bluuebunny/crossref_metadata_2025 huggingface dataset:
Kualitas Antarmuka Terhadap Minat Beli: Dimediasi Kepercayaan Konsumen pada Aplikasi Belanja Online
Authors: Tukino Tukino , Nurastuti Preatmi , Hartati Nani , Yuningsih Nining , Sudharsono Muhamad
Published: August 2021

Penelitian menguji model pengaruh kualitas antarmuka terhadap minat beli konsumen dengan variabel mediasi kepercayaan konsumen kepada penjual di aplikasi belanja online Shopee.com. Penelitian menggunakan pendekatan kuantitatif dengan sampel konsumen Shopee.com sebanyak 152 orang. Analisis menggunakan model struktural diolah software SMARTPLS 3.0. Hasil penelitian ini membuktikan bahwa kualitas antarmuka tidak berpengaruh terhadap minat beli, kualitas antarmuka berpengaruh terhadap kepercayaan, dan kepercayaan berpengaruh terhadap minat beli. Kepercayaan memediasi kualitas antarmuka terhadap minat beli konsumen pada aplikasi belanja online Shopee.com, sehingga tanpa kepercayaan maka tidak akan ada minat beli pada konsumen belanja online.

The study aims to examine the model of the influence of interface quality on consumer buying interest with the mediating variable of consumer trust in sellers in the Shopee.com online shopping application. The study uses a quantitative approach with a sample of 152 Shopee.com consumers. Analysis using a structural model processed by SMARTPLS 3.0 software. The results of this study prove that the quality of the interface has no effect on buying interest, the quality of the interface has an effect on trust, and trust has an effect on buying interest. Trust mediates the effect of interface quality on consumer buying interest in the Shopee.com online shopping application, so without trust there will be no buying interest in online shopping consumers.
Budaya Organisasi Terhadap Kinerja Dimediasi Kepuasan dan Loyalitas Kerja Karyawan
Authors: Qorfianalda Sardika , Wulandari Anna
Published: August 2021

Penelitian ini menguji model pengaruh budaya organisasi terhadap kinerja dengan variabel mediasi kepuasan kerja dan loyalitas kerja di PT. Padang Golf Cikarang. Penelitian menggunakan pendekatan kuantitatif dengan sampel karyawan PT. Padang Golf Cikarang sebanyak 40 orang. Analisis menggunakan model struktural diolah software SMARTPLS 3.0. Budaya organsiasi berpengaruh terhadap kepuasan kerja, kepuasan berpengaruh terhadap kinerja, budaya organsiasi berpengaruh terhadap loyalitas kerja, tetapi loyalitas tidak berpengaruh terhadap kinerja. Kepuasan kerja memediasi budaya organisasi terhadap kinerja, tetapi loyalitas kerja tidak memediasi budaya organisasi terhadap kinerja.

This study aims to examine the model of the influence of organizational culture on performance with the mediating variables of job satisfaction and job loyalty at PT. Cikarang Golf Course. The study used a quantitative approach with a sample of employees of PT. Cikarang Golf Course as many as 40 people. Analysis using a structural model processed by SMARTPLS 3.0 software. The results of this study that organizational culture affects job satisfaction, job satisfaction affects performance, organizational culture affects work loyalty, but work loyalty has no effect on performance. Job satisfaction mediates the effect of organizational culture on performance, but job loyalty does not mediate the influence of organizational culture on performance.
Pengaruh Pendidikan dan Pelatihan terhadap Etos Kerja serta Implikasinya terhadap Kinerja
Authors: Mariatie Novtri , Hasanah Siti
Published: August 2021

Penelitian bertujuan mengetahui pengaruh pendidikan dan pelatihan terhadap etos kerja serta implikasinya terhadap kinerja karyawan. Objek penelitian adalah karyawan yang berada di Kabupaten Bekasi. Sampel penelitian sebanyak 100 karyawan sebagai responden yang mengisi kuesioner. Analisis menggunakan model perbandingan struktural (SEM) dengan program perangkat lunak Smart PLS. Hasilnya menunjukan bahwa pendidikan dan pelatihan berpengaruh terhadap etos kerja, serta etos kerja berpengaruh terhadap kinerja karyawan. Dengan pendidikan dan pelatihan yang optimal maka akan meningkatkan etos kerja sehingga kinerja karyawan pun semakin meningkat.

This study aims to determine the effect of education and training on work ethic and its implications for employee performance. The object of research is employees who are in Bekasi Regency. The research sample was 100 employees as respondents who filled out the questionnaire. The analysis uses a structural comparison model (SEM) with the Smart PLS software program. The results show that education and training affect work ethic, and work ethic affects employee performance. With optimal education and training, it will improve work ethic so that employee performance will increase.
Reform of the Political Party Law and the Election Law Related to the Criminal Responsibility of Political Parties in Indonesia
Authors: Harun M. , Putra Jaya Nyoman Serikat , Sularto R.B
Published: August 2021

This study tries to analyze the criminal liability of political parties in the Political Party Law and the Election Law in Indonesia, as well as conceptualize the renewal of the criminal liability of political parties. This research includes normative legal research, with the type of data used in this study is qualitative data. The results of the study indicate that political parties are corporations that can and are capable of being held criminally responsible, as seen in Law Number 2 of 2008 as amended by Law Number 2 of 2011 concerning Political Parties. Criminal liability can be further regulated by imposing it on individual legal subjects. As a conceptualization of the renewal of the criminal responsibility of political parties, it is necessary to define the affirmation of political parties as the subject of criminal acts, sanctions and types of criminal acts, special punishment rules, and reasons for the elimination of a prosecution.
Estilos del sentido del humor predominantes en docentes del nivel preescolar
Authors:   Universidad Nacional de Educación Enrique Guzmán y Valle, Herrera Alvarez Angela María , Lavado Guzmán Milagritos Yrene ,   Universidad Privada Norbert Wiener
Published: August 2021

El estudio tuvo como objetivo describir los estilos de sentido de humor predominantes en docentes del nivel preescolar. Para esto, se consideró que estos pueden contribuir a generar espacios de aprendizaje en el aula y, a su vez, que el desarrollo de los niños en edad preescolar se ve favorecido en espacios donde lo lúdico y gracioso está presente, de manera tal que se logre una mejor construcción del conocimiento. La intervención se desarrolló bajo un diseño descriptivo con una muestra de 127 docentes de preescolar de la región selva central del Perú, a quienes se le administró el instrumento Humor Styles Questionnaire (HSQ) que permitió evaluar los estilos de humor de los docentes. Como resultado, se encontró que el 74.8% considera que cuenta con sentido del humor alto; dentro de los estilos, se halló que un 67% de docentes reconocen tener un estilo afiliativo y mejoramiento personal, lo cual es beneficioso para su práctica educativa y, en cuanto al estilo desadaptativo, el 12 % de docentes considera que posee ese humor. Se concluye que los docentes del nivel preescolar poseen un buen nivel de estilos del humor, lo cual favorecería la práctica pedagógica. Asimismo, es necesario erradicar el estilo desadaptativo en algunas docentes, ya que podría ocasionar problemas tanto en el entorno personal como profesional.
Solar Microgrids in Rural India
Authors: Chakravarty Debalina , Roy Joyashree
Published: August 2021

This study evaluates the benefits that rural households in India derive from dedicated solar microgrid service systems. A case study was conducted in Lakshmipura-Jharla, Rajasthan, a village in western India with significant potential for producing solar energy. In 2013, a private investor set up a solar microgrid in the village and distributed energy-efficient appliances. Its goal was to give poor households access to modern energy services. The study data were collected through a survey conducted among randomly selected households in the village. The survey found that such an electricity provision service had multidimensional benefits: flexible use of the energy service, more effective time allocation among women, more study time for students, improved indoor air quality, and safer public places. Given the initial unmet demand for modern energy in the village, technological interventions supported by policy has helped to expand consumption possibilities and new demand for services has emerged. The household-level frontier rebound effect is estimated to be more than 100%, reflecting a one-and-a-half times increase in the demand for illumination services among rural households. Frontier rebound effect estimates help quantify the benefits of solar microgrids and energy-efficient appliances for households in rural areas...
Adoption of Soil Conservation Measures
Authors: Peddi Dayakar , KS Kavi Kumar
Published: August 2021

Land degradation resulting from soil erosion is a major problem in rain-fed agricultural areas in India. This study analyses the key determinants of farmers’ decisions to adopt on-farm soil and water conservation (SWC) measures in the rain-fed watershed areas of Siddipet district in Telangana. Here, SWC measures have been undertaken by the government and NGOs at the sub-watershed/community level and by individual farmers at the farm level. The study is based on a primary survey of over 400 farmers conducted in January–March 2018. In addition to estimating the influence of biophysical and market access variables on farmers’ decisions to undertake SWC practices, the study includes a logistic model that found a complementarity between community and individual plot-level interventions to improve soil health. The findings also highlight the influence of conservation measures practised in the neighbourhood on farmers’ decisions to implement SWC measures.
Why Socio-metabolic Studies are Central to Ecological Economics
Authors: Singh Simron J , Talwar Simran , Shenoy Megha
Published: August 2021

Global material extraction has tripled since the 1970s, with more than 100 billion tonnes of materials entering the world economy each year. Only 8.6% of this is recycled, while 61% ends up as waste and emissions that is the leading cause of global warming, and large-scale pollution of land, rivers, and oceans. This paper introduces Socio-metabolic Research (SMR) and demonstrates its relevance for ecological economics scholarship in India. SMR is a research framework for studying the biophysical stocks and flows of material and energy associated with societal production and consumption. SMR is widely conducted in Europe, US, and China. In India, it is still at an infant stage. In this paper, we review pioneering efforts of SMR in India, and make the case for advancing the field in the sub-continent. The crucial question is whether India can source materials and energy necessary for human development in a sustainable manner.
Making Nature Count
Authors: Srinivasan Umesh , Shanker Kartik
Published: August 2021

Earth’s biodiversity is the ultimate engine of local and global economies and compromising the renewability of our natural resources will ultimately halt economic growth. Despite this, humankind has continued to exploit natural resources such as fisheries and forests at highly unsustainable rates in the pursuit of flawed development paradigms and simplistic metrics such as gross domestic product (GDP). This has already led to the loss of natural habitats and the decline and extinction of species as well as consequences such as an increase in zoonotic pandemics. The Economics of Biodiversity, a recent report by Sir Partha Dasgupta, addresses how the failure of our current institutions has brought us to where we stand and suggests ways by which we may reform our economic thought to mitigate the impacts on biodiversity. The report identifies important first steps: changing the way we measure economic “success”...
Conserving Economics for Biodiversity
Authors: S  Raina Rajeswari
Published: August 2021

The Economics of Biodiversity: The Dasgupta Review (Dasgupta 2021), henceforth the Review, tells us that we are embedded in Nature and our economies are bounded within Nature. It helps us estimate the value of natural capital and include it in estimations of economic output. The Review’s key messages concern (i) keeping our demands well within Nature’s supply, (ii) moving away from gross domestic product (GDP) towards inclusive wealth as a measure of economic success, and (iii) acknowledging the institutional failure in addressing global environmental problems and resolving them through institutional reforms in the financial and education systems. However, this commentary suggests that the Review is about conserving economics for biodiversity. It offers little opportunity for transformative change in our thinking and acting, to change our relationship with Nature so that we can conserve its diversity and dynamism...
Self-care or Delay in Seeking Healthcare
Authors: Basappa Shivanand Savatagi
Published: August 2021

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The Right to Liberty in a Pandemic
Authors: McWhirter Rebekah
Published: August 2021

The European Convention on Human Rights has given rise to the most extensive and influential case law of any human rights jurisdiction, and the inclusion of an express infectious diseases exception to the right to liberty suggests that its jurisprudence is likely to provide the best available guidance to states on the circumstances in which such measures may be justifiable and lawful. However, this article argues that the principles developed to date are limited in their applicability to the current crisis, and are insufficient for determining the appropriate balance between public health and the right to liberty when seeking to control the spread of a large-scale, highly infectious disease.
ILMU SEBAGAI SUBSTANSI DA’WAH DALAM ISLAM
Authors: Ujang Habibi
Published: August 2021

Tujuan penelitian ini untuk mengetahui kedudukan ilmu sebagai substansi da’wah dalam Islam. Metode penelitian menggunakan kualitatif. Hasil dalam artikel ini menunjukkan bahwa Islam menjunjung tinggi ilmu, baik ilmu itu sendiri maupun orang-orang yang menekuni ilmu, mengerahkan tenaga dan waktunya untuk menggali ilmu. Karena begitu pentingnya ilmu sehingga Allah menyebutkan kata ini sampai beratus-ratus kali. Bagi Islam, sumber ilmu yang paling benar adalah dari al-Qur’an dan hadits yang shahih, sehingga bagi seorang muslim pun harus menyandarkan ilmu nya kepada keduanya dan melandasinya dengan konsep aqidah atau tauhid yang kokoh kepada Allah sebagai sumber ilmu yang absolut.
Autoantibodies Against Unmodified and Citrullinated Human Endogenous Retrovirus K Envelope Protein in Patients With Rheumatoid Arthritis
Authors: Wang Xiaoxing , Hefton Amanda , Ni Kathryn , Ukadike Kennedy C. , Bowen Michael A. , Eckert Mary , Stevens Anne , Lood Christian , Mustelin Tomas
Published: August 2021

Objective

Autoantibodies against proteins encoded by human endogenous retrovirus K (HERV-K) have been reported in patients with rheumatoid arthritis (RA), but their relevance, if any, has remained unresolved. We revisited this question and tested if such autoantibodies may react with citrullinated epitopes on the envelope (Env) protein of HERV-K.

Methods

Immunoblotting and ELISAs were conducted with unmodified Env protein and with Env citrullinated by protein arginine deiminase 4 (PAD4). Sera from 100 patients with RA, plasma from 32 patients with juvenile idiopathic arthritis (JIA), and healthy adult and pediatric controls were included. Antibody reactivity was evaluated for correlations with clinical and laboratory variables of the patients.

Results

We replicated and expanded upon published data suggesting that patients with RA or JIA have autoantibodies against HERV-K Env, some with high titers. Anti-HERV-K antibodies correlated with cigarette smoking and with circulating myeloperoxidase-DNA complexes indicative of nonapoptotic neutrophil cell death. Further, most of the patients with RA, but not those with JIA, had autoantibodies that reacted more strongly with Env that was citrullinated by PAD4. These anticitrullinated Env autoantibodies correlated with seropositivity and tended to be higher in patients with erosive disease.

Conclusion

Our data suggest that anti-HERV-K immunity is elevated in RA and JIA and may have a connection with pathogenic protein citrullination in RA.
Persistence to Biologic Therapy Among Patients With Ankylosing Spondylitis: An Observational Study Using the OPAL Dataset
Authors: Griffiths Hedley , Smith Tegan , Mack Christopher , Leadbetter Jo , Butcher Belinda , Acar Mustafa , Ciciriello Sabina
Published: August 2021

Objective

To describe the treatment response and persistence to biologic disease-modifying antirheumatic drug (bDMARD) therapy in patients with ankylosing spondylitis (AS) in a real-world Australian cohort.

Methods

This was a retrospective, noninterventional cohort study that extracted data for patients with AS from the Optimising Patient outcomes in Australian RheumatoLogy (OPAL) dataset for the period of August 2006 to September 2019. Patients were classified as either bDMARD initiators if they commenced a bDMARD during the sampling window, or bDMARD-naïve if they did not. Results were summarized descriptively. Treatment persistence was calculated using Kaplan-Meier methods. Differences in treatment persistence were explored using log-rank tests.

Results

There were 5048 patients with AS identified. Of these, 2597 patients initiated bDMARDs and 2451 remained bDMARD-naïve throughout the study window. Treatment with first-, second-, and third-line bDMARDs significantly reduced disease activity. Median persistence on first-line bDMARDs was 96 months (95% CI 85–109), declining to 19 months (95% CI 16–22) in second-line therapy, and 15 months (95% CI 11–18) in third-line therapy. Median persistence was longest for the golimumab (GOL) group in all lines of therapy and shortest for the etanercept (ETN) group. Differences in persistence rates according to the time period that bDMARDs were prescribed (pre- and post-2012) were also seen for ETN and adalimumab.

Conclusion

In this cohort, all bDMARDs effectively reduced AS disease activity. Treatment persistence was sustained for up to 8 years for patients remaining on their first bDMARD, longer than on subsequent agents. Further research is needed to determine its influence on treatment recommendations.
Variations in Pediatric Rheumatology Workforce and Care Processes Across Canada
Authors: Lee Jennifer J.Y. , Laxer Ronald M. , Feldman Brian M. , Barber Claire E.H. , Batthish Michelle , Berard Roberta , Tucker Lori B. , Levy Deborah M. ,   on behalf of the Pediatrics Committee of the Canadian Rheumatology Association
Published: August 2021

Objective

To examine the Canadian pediatric rheumatology workforce and care processes.

Methods

Pediatric rheumatologists and allied health professionals (AHPs) participated. A designee from each academic center provided workforce information including the number of providers, total and breakdown of full-time equivalents (FTEs), and triage processes. We calculated the clinical FTE (cFTE) available per 75,000 (recommended benchmark) and 300,000 (adjusted) children using 2019 census data. The national workforce deficit was calculated as the difference between current and expected cFTEs. Remaining respondents were asked about ambulatory practices.

Results

The response rate of survey A (workforce information) and survey B (ambulatory practice information) was 100% and 54%, respectively. The majority of rheumatologists (91%) practiced in academic centers. The median number of rheumatologists per center was 3 (IQR 3) and median cFTE was 1.9 (IQR 1.5). The median cFTE per 75,000 was 0.2 (IQR 0.3), with a national deficit of 80 cFTEs. With the adjusted benchmark, there was no national deficit, but there was a regional maldistribution of rheumatologists. All centers engaged in multidisciplinary practices with a median of 4 different AHPs, although the median FTE for AHPs was ≤ 1. Most centers (87%) utilized a centralized triage process. Of 9 (60%) centers that used an electronic triage process, 6 were able to calculate wait times. Most clinicians integrated quality improvement practices, such as previsit planning (67%), postvisit planning (68%), and periodic health outcome monitoring (36–59%).

Conclusion

This study confirms a national deficit at the current recommended benchmark. Most rheumatologists work in multidisciplinary teams, but AHP support may be inadequate.
Heterogeneity in Patient Characteristics and Differences in Treatment Across 4 Canadian Rheumatoid Arthritis Cohorts
Authors: Hazlewood Glen S. , Bombardier Claire , Li Xiuying , Movahedi Mohammad , Choquette Denis , Coupal Louis , Bykerk Vivian P. , Schieir Orit , Mosher Dianne , Marshall Deborah A. , Bernatsky Sasha , Spencer Nicole , Richards Dawn P. , Proulx Laurie , Barber Claire E.H.
Published: August 2021

Objective

To compare clinical characteristics and treatment of patients with rheumatoid arthritis (RA) across 4 Canadian cohorts.

Methods

The 4 longitudinal cohorts included the following: the Canadian Early Arthritis Cohort (CATCH; n = 2878), Ontario Best Practices Research Initiative (OBRI; n = 3734), RHUMADATA (Quebec, n = 2890), and the Rheum4U Precision Health Registry (Calgary, Alberta, n = 709). Data were from cohort inception (range 1998–2016) to 2020. Clinical characteristics and drug treatments were summarized descriptively.

Results

In total, 10,211 patients with RA were included. The percentage of patients who entered the cohort with early RA (2 yrs of disease at enrollment) ranged from 29% (Rheum4U) to 100% (CATCH). Mean age (55 yrs), sex (74% female), and seropositivity (69%) were similar between cohorts. At the time of initial disease-modifying antirheumatic drug (DMARD) use, median Disease Activity Score in 28 joints (DAS28) varied, ranging from 2.99 (Rheum4U) to 5.19 (CATCH), but were more similar at the time of the first DMARD switch (range 3.57–5.03), first biologic (bDMARD) or targeted synthetic DMARD (tsDMARD) use (range 4.01–4.67), and second bDMARD or tsDMARD (range 3.71–4.39). The initial DMARD was most commonly methotrexate, either in monotherapy (32%, range 18–40%) or dual therapy (34%, range 29–42%). The first DMARD switch was to another DMARD monotherapy in 20% (range 10–32%), dual therapy in 49% (range 39–56%), and bDMARD or tsDMARD in 24% (range 15–28%). The first bDMARD was an anti–tumor necrosis factor in 79% (range 78–82%).

Conclusion

Canadian RA cohorts demonstrate some heterogeneity in treatment, which could reflect differences in inclusion criteria, calendar year, or regional differences. This project is a first step toward conducting harmonized analyses across Canadian RA cohorts.
Risk Factors for Diagnosis of Psoriatic Arthritis, Psoriasis, Rheumatoid Arthritis, and Ankylosing Spondylitis: A Set of Parallel Case-control Studies
Authors: Meer Elana , Thrastardottir Telma , Wang Xingmei , Dubreuil Maureen , Chen Yong , Gelfand Joel M. , Love Thorvardur J. , Ogdie Alexis
Published: August 2021

Objective

To compare potential risk factors for the diagnosis of psoriatic arthritis (PsA), psoriasis (PsO), rheumatoid arthritis (RA), and ankylosing spondylitis (AS).

Methods

Four parallel case-control studies were conducted within The Health Improvement Network using data between 1994 and 2015. Patients with PsA, PsO, RA, or AS were identified using validated code lists and matched to controls on age, sex, practice, and year. Risk factors were selected in the time prior to diagnosis. Multivariable logistic regression models were constructed for each disease using automated stepwise regression to test potential risk factors.

Results

Patients with incident PsA (n = 7594), PsO (n = 111,375), RA (n = 28,341), and AS (n = 3253) were identified and matched to 75,930, 1,113,345, 283,226, and 32,530 controls, respectively. Median diagnosis age was 48 (IQR 38–59), 43 (IQR 28–60), 60 (IQR 48–71), and 41 (IQR 32–54) years, respectively. In multivariable models, there were some shared and some differing risk factors across all 4 diseases: PsA was associated with obesity, pharyngitis, and skin infections; PsA and PsO were associated with obesity and moderate alcohol intake; PsA and AS were associated with uveitis; and PsA and RA were associated with preceding gout. Both RA and AS were associated with current smoking, former moderate drinking, anemia, osteoporosis, and inflammatory bowel disease. All shared former or current smoking as a risk factor; statin use was inversely associated with all 4 diseases.

Conclusion

Shared and different risk factors for PsA, PsO, RA, and AS were identified. Statin use was inversely associated with all 4 conditions.
Anxiety and Depressive Symptoms in Juvenile Idiopathic Arthritis Correlate With Pain and Stress Using PROMIS Measures
Authors: Fair Danielle C. , Nocton James J. , Panepinto Julie A. , Yan Ke , Zhang Jian , Rodriguez Martha , Olson Judyann
Published: August 2021

Objective

Describe anxiety and depressive symptoms in children with juvenile idiopathic arthritis (JIA) using Patient Reported Outcomes Measurement Information System (PROMIS) measures and evaluate potential correlations with disease manifestations.

Methods

We performed a cross-sectional study of children with JIA and a parent proxy who completed PROMIS measures on depression, anxiety, stress, and pain. The Childhood Health Assessment Questionnaire (CHAQ) measured mobility, and the clinical Juvenile Arthritis Disease Activity Score in 10 joints (cJADAS10) measured disease activity.

Results

Eighty-four patients completed the study. Demographic median values included age (14 yrs), disease duration (4.73 yrs), CHAQ score (0), total active joint count (0), and cJADAS10 (2). Using cJADAS10, 57 patients (70%) had inactive or low disease activity. Mean PROMISt-scores for depressive and anxiety symptoms were lower in children with JIA compared to the reference population (P< 0.0001). Nineteen patients (23%) had moderate to severe symptoms of anxiety and/or depression. Age and CHAQ score (mobility) correlated with depressive symptoms (r= 0.36,P=0.0008 andr= 0.32,P =0.0029, respectively) but not anxiety. Depressive and anxiety symptoms correlated with pain (r= 0.64 andr= 0.47, respectively,P <0.0001) and stress (r= 0.79 andr= 0.75, respectively,P <0.0001) but not with sex, JIA subtype, disease duration, or disease activity.

Conclusion

Approximately one-quarter of children with JIA reported moderate to severe symptoms of anxiety and depression. These symptoms are associated with pain and stress, but they are not associated with other disease manifestations. Understanding how mental health symptoms and JIA affect each other is necessary in order to improve patient outcomes and provide well-rounded care.
Domains to Be Considered for the Core Outcome Set of Axial Spondyloarthritis: Results From a 3-round Delphi Survey
Authors: Boel Anne , Navarro-Compán Victoria , Boonen Annelies , Mease Philip , Kiltz Uta , Dougados Maxime , Landewé Robert , van der Heijde Désirée
Published: August 2021

Objective

Advances in the field of axial spondyloarthritis (axSpA) and the methodology to develop core sets have led the Assessment of SpondyloArthritis international Society (ASAS) group to update the ASAS–Outcomes in Rheumatology (OMERACT) core set. An important aspect was to ensure it would be applicable to the entire spectrum of axSpA. The first step was to define the most relevant disease domains.

Methods

A 3-round Delphi survey was conducted to gather opinions of 188 patients and 188 axSpA experts to define the most relevant disease domains to be included in the core set. The Delphi survey evaluated 2 separate research settings: (1) studies assessing symptom-modifying therapies; and (2) studies evaluating disease-modifying therapies. Importance of the domains was rated on a 1–9 Likert scale. A domain was considered for inclusion if, for both stakeholder groups, ≥ 70% of participants scored the domain as critical (7–9) and ≤ 15% scored it as not important (1–3) after 3 rounds.

Results

A total of 132 (70%) patients and 135 (72%) experts completed at least 1 round. After 3 rounds, 7 domains (pain, physical function, stiffness, disease activity, mobility, overall functioning and health, peripheral manifestations) were selected for the symptom-modifying therapies setting. For the disease-modifying therapies setting, 6 domains (physical function, disease activity, mobility, structural damage, extramusculoskeletal manifestations, peripheral manifestations) were selected. All domains selected by experts were also selected by patients. Patients selected all offered domains except emotional function.

Conclusion

This study provides the domains selected by patients and axSpA experts that should be considered for the core set for axSpA.
Screening for Hepatitis B Virus Prior to Initiating Tocilizumab and Tofacitinib in Patients With Rheumatic Diseases: A Cross-sectional Study
Authors: Mohareb Amir M. , Patel Naomi J. , Fu Xiaoqing , Kim Arthur Y. , Wallace Zachary S. , Hyle Emily P.
Published: August 2021

Objective

Hepatitis B virus (HBV) can reactivate among rheumatology patients initiating tocilizumab (TCZ) or tofacitinib (TOF). HBV screening is recommended by the Centers for Disease Control and Prevention (CDC), the American Association for the Study of Liver Diseases (AASLD), and the Canadian Rheumatology Association, but it is not explicitly recommended by the American College of Rheumatology.

Methods

We conducted a cross-sectional study to characterize HBV screening practices for adult rheumatology patients initiating TCZ or TOF before December 31, 2018, in the Greater Boston area. We classified appropriate HBV screening patterns prior to TCZ or TOF (i.e., HBV surface antigen [HBsAg], total core antibody [anti-HBcAb], and surface antibody [HBsAb]) as follows: complete (all 3 tested), partial (any 1 or 2 tests), or none. We determined the frequency of inappropriate HBV testing (HBV e-antigen, anti-HBcAb IgM, or HBV DNA without a positive HBsAg or total anti-HBcAb) and used multivariable regression to assess factors associated with complete HBV screening.

Results

Among 678 subjects initiating TCZ, 194 (29%) completed appropriate HBV screening, 307 (45%) had partial screening, and 177 (26%) had none. Among 391 subjects initiating TOF, 94 (24%) completed appropriate HBV screening, 195 (50%) had partial screening, and 102 (26%) had none. Inappropriate testing was performed in 22% of subjects. Race was associated with complete HBV screening (White vs non-White: OR 0.74, 95% CI 0.57–0.95), whereas prior immunosuppression was not (conventional synthetic disease-modifying antirheumatic drugs [DMARDs]: OR 1.05, 95% CI 0.72–1.55; biologic DMARDs: OR 0.73, 95% CI 0.48–1.12).

Conclusion

Patients initiating TCZ or TOF are infrequently screened for HBV despite recommendations from the AASLD and CDC.
Using UX Personas to Improve Library GIS and Data Services
Authors: Hixson Taylor , Parrott Justin
Published: August 2021

This study describes the process of persona-creation in a liberal-arts university well-integrated within a global network of Geographic Information System researchers. We introduce the concept of personas as an effective user experience research methodology with potential applications to academic library services. We detail the collection of data from high-level researchers as a way to inform the library’s strategic planning and programming. We present the results of the study in the form of three personas: Rachel the Novice, A.J. the Professor, and Jean-Paul the Big-Thinker. These results are specific to our institution, but the method itself can transfer to other contexts. We note the study’s limitations in the final analysis, and make suggestions for maintaining and refining the personas to accurately represent the community of users.
Location-Based Trickery: Librarian Efforts to Provide Access to Unaffiliated Users
Authors: Stregger Elizabeth , McLean Jaclyn
Published: August 2021

Walk-in access for unaffiliated (walk-in) users in academic libraries is under threat. In North America, this is due to outdated technology as well as licensing changes publishers and vendors impose on libraries in the name of progress. We conducted a survey in autumn 2018 to get a snapshot of the current state of unaffiliated user access at post-secondary libraries across North America. We discuss the current state of access for walk-in users as well as current and future trends in user authentication which threaten this access. We look with a wider lens on open access, community access to paywalled research, and general access to information.
Semantic-based automated reassembly of heritage fragments
Authors: Paumard Marie-Morgane
Published: August 2021

L'intelligence artificielle apporte des solutions à de nombreux problèmes de conservation du patrimoine. Parmi ceux-ci, la reconstruction d'artefacts pourrait être facilitée grâce à l’automatisation. Après la diffusion des techniques de réassemblage basées sur la continuité des motifs ou des fractures, la dernière décennie a vu l'essor des algorithmes basés sur la sémantique. Ceux-ci permettent d'effectuer des tâches visuelles en utilisant le sens de ce qui est représenté sur les images. Nous présumons que ces méthodes aideront à résoudre les problèmes patrimoniaux ne pouvant être solutionnés par les méthodes classiques, par exemple lorsque les fragments sont trop érodés pour utiliser les continuités.
Some Mechanical Properties of Polymer Modified Concrete by Adding Waste Iron Filings and Chips
Authors: Kashkool Marwah Jaafar , Almadi Wisam Abdulilah , Jabal Qusay A. , Al Asadi Layth Abdul Rasool , Alghurabi Jaber Kadhim
Published: August 2021

The study aims to improve some mechanical properties like compressive strength, tensile strength, modulus of elasticity and flexural strength of polymer modified concrete (PMC). This improving for PMC done by using waste iron filling as replacement from fine aggregate. waste iron filings and chips used in this research as percentages from sand ranged from 0 % to 40 % , the compressive strength of ordinary polymer concrete increase from 32.2 MPa to 41.81 MPa by 40% replacement of sand with waste iron filings and chips, tensile strength increased also from 2.83 MPa to 4.23 MPa by 40% replacement also. Flexural strength increased from 3.7 MPa for reference mix to about 7.1 MPa for mixes with 40% replacement, modulus of elasticity increased from 21087 MPa to 25233 MPa by using maximum percentage of waste iron filings. There is a slight increment in mechanical properties of polymer modified concrete after 30% ratio of waste iron filings and chips. Also research includes mixes modified with larger dosage of super plasticizer and less water/cement ratio to improve mechanical properties of PMC.
Guillain-Barré Syndrome After Acute Hepatitis E Infection: A Case Report and Literature Review
Authors: Rose Mariah Q. , Santos Christan D. , Rubin Devon I. , Siegel Jason L. , Freeman William D.
Published: August 2021

Introduction

Guillain-Barré syndrome precipitated by hepatitis E virus infection is rare, yet its incidence is increasing.

Clinical Findings

A 57-year-old man was transferred from another facility with fatigue, orange urine, and progressive weakness over 4 to 6 weeks. Initial laboratory results included total bilirubin, 9.0 mg/dL; direct bilirubin, 6.4 mg/dL; aspartate aminotransferase, 1551 U/L; alanine aminotransferase, 3872 U/L; and alkaline phosphatase, 430 U/L. Immunoglobulin M and quantitative polymerase chain reaction test results were positive for hepatitis E virus. Contrast-enhanced magnetic resonance imaging of the brain and spine showed no gross abnormalities. Analysis of cerebrospinal fluid obtained by lumbar puncture revealed the following (reference values in parentheses): total white blood cell count, 15/μL (0–5/μL), with 33% neutrophils and 54% lymphocytes; protein, 0.045 g/dL (0.015–0.045 g/dL); and glucose, 95 mg/dL (within reference range). Neurological examination revealed weakness in both upper extremities, with proximal strength greater than distal strength. The patient could not elevate either lower extremity off the bed and had areflexia and reduced sensation throughout all extremities.

Diagnosis

Guillain-Barré syndrome secondary to acute hepatitis E virus infection was diagnosed on the basis of clinical characteristics, serum and cerebrospinal fluid analyses, and nerve conduction studies.

Conclusions

Nurses and clinicians should obtain a thorough history and consider hepatitis E virus infection as a precipitating factor in patients with sensory and motor disturbances consistent with Guillain-Barré syndrome. The case gives insight into the diagnostic process for Guillain-Barré syndrome and highlights the vital role of bedside nurses in evaluating and treating these patients.
An Evidence-Based Initiative to Reduce Alarm Fatigue in a Burn Intensive Care Unit
Authors: Gorisek Rayna , Mayer Celeste , Hicks W. Braxton , Barnes Janey
Published: August 2021

Background

Alarm fatigue occurs when nurses are exposed to multiple alarms of mixed significance and become desensitized to alarms to the point that a critical alarm may receive no response or a delayed response. In burn intensive care units, reducing the risk of alarm fatigue is uniquely challenging because of the critically ill patient population and the nature of burn skin injuries. Nurses and the interdisciplinary team can become fatigued and desensitized to alarms, decreasing response rates for necessary interventions.

Objective

To decrease the risk of alarm fatigue by using an initiative designed to reduce nonactionable and false alarms in a burn intensive care unit.

Methods

Baseline data (alarm count per patient-day by alarm type) were collected for 1 month before education and implementation of evidence-based interventions. Data were collected every 6 months for 2 years.

Interventions

A series of interventions included raising awareness of the risks associated with alarm fatigue, customizing alarm parameters and default settings, providing education on electrode placement and daily electrode changes, using physical reminders, and consistently sharing alarm data. The education, delivered in modules, aligned with the evidence-based interventions.

Results

Preintervention baseline data were compared to postintervention data at 6, 12, 18, and 24 months. The results showed a significantly sustained reduction (P < .001) in total alarm rate over time.

Conclusion

A quality improvement initiative based on evidence-based practice can contribute to a sustainable reduction in nonactionable and false alarms, ultimately improving patient safety.
Oral Care in Critically Ill Patients Requiring Noninvasive Ventilation: An Evidence-Based Review
Authors: Johnny Jace D. , Drury Zachary , Ly Tracey , Scholine Janel
Published: August 2021

Topic

Hospital-acquired pneumonia commonly develops after 48 hours of hospitalization and can be divided into non–ventilator-acquired and ventilator-acquired pneumonia. Prevention of non–ventilator-acquired pneumonia requires a multimodal approach. Implementation of oral care bundles can reduce the incidence of ventilator-acquired pneumonia, but the literature on oral care in other populations is limited.

Clinical Relevance

Use of noninvasive ventilation is increasing owing to positive outcomes. The incidence of non–ventilator-acquired pneumonia is higher in patients receiving noninvasive ventilation than in the general hospitalized population but remains lower than that of ventilator-acquired pneumonia. Non–ventilator-acquired pneumonia increases mortality risk and hospital length of stay.

Purpose

To familiarize nurses with the evidence regarding oral care in critically ill patients requiring noninvasive ventilation.

Content Covered

No standard of oral care exists for patients requiring noninvasive ventilation owing to variation in study findings, definitions, and methods. Oral care decreases the risk of hospital-acquired pneumonia and improves comfort. Nurses perform oral care less often for nonintubated patients, as it is perceived as primarily a comfort measure. The potential risks of oral care for patients receiving noninvasive ventilation have not been explored. Further research is warranted before this practice can be fully implemented.

Conclusion

Oral care is a common preventive measure for non–ventilator-acquired pneumonia and may improve comfort. Adherence to oral care is lower for patients not receiving mechanical ventilation. Further research is needed to identify a standard of care for oral hygiene for patients receiving noninvasive ventilation and assess the risk of adverse events.
Triggers and Interventions of Patients Who Require Medical Emergency Team Reviews: A Cross-Sectional Analysis of Single Versus Multiple Reviews
Authors: Byrne Gobnait , Ennis Shauna , Barnes Anne Marie , Morrison Patricia , Connors Siobhan , Quirke Mary B.
Published: August 2021

Background

Medical emergency teams constitute part of the escalation protocol of early warning systems in many hospitals. The literature indicates that medical emergency teams may reduce hospital mortality and cardiac arrest. A greater understanding of pathways of patients who experience multiple medical emergency team reviews will inform clinical decision-making.

Objectives

To explore differences between patients who require a single medical emergency team review and those who require multiple reviews, and to identify any differences between patients who were reviewed only once during admission and patients who required multiple reviews.

Methods

Data for this retrospective cross-sectional review, including demographic data, call triggers, outcomes, and interventions, were routinely collected from January 2013 through December 2015. The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) collaborative’s cross-sectional studies checklist (version 4).

Results

Of 54 787 admitted patients, 1274 (2%) required a call to a medical emergency team; of those, 260 patients (20%) needed multiple calls. Patients requiring multiple calls demonstrated higher mortality (odds ratio, 1.49 [95% CI, 1.12–1.98]). A logistic regression model identified surgical patients and those receiving antibiotics and respiratory interventions at the first medical emergency team review as being more likely to require multiple reviews. Patients transferred to a higher level of care after the first review were less likely to require another review.

Conclusions

Patients requiring multiple medical emergency team reviews have higher mortality. Surgical patients have a higher risk of requiring multiple reviews. Hospitals need to include more details on surgical patients when auditing medical emergency team activation.
Experiences of Patients Using a Fitness Tracker to Promote Ambulation Before a Heart Transplant
Authors: Macapagal Frederick R. , Bonuel Rizalina , Rodriguez Holly , Mcclellan Emma
Published: August 2021

Background

Patients who have an intra-aortic balloon pump or a pulmonary artery catheter with vasoactive infusion while awaiting heart transplant have reduced mobility due to heart failure and activity restrictions. Stroke volume, respiratory capacity, and muscle strength decrease, and sleep disturbances occur. Patients require motivation to enhance ambulation.

Objective

To explore patients’ experiences with a fitness tracker to promote ambulation before heart transplant.

Methods

In 2017, a fitness tracker was issued to 43 patients before heart transplant who met the study criteria, which included orders to ambulate. Semistructured interviews were conducted after 2 weeks of fitness tracker use with 8 random participants, who were followed up to enhance the credibility of and validate the findings. Responses were interpreted by using descriptive phenomenology and purposive sampling. An expert in phenomenology examined the transcript interpretations and attested that the findings were supported by the data and were internally coherent. The Colaizzi method was used to analyze data.

Results

A total of 361 significant statements were identified during the participants’ interviews and yielded 224 formulated meanings and 16 themes. Themes were categorized into 4 clusters: happy/delighted, motivator, beneficial, and future potential.

Conclusions

Participants were happy to get a fitness tracker and motivated to be active and increase activity/ambulation. Patients expressed benefits from walks: better sleep, more stamina, and feeling stronger. They believed that this intervention could have potential benefit for future patients.
Intensive Care Unit Scoring Systems
Authors: Pellathy Tiffany Purcell , Pinsky Michael R. , Hravnak Marilyn
Published: August 2021

Background

Illness severity scoring systems are commonly used in critical care. When applied to the populations for whom they were developed and validated, these tools can facilitate mortality prediction and risk stratification, optimize resource use, and improve patient outcomes.

Objective

To describe the characteristics and applications of the scoring systems most frequently applied to critically ill patients.

Methods

A literature search was performed using MEDLINE to identify original articles on intensive care unit scoring systems published in the English language from 1980 to 2020. Search terms associated with critical care scoring systems were used alone or in combination to find relevant publications.

Results

Two types of scoring systems are most frequently applied to critically ill patients: those that predict risk of in-hospital mortality at the time of intensive care unit admission (Acute Physiology and Chronic Health Evaluation, Simplified Acute Physiology Score, and Mortality Probability Models) and those that assess and characterize current degree of organ dysfunction (Multiple Organ Dysfunction Score, Sequential Organ Failure Assessment, and Logistic Organ Dysfunction System). This article details these systems’ differing features and timing of use, score calculation, patient populations, and comparative performance data.

Conclusion

Critical care nurses must be aware of the strengths, limitations, and specific characteristics of severity scoring systems commonly used in intensive care unit patients to effectively employ these tools in clinical practice and critically appraise research findings based on their use.
Mobilization of Patients Receiving Extracorporeal Membrane Oxygenation Before Lung Transplant
Authors: Patrick Kelly , Adams Anthony
Published: August 2021

Background

Extracorporeal membrane oxygenation is increasingly used to provide cardiopulmonary support to patients awaiting lung transplant. Although studies have shown that these patients benefit from early mobilization, the care team often has concerns about related complications, particularly for patients requiring femoral cannulation.

Objective

To assess the safety of mobilizing patients receiving extracorporeal membrane oxygenation before lung transplant using a standardized mobility protocol.

Methods

A retrospective review was performed of the electronic health records of patients receiving extracorporeal membrane oxygenation before or immediately after lung transplant who were mobilized according to a standardized protocol from April through October 2018. The setting was an 18-bed cardiothoracic intensive care unit in a Magnet-designated teaching hospital. Patients were helped to ambulate by an interdisciplinary team, with careful assessment for any related complications.

Results

During the study period, 37 patients received extracorporeal membrane oxygenation, and 9 were mobilized. Two hundred forty-two therapy sessions were conducted involving 47 700 feet of ambulation. Patients experienced the following complications: chugging (1 patient), decrease in flow rate (2 patients), bleeding at the cannula site (2 patients), neck hyperextension (1 patient), fear/anxiety (1 patient), and shortness of breath (2 patients). Bleeding and neck hyperextension led to discontinuation of therapy until the problems were resolved. No changes were made to the protocol.

Conclusions

Patients receiving extracorporeal membrane oxygenation before lung transplant, including those with femoral cannulation, can be mobilized safely with the use of an interprofessional ambulation protocol. Further evaluation is indicated, including research on clinical outcomes.