kullanılmıştır. Ancak grup
karşılaştırmalarında eleman sayısının 30’un altında olduğu durumlarda
nonparametrik testler kullanılmıştır. Araştırmanın sonuçları incelendiğinde,
okul yöneticilerinin öğretmenlerin algılarına kıyasla daha fazla yönetsel
davranışları sergilediklerini düşündükleri ve okul yöneticilerinin “çok az”
düzeyde sanal kaytarma davranışlarında bulundukları sonucuna ulaşılmıştır.
Ayrıca, hem okul yöneticisi hem de öğretmen algılarına göre okul
yöneticilerinin, yönetimsel liderlik davranışlarını, öğretimsel liderlik
davranışlarına göre daha fazla sergiledikleri ortaya çıkmıştır. Okul
yöneticilerinin yönetsel ve sanal kaytarma davranışlarına ilişkin algıları
farklı değişkenler açısından farklılık göstermezken, öğretmen algılarının
öğretmenlerin görev yaptıkları okul türüne göre farklılaştığı görülmüştür. Son
olarak, öğretmen algılarına göre okul yöneticilerinin yönetsel davranışları
sergileme düzeyleri ile sanal kaytarma davranışları gösterme düzeyleri arasında
herhangi bir ilişkinin olmadığı sonucuna ulaşılmıştır.
Sanat Yapıtı Bellek İlişkisi
Authors: Tekin Abdül
Published: September 2019

Post
Prodüksiyon terimi Nicolas Bourriaud tarafından sanatta yapıtın icrası
sonrasını ifade eden ve sinema- televizyon dünyasının yaygın olarak kullandığı
bir terimdir. Bu terim Bourriaud penceresinden sanatla ilişkilendirilirken daha
çok yapıtın üretimi sonrasında meydana gelen etkiler üzerinden düşünmeyi
önermektedir. Bu tarif açıkça zamanın sanat eserinde üretim sonrasını daha
önemli kılan bir yaklaşımı sunmaktadır. Zaman burada yalnızca değiştiren,
dönüştüren yanı ile değil aynı zamanda yapıtı üreten kişinin kontrolü dışında
gelişen bir etken olarak da önemli olduğu gözlenmektedir. Toplumsal anlamda
yapıldığı zamanın ötesine geçen sanat eserlerinin bu bağlamda ulaşılan her
bellekte farklı anlamlarla ilişkilendirilmesi önemsenmektedir. Zamanın yapıtın
gerçek değerine ulaşmada önemli bir unsur olduğu gözlenir. Geleneksel müze ve
galeri sisteminin eleştirisinde sıklıkla dile getirilen müzelerin ve
galerilerin zamanın dönemsel özelliklerini yansıtmada yeterince uygun olmaması
bu durumu destekler. Hatta dönüşen zamanın yapıtın anlamlandırılmasındaki
etkilerinin tam anlamıyla ifadesinde de zamanın galeri ve müzelerde yeterince
temsil edilemediği dahi iddia edilebilir. Aynı zamanda bu tür mekanların benzer
zamanlarda yapılan eserleri bir araya getirerek eseri sunma yöntemi de üzerine
düşünülmesi gereken bir durumdur. Bu durum dönüşen zamanın etkilerini yeterince
anlaşılabilmesinde önem taşımaktadır. Zamanın bütün bu etkileri
değerlendirildiğinde post-prodüksiyon tanımının da hatırlattığı bellek zaman
ilişkisi zamanın sanata etkileri hesaba katıldığında daha da önemli olmaktadır.
From the Explored to the Unexplored: Computer-Tailored Drug Design Attempts in the Discovery of Selective Caspase Inhibitors
Authors: Kumi Ransford O. , Issahaku Abdul R. , Soremekun Opeyemi S. , Agoni Clement , Olotu Fisayo A. , Soliman Mahmoud E.S.
Published: September 2019

The pathophysiological roles of caspases have made them attractive targets in the treatment and amelioration of neurologic diseases. In normal conditions, the expression of caspases is regulated in the brain, while at the onset of neurodegeneration, such as in Alzheimer’s disease, they are typically overexpressed. Till date, several therapeutic efforts that include the use of small endogenous binders have been put forward to curtail dysfunctionalities that drive aberrant death in neuronal cells. Caspases are highly homologous, both in structure and in sequence, which leaves us with the question: is it possible to specifically and individually target caspases, while multiple therapeutic attempts to achieve selective targeting have failed! Based on antecedent events, the use of Computer-Aided Drug Design (CADD) methods has significantly contributed to the design of small molecule inhibitors, especially with selective target ability and reduced off-target therapeutic effects. Interestingly, we found out that there still exists an enormous room for the integration of structure/ligand-based drug design techniques towards the development of highly specific reversible and irreversible caspase inhibitors. Therefore, in this review, we highlight drug discovery approaches that have been directed towards caspase inhibition in addition to an insightful focus on applicable CADD techniques for achieving selective targeting in caspase research.
ST-elevation Myocardial Infarction Due to Stent Underexpansion Managed with Coronary Lithoplasty
Authors: Tripolino Cesare , Tassone Eliezer Joseph , Morabito Gaetano , Grillo Placido , Missiroli Bindo
Published: September 2019

Background:

Coronary calcified lesions may limit optimal stent deployment resulting in
stent underexpansion, increasing the risk of thrombosis. The Shockwave Lithoplasty System, a new
technology combining a balloon angioplasty catheter with the use of sound waves, it is able to break
calcium deposits without affecting vascular soft tissue.

Case Presentation:

An 80-year-old Caucasian man with ST elevation myocardial infarction
underwent emergent coronary angiography showing complete intrastent thrombosis at the proximal
trait of LAD. After thrombus removal, it was evident that stent under-expansion at its proximal edge
was caused by vascular calcification. Coronary shockwave lithoplasty was chosen to treat this lesion.
After calcium deposits disruption we were able to obtain complete stent expansion.

Conclusion:

Our case demonstrates the usefulness and safety of the lithoplasty system in the context
of ST elevation myocardial infarction.
Usefulness of CSF Biomarkers in Predicting the Progression of Amnesic and Nonamnesic Mild Cognitive Impairment to Alzheimer’s Disease
Authors: Ortega Ricard L. , Dakterzada Farida , Arias Alfonso , Blasco Ester , Naudí Alba , Garcia Francisco P. , Piñol-Ripoll Gerard
Published: September 2019

Objective:

The aim of this study was to investigate the usefulness of Alzheimer’s disease Cerebrospinal Fluid (CSF) biomarkers in predicting the progression to dementia in patients with Mild Cognitive Impairment (MCI).

Methods:

One hundred and thirteen patients were consecutively recruited from April 2012 to April 2014. Measurement of CSF biomarkers (amyloid-β42 (Aβ42), total tau (t-tau) and phosphorylated tau (p-tau)) and a neuropsychological evaluation were performed for all patients. We categorized patients with MCI as A+A- and N+N- based on the presence/absence of amyloid pathology and neurodegeneration, respectively.

Results:

Of 72 patients with MCI, 26 (36%) progressed to dementia. These patients had lower CSF Aβ42 levels and higher p-tau and t-tau levels at baseline. The proportion that progressed to dementia was 14.3% (2/14), 36.8% (7/19), 66.7% (4/6) and 75% (12/16) in the A-N-, A+N-, A-N+ (SNAP), and A+N+ patients, respectively (p < 0.05). There were significant differences in the probability of progression from amnestic MCI (aMCI) to AD between the A+N+ and A-N- patients (OR = 8.1, 95% CI 1.5-42.3, p = 0.001) but not between SNAP (OR = 7.3, 95% CI 0.9-61, p = 0.02) or A+N- (OR = 2.1, 95% CI 0.4 to 10.4, p = 0.15) patients compared to the A-N- subgroup. None of the biomarker profiles of the subgroups predicted the time until the progression to AD.

Conclusion:

The use of CSF AD biomarkers in clinical practice improves the certainty of diagnosis and prognosis of patients, especially in patients in the prodromal phase or in patients with atypical presentations.
The Analysis of the Effects of Executive Functions, Working Memory and Other Factors on Medication Adherence in Elderly Men with Benign Prostatic Hyperplasia and Overactive Bladder Symptoms
Authors: Kosilov Kirill , Kuzina Irina , Kuznetsov Vladimir , Kosilova Liliya , Ivanovskaya Marina , Kosilova Ekaterina
Published: September 2019

Aim:

Evaluation of the executive function and working memory influence, as well as the
general state of memory, on adherence to Benign Prostatic Hyperplasia (BPH) and overactive bladder
symptoms treatment in elderly men.

Background:

The influence of the executive function and working memory on treatment adherence
in older men with BPH has not been studied enough.

Objective:

To determine the level of influence of various factors on the treatment adherence in
older men with BPH.

Method:

The executive function and working memory evaluation, as well as a general memory
assessment, were carried out using the Wisconsin Test, the Wechsler Memory Scale, and the California
Verbal Test. Hierarchical and simultaneous regressions were calculated to study the effect of
executive function and working memory.

Result:

After the end of the study, the symptoms of hyperactive bladder significantly decreased,
the symptoms of evacuation did not change significantly, and the cognitive status of the patients
remained unchanged. The predictor variables significantly influencing adherence of elderly men to
BPH and overactive bladder (OAB) treatment are executive function and working memory composite
(β = .33, p & lt; .05), severe symptoms of lower urinary tract (-.34, p & lt; .05), and age
(-.27, p & lt; .05).

Conclusion:

The status of executive function and working memory, as well as the age and severity
of the pathological symptoms of the lower urinary tract, should be taken into account when predicting
the risks of rejecting BPH and OAB treatment in elderly patients.
Thermodynamics, Kinetics and Isotherms Studies for Sorption of Direct Dye onto the Pectinase Pre-treated Jute Yarn
Authors: Zolriasatein Ali Akbar
Published: September 2019

Background & Objective:

In this paper, jute yarns were bio-treated with pectinase
enzyme. Then, the untreated and bio-treated yarns were dyed with Direct Yellow 24. The biotreated
jute yarn showed higher dye sorption compared to that of untreated jute yarn.

Methods:

The sorption isotherms were fitted with the Nernst, Freundlich, Langmuir, Temkin
and BET models. At all temperatures studied, the experimental data were better described
with the Freundlich model. Thermodynamic parameters such as a change in free energy
(ΔG0), the enthalpy (ΔH0), and the entropy (ΔS0) were also evaluated. The values of ΔH0 and
ΔG0 indicated that the sorption of direct dye onto jute yarn was a physical sorption process.
Furthermore, the sorption process was exothermic and spontaneous.

Results:

The results indicated that bio-treated jute yarn was more favorable (1/n < 1) for the
sorption of direct dye as compared to that of untreated jute yarn (1/n > 1).

Conclusion:

Among the kinetic models studied, it was found that the pseudo second-order
kinetic model was the best model to describe the sorption process of Direct Yellow 24 onto
the bio-treated and untreated jute yarns.
A Clinical Evaluation of Agnikarma in the management of Greeva Sandhigata Vata w.s.r. to Cervical Spondylosis
Authors: Bhorale Vinodkumar K. , Hungundi M. R.
Published: September 2019

Today is the era of modernization and fast life. Everybody is busy and living stressful life changing of life style of modern human being has created several disharmonie. In his biological system. Advancement of busy, professional and social life, improper sitting posture in offices, continuous work in one posture and over exertion, jerking movements during travelling and sports - all these factors create undue pressure and stress injury to the spine and play an important role in producing disease like cervical spondylosis. Agnikarma is said to be the most superior among all the Anushastra Karma. Agnikarma is superior to Ksharakarma as disease burnt with Agni will never recur. Disease that cannot be cured with medicines, Kshara and Surgery, can be cured with Agnikarma.
Benefits of Blockchain Initiatives for Value-Based Care: Proposed Framework
Authors: Zhang Rongen , George Amrita , Kim Jongwoo , Johnson Veneetia , Ramesh Balasubramaniam
Published: September 2019

Background

The potential of blockchain technology to achieve strategic goals, such as value-based care, is increasingly being recognized by both researchers and practitioners. However, current research and practices lack comprehensive approaches for evaluating the benefits of blockchain applications.

Objective

The goal of this study was to develop a framework for holistically assessing the performance of blockchain initiatives in providing value-based care by extending the existing balanced scorecard (BSC) evaluation framework.

Methods

Based on a review of the literature on value-based health care, blockchain technology, and methods for evaluating initiatives in disruptive technologies, we propose an extended BSC method for holistically evaluating blockchain applications in the provision of value-based health care. The proposed method extends the BSC framework, which has been extensively used to measure both financial and nonfinancial performance of organizations. The usefulness of our proposed framework is further demonstrated via a case study.

Results

We describe the extended BSC framework, which includes five perspectives (both financial and nonfinancial) from which to assess the appropriateness and performance of blockchain initiatives in the health care domain.

Conclusions

The proposed framework moves us toward a holistic evaluation of both the financial and nonfinancial benefits of blockchain initiatives in the context of value-based care and its provision.
Use of Health Apps by Nurses for Professional Purposes: Web-Based Survey Study
Authors: Mayer Miguel Angel , Rodríguez Blanco Octavi , Torrejon Antonio
Published: September 2019

Background

In the last few years, the number of mobile apps for health professionals has increased exponentially. Nevertheless, there is a lack of knowledge about the professional use, training requirements, and quality perception of these apps among health care professionals such as nurses. Considering that the nursing profession is the largest segment of health care workforce in many countries such as Spain, the impact of the use of health apps by these professionals can be critical to the future of modern health care.

Objective

The main objective of this study was to determine if nurses were using health apps professionally and what types of apps they were using. The secondary objectives were (1) to find out if, among nurses, there is a need for training in the use of health apps and (2) to explore nurses’ perceptions of health professional apps, determining whether there is a need for a certification process for health apps and the type of institution or organization that should review and validate these apps for professional use.

Methods

After an initial piloting survey, all registered nurses at the Nursing Association of Barcelona were invited to participate in a 34-item online survey. Eventually, 1293 nurses participated in the survey; however, 52 did not complete the survey properly, omitting both age or gender information, and they were excluded from the analysis.

Results

About half of the respondents (600/1241, 48.35%) had health professional apps installed on their devices and were included for analysis. Most participants in the survey were women (474/600, 79.0%) and the remaining were men (126/600, 21.0%). The most popular types of apps used and installed among nurses were related to drug information, health calculators, and health guidelines. Overall, 97.0% (582/600) of nurses thought that the health apps should be certified, and 80.0% (480/600) agreed that the certification process should be carried out by professional or health institutions. Furthermore, 14.5% (87/600) of participants mentioned that they were asked by their patients to prescribe a health app and only 6.5% (28/430) recommended them often. Most nurses (354/433, 81.8%) who answered the question about the importance of receiving specific training on using and prescribing health apps considered this point a very relevant issue.

Conclusions

About half of the nurses in Catalonia use health apps for professional purposes, and they believe that these types of tools should be validated and certified by health or professional institutions before using them in clinical environments. Although the prescription of health apps in clinical environments is infrequent among nurses, they would be willing to prescribe apps if they were certified by a health organization. Finally, among nurses, there is a need for training in using and prescribing health apps for health care purposes.
Assessing the Appeal of Instagram Electronic Cigarette Refill Liquid Promotions and Warnings Among Young Adults: Mixed Methods Focus Group Study
Authors: Laestadius Linnea I , Penndorf Kendall E , Seidl Melissa , Cho Young I
Published: September 2019

Background

While marketing for electronic cigarette refill liquids (e-liquids) is widespread on Instagram, little is known about the post elements that create appeal among young adult Instagram users. Further information is needed to help shape regulatory strategies appropriate for social media.

Objective

This study examined young adult Instagram user perceptions of actual e-liquid marketing posts and US Food and Drug Administration (FDA)–mandated nicotine addiction warning statements on Instagram.

Methods

A series of 12 focus groups (n=69) were held with non–tobacco users, vapers, smokers, and dual users in Wisconsin between September and December 2018. Participants discussed the elements of posts that they found appealing or unappealing, in addition to completing a survey about each post and e-liquid. Focus group transcripts were analyzed by smoking status using a framework analysis approach.

Results

Although willingness to try e-liquids was highest among nicotine users, focus group discussions indicated that Instagram posts promoting e-liquids held appeal for individuals across smoking statuses. The primary elements that created appeal were the perceived trustworthiness of the Instagram account, attractive design and flavor visuals, and promotion of flavors and nicotine levels that met personal preferences. Post appeal was reduced by references to vaping subcultures, indicators that the post creator did not take nicotine addiction seriously, and FDA-mandated nicotine warning statements. Non–tobacco users were particularly drawn to posts featuring nicotine-free e-liquids with attractive visual designs and flavors known from foods.

Conclusions

Young adults consider a broad range of elements in assessing the appeal of e-liquid marketing on Instagram, with minor but notable distinctions by smoking status. Non–tobacco users are uniquely drawn to nicotine-free e-liquids and are more deterred by the FDA’s mandated nicotine addiction warning statements than those from other smoking statuses. This suggests that it may be possible to tailor policy interventions in a manner that helps to reduce novel uptake of vaping without significantly diminishing its potential harm-reduction benefits.
Benefits of Blockchain Initiatives for Value-Based Care: Proposed Framework (Preprint)
Authors: Zhang Rongen , George Amrita , Kim Jongwoo , Johnson Veneetia , Ramesh Balasubramaniam
Published: September 2019

BACKGROUND

The potential of blockchain technology to achieve strategic goals, such as value-based care, is increasingly being recognized by both researchers and practitioners. However, current research and practices lack comprehensive approaches for evaluating the benefits of blockchain applications.

OBJECTIVE

The goal of this study was to develop a framework for holistically assessing the performance of blockchain initiatives in providing value-based care by extending the existing balanced scorecard (BSC) evaluation framework.

METHODS

Based on a review of the literature on value-based health care, blockchain technology, and methods for evaluating initiatives in disruptive technologies, we propose an extended BSC method for holistically evaluating blockchain applications in the provision of value-based health care. The proposed method extends the BSC framework, which has been extensively used to measure both financial and nonfinancial performance of organizations. The usefulness of our proposed framework is further demonstrated via a case study.

RESULTS

We describe the extended BSC framework, which includes five perspectives (both financial and nonfinancial) from which to assess the appropriateness and performance of blockchain initiatives in the health care domain.

CONCLUSIONS

The proposed framework moves us toward a holistic evaluation of both the financial and nonfinancial benefits of blockchain initiatives in the context of value-based care and its provision.