bluuebunny/crossref_metadata_2025 huggingface dataset:
Can I help you? Information sharing in online discussion forums by people living with a long-term condition
Authors: Bond Carol S
Published: November 2016

Background Peer-to-peer health care is increasing, especially amongst people living with a long-term condition. How information is shared is, however, sometimes of concern to health care professionals.Objective This study explored what information is being shared on health-related discussion boards and identified the approaches people used to signpost their peers to information.Methods This study was conducted using a qualitative content analysis methodology to explore information shared on discussion boards for people living with diabetes. Whilst there is debate about the best ethical lens to view research carried out on data posted on online discussion boards, the researchers chose to adopt the stance of treating this type of information as “personal health text”, a specific type of research data in its own right.Results Qualitative content analysis and basic descriptive statistics were used to analyse the selected posts. Two major themes were identified: ‘Information Sharing from Experience’ and ‘Signposting Other Sources of Information’.Conclusions People were actively engaging in information sharing in online discussion forums, mainly through direct signposting. The quality of the information shared was important, with reasons for recommendations being given. Much of the information sharing was based on experience, which also brought in information from external sources such as health care professionals and other acknowledged experts in the field.With the rise in peer-to-peer support networks, the nature of health knowledge and expertise needs to be redefined. People online are combining external information with their own personal experiences and sharing that for others to take and develop as they wish.
Food Yields and Nutrient Analyses of the Three Sisters: A Haudenosaunee Cropping System
Authors: Mt.Pleasant Jane
Published: November 2016

Scholars have studied The Three Sisters, a traditional cropping system of the Haudenosaunee (Iroquois), from multiple perspectives. However, there is no research examining food yields, defined as the quantities of energy and protein produced per unit land area, from the cropping system within Iroquoia. This article compares food yields and other nutrient contributions from the Three Sisters, comprised of interplanted maize, bean and pumpkin, with monocultures of these same crops. The Three Sisters yields more energy (12.25 x 106 kcal/ha) and more protein (349 kg/ha) than any of the crop monocultures or mixtures of monocultures planted to the same area. The Three Sisters supplies 13.42 people/ha/yr. with energy and 15.86 people/ha/yr. with protein. Nutrient contents of the crops are further enhanced by nixtamalization, a traditional processing technique where maize is cooked in a high alkaline solution. This process increases calcium, protein quality, and niacin in maize.
Faktor Risiko yang Berperan pada Mortalitas Sepsis
Authors: Saraswati Desy Dewi , Pudjiadi Antonius H. , Djer Mulyadi M. , Supriyatno Bambang , Syarif Damayanti R. , Kurniati Nia
Published: November 2016

Latar belakang. Sepsis merupakan penyebab utama kematian bayi dan anak. Status imun pejamu dan malnutrisi merupakan faktor penting yang menentukan luaran pada sepsis. Skor pediatric logistic organ dysfunction (PELOD) adalah sistem skoring disfungsi organ pada sakit kritis, untuk memprediksi mortalitas pasien sepsis.Tujuan. Mengetahui faktor risiko usia, status gizi, dan skor PELOD terhadap mortalitas sepsis.Metode. Retrospektif analitik berupa data rekam medis pasien berusia 1 bulan – 18 tahun di PICU RSCM bulan Apri1- Agustus 2011 dengan diagnosis sepsis menurut kriteria konsensus sepsis internasional.Hasil. Sembilanpuluh dua dari 209 pasien mengalami sepsis, 22 (23,9%) di antaranya meninggal. Median usia subjek 15 (rentang 2-192) bulan dengan sebaran terbanyak pada kelompok usia 1 bulan – 1 tahun (62%). Sebagian besar subjek (57,61%) memiliki status gizi kurang. Fokus infeksi tersering adalah infeksi saraf pusat dan gastrointestinal, masing-masing 32 (34,77%) subjek. Gizi buruk (p<0,001; OR 26,88;IK95% 4,74-152,61) dan skor PELOD ≥20 (p<0,001; OR 78,8;IK95%14,23-436,36) merupakan faktor risiko yang secara independen berperan terhadap mortalitas sepsis pada anak.Kesimpulan. Gizi buruk dan skor PELOD ≥20 berperan terhadap mortalitas sepsis pada anak. Usia <5 tahun tidak terbukti sebagai faktor risiko mortalitas sepsis pada anak.
Ketepatan Skoring McIsaac untuk Mengidentifikasi Faringitis Group A Streptococcus pada Anak
Authors: Damayanti Emalia , Iriani Yulia , Yuwono Yuwono
Published: November 2016

Latar belakang. Pemberian antibiotik faringitis Group A Streptococcus (GAS) penting untuk mencegah komplikasi demam rematik dan penyakit jantung rematik. Namun, gambaran klinis saja tidak dapat diandalkan untuk memastikan atau menyingkirkan faringitis GAS. Skoring McIsaac merupakan sistem penilaian klinis untuk memprediksi faringitis GAS yang penggunaannya dapat meningkatkan ketepatan identifikasi kasus faringitis GAS serta kebutuhan akan antibiotik.Tujuan. Menguji ketepatan skoring McIsaac dalam mendiagnosis faringitis GAS anak.Metode. Uji diagnostik yang dilakukan dari bulan Januari-Agustus 2012 pada 96 anak usia 3-14 tahun dengan faringitis akut di RSUP Dr Mohammad Hoesin dan Puskesmas Pembina, Palembang. Skoring McIsaac dihitung berdasarkan empat gejala klinis yang hasilnya dibandingkan dengan rapid antigen detection test (RADT) atau biakan usap tenggorok apabila RADT negatif. Analisis data menggunakan piranti lunak SPSS versi 17.0 dan Stata SE 10.0.Hasil. Ditemukan 13,54% faringitis GAS. Titik potong optimal skoring McIsaac ≥4 dengan sensitivitas 84,62% (IK 95% 54,55-98,08%), spesifisitas 68,67% (IK 95% 57,56-78.41%), nilai duga positif 29,73% (IK 95% 15,87-46,98%), dan nilai duga negatif 96,61% (IK 95% 88,29-99,59%). Untuk nilai 5 mempunyai sensitivitas 38,46% (IK 95% 13,86-68,42%), spesifisitas 98,8% (IK 95% 93,47-99,97%), nilai duga positif 83,33% (IK 95% 35,88-99,58%), dan nilai duga negatif 91,11% (IK 95% 83.23-96,08%).Kesimpulan. Diagnosis faringitis GAS dapat disingkirkan apabila hasil skoring McIsaac <4, memerlukan pemeriksaan penunjang lebih lanjut (RADT atau biakan usap tenggorok) pada hasil skoring 4, dan sangat mungkin (98,8%) untuk hasil skoring 5.
Manfaat Pemberian ASI Eksklusif dalam Pencegahan Kejadian Dermatitis Atopi pada Anak
Authors: Halim Anita , Munasir Zakiudin , Rohsiswatmo Rinawati
Published: November 2016

Latar belakang. Dermatitis atopi merupakan manifestasi penyakit alergi yang sering terjadi pada anak. Prevalens dermatitis atopi (DA) meningkat di seluruh dunia dengan awitan tersering pada usia 1 tahun pertama, cenderung relaps, dan diikuti allergic march hingga dewasa. Peran ASI dalam mencegah DA masih kontroversi. Studi mengenai hal ini belum banyak dilakukan di Indonesia.Tujuan. Mengetahui manfaat pemberian ASI eksklusif dalam mencegah DA pada anak.Metode. Desain kasus kontrol berpasangan dengan matching usia dan riwayat atopi keluargaHasil. Limapuluh empat pasang subjek kasus-kontrol berusia 7-24 bulan ikut serta dalam penelitian. Sebagian besar kelompok kasus berusia 7-12 bulan, memiliki atopi keluarga, dengan awitan tersering pada usia 6 bulan pertama, dan predileksi pada wajah. Tidak terdapat perbedaan pola dan lama menyusui pada kelompok kasus dan kontrol. Manfaat ASI dalam mencegah DA pada anak belum terbukti (RO 0,867; IK95% 0,512-2,635; p 0,851).Kesimpulan. Penelitian ini belum dapat membuktikan manfaat pemberian ASI eksklusif untuk mencegah DA pada anak.
Prevalens dan Faktor Prediktor dari Kemampuan Berjalan Pasien Palsi Serebral pada Masa Anak di Rumah Sakit Cipto Mangunkusumo dan Yayasan Pembinaan Anak Cacat
Authors: Parmato Primo , Wahyuni Luh Karunia , Hendarto Aryono
Published: November 2016

Latar belakang. Permasalahan palsi serebral (PS) yang menjadi perhatian bagi orangtua adalah kemampuan berjalan.Tujuan. Mengetahui prevalens kemampuan berjalan pasien PS dan faktor prediktor yang berhubungan terhadap kemampuan berjalan pasien PS pada masa anak.Metode. Dilakukan penelitian terhadap 102 pasien PS berusia 6 tahun ke atas dengan pengisian kuesioner melalui wawancara orang tua dan melihat rekam medis di RSCM dan YPAC.Hasil. Duapuluh tujuh (26,5%) pasien berjalan tanpa alat bantu, 13 (12,7%) pasien berjalan dengan alat bantu, dan 62 (60,8%) pasien tidak berjalan walau dengan alat bantu. Faktor prediktor yang bermakna secara statistik adalah mampu duduk tanpa topangan sebelum usia 2 tahun (p<0,001; OR=6,89; IK 95%=2,42-19,71) dan tipe PS spastik unilateral (OR=7,36; IK 95%=1,86-29,18).Kesimpulan. Prevalens kemampuan berjalan pasien PS di RSCM dan YPAC adalah 26,5% berjalan tanpa alat bantu, 12,7% berjalan dengan alat bantu, dan 60,8% tidak berjalan walaupun dengan alat bantu. Faktor prediktor yang berhubungan dengan kemampuan berjalan pada masa anak adalah mampu duduk tanpa topangan sebelum usia 2 tahun dan tipe spastik unilateral.
Gambaran Infeksi Acinetobacter baumannii dan Pola Sensitifitasnya terhadap Antibiotik
Authors: Gustawan I Wayan , Satari Hindra Irawan , Amir Idham , Astrawinata Dalima AW
Published: November 2016

Latar belakang. Adanya peningkatan insiden infeksi Acinetobacter baumannii yang disertai peningkatan kejadian resistensi antibiotik, peningkatan morbiditas dan mortalitas, dan terbatasnya laporan kejadian infeksi bakteri ini pada pasien anak.Tujuan. Mengetahui gambaran infeksi Acinetobacter baumannii dan pola sensitifitasnya terhadap antibiotik di Departemen Ilmu Kesehatan Anak RSUPN Dr Cipto Mangunkusumo.Metode. Merupakan penelitian deskriptif retrosfektif melalui penelusuran data hasil biakan darah di laboratorium dan rekam medis dari Januari-Desember 2012.Hasil. Didapatkan 47 isolat darah Acinetobacter baumannii dari 32 pasien. Penelusuran rekam medis mendapatkan 24 data pasien lengkap. Semuanya merupakan pasien ruang NICU, sebagian besar laki-laki (18/24) dan neonatus kurang bulan (18/24). Gambaran klinis menunjukkan rerata frekuensi denyut jantung 148 kali/menit, frekuensi napas 55 kali/menit, suhu aksila 37,10C, kadar leukosit 12767,8/mm3, kadar trombosit 58491,3/mm3, kadar procalcitonin 17,6 ng/mL, dan CRP 88,5 mg/L. Rerata lama perawatan sebelum terjadi infeksi 23,9 hari. Sebagian besar pasien menggunakan alat medis seperti ventilator, CPAP, jalur vena sentral, jalur vena perifir, dan pipa nasogastrik dengan rerata lama pemakaian masing-masing 17,9, 4,5, 20,9, 13,3, dan 17,3 hari. Semua pasien mendapat antibiotik sebelum infeksi dengan rerata lama pemberian 22,5 hari. Uji kepekaan antibiotik mendapatkan 23 isolat (23/24) merupakan MDR. Resistensi antibiotik didapatkan pada golongan aminoglikosida, carbapenem, quinolon, sefalosporin, penisilin-beta lactamase inhibitor, dan tigesiklin. Sebagian besar penderita meninggal dalam perawatan (18/24).Kesimpulan. Semua pasien yang menderita infeksi Acinetobacter baumannii dirawat di ruang NICU, sebagian besar pasien merupakan kasus MDR.
Perbandingan Gangguan Perilaku Anak Penderita Penyakit Jantung Bawaan dan Saudaranya yang Sehat
Authors: Afitasari Afitasari , Sofyani Sri , Mutiara Erna
Published: November 2016

Latar belakang. Penyakit Jantung Bawaan (PJB) merupakan salah satu penyakit kronis. Karakteristik penyakit pada anak penderita penyakit kronis dapat memengaruhi psikososial dari saudara kandungnya yang sehat.Tujuan. Menilai masalah gangguan perilaku pada penderita PJB dan saudara kandungnya yang sehat.Metode. Studi potong lintang dilakukan dari bulan Desember 2012 sampai dengan Januari 2013 di Poliklinik Anak Rumah Sakit. H. Adam Malik Medan. Limapuluh orang anak penderita PJB dan 50 orang saudara yang sehat mengisi Child Behavior Checklist (CBCL) yang dibantu oleh ibu atau ayah. Gangguan perilaku yang dinilai adalah gangguan internalisasi dan eksternalisasi. Pengolahan data menggunakan uji kai kuadrat.Hasil. Didapat 13 anak penderita PJB memiliki nilai internalisasi dan eksternalisasi terganggu, sementara pada anak yang sehat tidak dijumpai gangguan internalisasi dan eksternalisasi (p=0,001). Nilai borderline dijumpai pada 6 orang saudara yang sehat dan 21 anak penderita PJB (p=0,001). Anak PJB dengan gangguan eksternalisasi lebih banyak dijumpai pada kelompok usia 13 tahun (p=0,006).Kesimpulan. Penderita PJB cenderung memiliki gangguan perilaku baik internalisasi maupun eksternalisasi.
Uji Diagnostik Pemeriksaan Antigen Nonstruktural 1 untuk Deteksi Dini Infeksi Virus Dengue pada Anak
Authors: Megariani Megariani , Mariko Rinang , Alkamar Amrin , Putra Andani Eka
Published: November 2016

Latar belakang. Di negara tropis dan subtropis, dengue adalah masalah kesehatan utama. Diagnosis dini sangat penting untuk manajemen infeksi dengue. Nonstruktural 1 merupakan pendekatan baru terhadap diagnosis dengue. Pemeriksaan rapid NS1 dilakukan untuk deteksi dini infeksi virus dengue pada anak.Tujuan. Menentukan nilai diagnostik NS1 mencakup sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif, dan keakuratan NS1 untuk deteksi dini infeksi virus dengue.Metode. Dilakukan penelitian cross sectional terhadap 50 orang anak demam hari ke-1, ke-2 atau ke-3 dengan tes tourniquet positif pada bulan April sampai Desember 2012. Rapid test NS1 dilakukan untuk dibandingkan dengan RT PCR sebagai gold standard.Hasil. Didapatkan 50 orang anak dengan demam dan tes tourniquet positif. Duapuluh lima anak NS1 positif dan 26 RT PCR positif. Rapid test NS1 memiliki sensitivitas 92,3%, spesifisistas 95,8%, nilai duga positif 96 %, nilai duga negatif 92 %, dan keakuratan 94%.Kesimpulan. Rapid test NS1 mempunyai sensitivitas dan spesifisitas yang tinggi untuk deteksi dini infeksi virus dengue pada anak.
Profil Pubertas dan Pertumbuhan Linear pada Hiperplasia Adrenal Kongenital dalam Pengobatan Serial Kasus
Authors: Sari Nurul Iman Nilam , Tridjadja Bambang , Kaswandani Nastiti , Sjarif Damayanti Rusli , Putra Sukman Tulus , Gunardi Hartono
Published: November 2016

Latar belakang. Terapi yang adekuat pada hiperplasia adrenal kongenital (HAK) diharapkan dapatmenghasilkan perkembangan pubertas dan pertumbuhan linear yang optimal. Saat ini, di Indonesia, belumada data profil pubertas dan pertumbuhan linear penderita HAK yang sedang menjalani terapi.Tujuan. Mengetahui profil pubertas dan pertumbuhan linear pada HAK di Indonesia yang sedang menjalaniterapi.Metode. Studi serial kasus terhadap 14 kasus HAK yang memasuki masa pubertas di Departemen IlmuKesehatan Anak Rumah Sakit Cipto Mangunkusumo Jakarta selama bulan November 2012 hingga April2013. Pencatatan data berisi anamnesis, pemeriksaan fisis, pemeriksaan laboratorium, dan radiologi boneage.Hasil. Hasil penelitian ini merupakan riset pendahuluan (preliminary research) terhadap 14 kasus HAK.Mayoritas subjek adalah perempuan, berusia di atas 8 tahun, HAK tipe Salt-Wasting (SW), dan terdiagnosissejak kurang dari satu tahun. Tujuh dari 14 subjek mengalami obesitas. Undertreatment terjadi pada 11/14subjek memiliki bone age accelerated dengan perhitungan tinggi badan dewasa yang pendek. Tiga belas subjeksudah pubertas dan 10/14 subjek mengalami pubertas prekoks. Rekomendasi dosis glukokortikoid yangdiberikan (median 18,12 mg/m2/hari) dengan median durasi terapi 8,1 tahun. Kontrol metabolik denganmenggunakan parameter 17-OHP bervariasi pada rentang 0,2-876 nmol/L (rerata 166,9 nmol/L).Kesimpulan. Sebagian besar subjek mendapatkan undertreatment sehingga memiliki bone age accelerateddengan estimasi tinggi badan dewasa pendek. Pubertas prekoks dialami oleh sebagian besar subjek.Pemberian glukokortikoid dengan dosis yang direkomendasikan. Ditemukan ketidakteraturan pengobatandan pemantauan yang buruk.
Akurasi Pemeriksaan HbA1c dalam Mendeteksi Gangguan Toleransi Glukosa pada Anak dan Remaja Obes dengan Riwayat Orang Tua DM Tipe 2
Authors: Wijaya Abdi , Aditiawati Aditiawati , Saleh Irsan
Published: November 2016

Latar belakang. Obesitas dengan riwayat orang tua diabetes mellitus (DM) tipe 2 berhubungan dengan gangguan toleransi glukosa,dislipidemia, dan DM. Toleransi glukosa terganggu (TGT) merupakan pertanda awal terjadinya DM tipe 2. Hemoglobin A1c(HbA1c) telah muncul menjadi alat diagnostik untuk mengidentifikasi DM dan subjek yang berisiko menderita DM. Rekomendasiini didasarkan pada data dari orang dewasa yang menunjukkan hubungan antara HbA1c dengan terjadinya DM di kemudian hari.Penelitian yang khusus ditujukan pada populasi anak dan remaja masih sedikit.Tujuan. Mengetahui penggunaan dan titik potong optimal pemeriksaan HbA1c dalam mendiagnosis gangguan toleransi glukosapada anak dan remaja obesitas dengan faktor risiko dibandingkan dengan tes toleransi glukosa oral (TTGO).Metode. Dilakukan uji diagnostik terhadap 40 anak obesitas (Indeks Massa Tubuh menurut umur dan jenis kelamin berdasarkan Zscore WHO 2008 􀁴 +2 SD) usia 10-15 tahun dengan riwayat orang tua DM tipe 2 tahun di Palembang dari Desember 2013 - Februari2014. Pada semua subjek dilakukan pemeriksaan HbA1c dan TTGO.Hasil.Ditemukan dua anak dengan TGT. Dari analisis kurva Receiver Operating Characteristic (ROC) didapatkan titik potong optimalpemeriksaan HbA1c adalah 5,55% dengan nilai sensitivitas 67% dan spesifisitas 20%, area Under the Curve (AUC) diperoleh sebesar79,3% (95% IK 45,7%-100%).Kesimpulan. Nilai pemeriksaan HbA1c >5,55% dianjurkan sebagai alat skrining untuk mengindentifikasi TGT pada anak danremaja obesitas dengan faktor risiko.
Hubungan antara Defisiensi Besi dengan Attention Deficit/Hyperactivity Disorder pada Anak
Authors: Susanti Desi Fajar , H Sunartini , Sutomo Retno
Published: November 2016

Latar belakang. Attention deficit hyperactivity disorder (ADHD) merupakan gangguan perilaku yang paling banyak dijumpai padaanak. Defisiensi besi diduga berperan dalam kejadian ADHD melalui perubahan neurotransmiter dopamin. Feritin serum merupakanindikator reliabel simpanan besi dalam tubuh termasuk otak.Tujuan. Untuk mengkaji hubungan antara defisiensi besi dan kejadian ADHD pada anak.Metode. Penelitian cross sectional dilakukan di RSUP Dr Sardjito dan Pusat Pengkajian dan Pengamatan Tumbuh Kembang Anak(P3TKA) Yogyakarta. Diagnosis ADHD berdasarkan kriteria DSM IV-TR. Subjek penelitian dipilih secara consecutive mencakup 35anak dengan ADHD and 35 anak tanpa ADHD. Dilakukan pengukuran kadar serum feritin pada semua subyek. Hubungan antaradefisiensi besi dengan ADHD dianalisis dengan chi square dan rerata feritin serum dengan uji Mean WhitneyHasil. Kadar feritin serum yang rendah ditemukan pada 34% anak dengan ADHD dan 25% pada anak tanpa ADHD tetapi secarastatistik tidak berbeda bermakna. Penelitian juga menunjukkan bahwa tidak ada perbedaan rerata feritin serum pada pasien ADHDdan tanpa ADHD (24.4 ±22.04 μg/L vs.24.4±19.9 μg/L, p > 0,01).Kesimpulan. Prevalensi defisiensi besi pada anak ADHD dibandingkan tanpa ADHD tidak berbeda secara bermakna.
Characterizations of a special family of Laguerre–Hahn forms of class one
Authors: Barhoumi Najoua
Published: November 2016

Our aim is to investigate through a special family of Laguerre–Hahn forms of class one verifying the three-term recurrence relation with
Anti-leukemic activity of DNA methyltransferase inhibitor procaine targeted on human leukaemia cells
Authors: Borutinskaite Veronika , Bauraite-Akatova Justina , Navakauskiene Ruta
Published: November 2016

Chromatin remodeling in DNA is fundamental to gene expression, DNA replication and repair processes. Methylation of promoter regions of tumor-suppressor genes and histone deacetylation leads to gene silencing and transcriptionally repressive chromatin. For the past few decades DNA methylation agents became very attractive as the targets for cancer therapy. The purpose of this work was to examine the effects of DNMT inhibitor procaine on growth inhibition, apoptosis and differentiation of human leukaemia cells. The changes in expression of genes, proteins and histone modifications caused by procaine were evaluated under different treatments. We demonstrated that procaine arrests growth of human leukaemia cells and in combination with all-trans retinoic acid (ATRA) induces cancer cell differentiation. Procaine causes reduction of expression of DNA methyltransferases as well. The treatment of human leukaemia cells with procaine increase the expression of molecules associated with differentiation (CD11b, E-cadherin, G-CSF) and apoptosis (PPARγ). Moreover, the examined DNMT inhibitor enhances certain gene transcription activation via chromatin remodelling – the changes in histone H3K4(Me)3 and H3K9Ac/S10P modifications were detected. Our results suggest, that DNMT inhibitor – procaine, can be used for further investigations on epigenetic differentiation therapy of leukaemia cells especially when used in combination with retinoic acid.
Characterizations of Kumaraswamy Laplace Distribution with Applications
Authors: Aryal Gokarna , Zhang Qiuming
Published: November 2016

In this article we study a generalization of the Laplace distribution. The generalization is motivated by the recent work of Cordeiro and de Castro [
Basic valency orientation in Homeric Greek
Authors: Sausa Eleonora
Published: November 2016

In a number of recent works, verbs and expressions encoding causative alternations have been regarded as a possible test for measuring the basic valency orientation of a language. This paper focuses on the basic orientation of valency in Homeric Greek. The test applied for determining this parameter is that proposed by Nichols et al. (2004, Transitivizing and detransitivizing languages.Linguistic Typology8(2). 149–211), focusing on 18 causative alternations. The investigation carried out in this paper shows that Homeric Greek belongs to the detransitivizing type, showing an active-middle alternation as the preferred pattern for expressing causative alternations. This study aims to enrich the typological literature on this topic and positions itself among other studies of valency orientation in ancient Indo-European languages, such as Old Hittite, Old Indo-Aryan, Proto-Germanic, and Proto-Slavic, which show transitivizing strategies along with voice alternation patterns.
The Mechanics of Omitted Variable Bias: Bias Amplification and Cancellation of Offsetting Biases
Authors: Steiner Peter M. , Kim Yongnam
Published: November 2016

Causal inference with observational data frequently requires researchers to estimate treatment effects conditional on a set of observed covariates, hoping that they remove or at least reduce the confounding bias. Using a simple linear (regression) setting with two confounders – one observed (X), the other unobserved (U) – we demonstrate that conditioning on the observed confounderXdoes not necessarily imply that the confounding bias decreases, even ifXis highly correlated withU. That is, adjusting forXmay increase instead of reduce the omitted variable bias (OVB). Two phenomena can cause an increasing OVB: (i) bias amplification and (ii) cancellation of offsetting biases. Bias amplification occurs because conditioning onXamplifies any remaining bias due to the omitted confounderU. Cancellation of offsetting biases is an issue wheneverXandUinduce biases in opposite directions such that they perfectly or partially offset each other, in which case adjusting forXinadvertently cancels the bias-offsetting effect. In this article we discuss the conditions under which adjusting forXincreases OVB, and demonstrate that conditioning onXincreases the imbalance inU, which turnsUinto an even stronger confounder. We also show that conditioning on an unreliably measured confounder can remove more bias than the corresponding reliable measure. Practical implications for causal inference will be discussed.
A Member Selection Model of Collaboration New Product Development Teams Considering Knowledge and Collaboration
Authors: Su Jiafu , Yang Yu , Zhang Xuefeng
Published: November 2016

Member selection to form an effective collaboration new product development (Co-NPD) team is crucial for a successful NPD. Existing researches on member selection mostly focus on the individual attributes of candidates. However, under the background of collaboration, knowledge complementarity and collaboration performance among candidates are important but overlooked. In this paper, we propose a multi-objective optimization model for member selection of a Co-NPD team, considering comprehensively the individual knowledge competence, knowledge complementarity, and collaboration performance. Then, to solve the model, an improved adaptive genetic algorithm (IAGA) is developed. Finally, a real case is provided to illustrate the application of the model, and the IAGA is implemented to select the desired team members for optimal team composition. Additionally, the standard generic algorithm and particle swarm optimization are used to compare with the IAGA to further verify the effectiveness of the IAGA.
Minimizers and EVEN
Authors: Shyu Shu-ing
Published: November 2016

It is widely acknowledged that polarity sensitivity pertains to the lexical nature of NPI minimizers, phrases denoting a minimal quantity, extent or degree. This paper, however, proposes that so-called “negative polarity” of Mandarin Chinese minimizers (yi-CL-N ‘one.CL+N’ andyidian-N ‘one.point N’) is not lexically determined, but is facilitated by utilizing the existinglian... dou‘including... all’ EVEN construction. Specifically, total negation is decomposed into a scalar operatorlian, which evokes a set of order ranked alternatives determined in context, and the maximizing/universal operatordou‘all’ that quantifies over the contextual alternatives plus the focused minimizer, which is placed at the end of the scale. The scalar minimizer syntactically scopes over the negation to represent the logic of ∀¬. This paper further distinguishes minimizers from lexical NPIrenhe‘any’ with respect to (i) scoping out of the negation for the former, (ii)beingirrelevant to the non-veridical licensing conditions that otherwise licenseanyand NPI-renhe, (iii) a clausemate relation betweendouand negation, and (iv) the lack of intervention effects of strong quantifiers between the minimizers and negation. The study lends further support to the claim that scalar EVEN is construed with minimizers. A comparison of Chinese minimizers with those in Hindi and Japanese has an implication for varieties of coding polarity ranging from purely lexical to syntactical means crosslinguistically.
High-performance Nanocavities-based Meta-crystals for Enhanced Plasmonic Sensing
Authors: Rippa M. , Castagna R. , Pannico M. , Musto P. , Bobeico E. , Zhou J. , Petti L.
Published: November 2016

We report on a novel procedure of fabrication to easily obtain highly reproducible nanocavities-shaped photonic crystals with strong plasmonic performances. Thus, we also report on the morphological and optical characterization of the obtained structures. They are classifiable as 2-layers (organic and inorganic) photonic crystals based on iso-Y-shaped nano-cavities. Such novel designed structures are compelling candidates for the development of highly sensitive biosensors due to their unique surface plasmon resonances (SPRs) and SPR enabled surface-enhanced Raman spectroscopy (SERS). The planar photonic crystal comprises a polymeric (ZEP520A) layer (thickness ~80 nm) sandwiched between a layer of gold (~50 nm thickness) and a glass substrate. For what concerns the cavities’ shape, iso-Y units are chosen on the basis of their third order nonlinearity and are coupled in hexagonal-based configuration to produce extended meta-structures. The substrates are functionalized with a probe made by a self-assembling monolayer (SAM) of 4-mercaptobenzoic acid (4-MBA). The average SERS Enhancement Factor >106 and SPR sensitivity of ~300 nm/RIU confirm that the proposed 2-layers iso-Y meta-structure is very suitable for high sensitive label-free plasmonic sensing.
Mounting Fans – Don’t Get in a Flap
Authors: Burt Yuki
Published: November 2016

Over the centuries, fans have been produced in a large range of shapes, styles, sizes and a variety and combination of materials. Each one, therefore, requires its own tailor-made mount, as poor display can cause severe damage. Long term display or storage in the open position, for instance, can lead to a fan becoming ‘set’ in that position, and if it can no longer be closed, its integrity is compromised. This article outlines some of the likely weaknesses of fans and the way in which they can deteriorate if not properly supported while on display. The vulnerabilities inherent in fans with a paper element are, more often than not, equally applicable to those incorporating other materials such as vellum or textiles. An understanding of the potential causes of degradation will guide good mount design and display practices.
Antenatal characteristics of Roma female population in Virovitica-Podravina County, Croatia
Authors: Šegregur Jadranko , Šegregur Domagoj
Published: November 2016

Introduction

This study reports about antenatal characteristics of Roma minority population. The study was designed to investigate data about health behaviours known to be associated with reproductive outcomes of Roma women that have very good living conditions and relatively high resource availability.

Methods

A retrospective study included 204 Roma and 408 non-Roma hospitalised singleton births that occurred in the Maternity Ward of the General Hospital Virovitica in the period from 1991 to 2010. Data about women’s age, marital status, smoking, reproductive health (abortions, delivery), antenatal care, perinatal complications and gestational age were taken from hospital records and analysed.

Results

Roma women were averagely more than three years younger than non-Roma women, only 10.8% were married. Smoking was more frequent. The average number of births of Roma and non-Roma women was similar, averagely two children per woman. The rate of induced abortions in the Roma women was higher, while the frequency of spontaneous abortions was equal. Inadequate antenatal care of Roma women was associated with two times higher incidence of perinatal complications. A higher frequency of deliveries at home without professional assistance in Roma pregnancy resulted in lower perinatal outcomes. It was confirmed that Roma mothers give birth earlier (38+6 vs. 39+4 weeks) and have a higher incidence of premature births (9.3% vs. 2.2%).

Conclusions

In the comparison of antenatal parameters between the two researched groups, poorer prenatal outcomes in the Roma population were found, despite full integration and considerable improvement in living standards of this ethnic Roma population.
The influence of parental education and other socio-economic factors on child car seat use
Authors: Rok Simon Mateja , Korošec Aleš , Bilban Marjan
Published: November 2016

Introduction

The behaviour of parents in ensuring car passenger safety for their children is associated with socio-economic (SE) status of the family; however, the influence of parental education has rarely been researched and the findings are contradictory. The aim of the study was to clarify whether parental education influences the use of a child car seat during short rides.

Methods

A cross-sectional survey was carried out in outpatient clinics for children’s healthcare across Slovenia. 904 parents of 3-year-old children participated in the study; the response rate was 95.9%. A self-administered questionnaire was used. A binary multiple logistic regression was applied to assess the association between parental unsafe behaviour as dependent variable, and education and other SE factors as independent variables.

Results

14.6% of parents did not use a child car seat during short rides. Families where mother had low or college education had higher odds of the non-use of a child car seat than families where mother had a university education. Single-parent families and those who lived in areas with low or medium SE status also had higher odds of the non-use of a child car seat.

Conclusions

Low educational attainment influences parents’ behaviour regarding the non-use of a child car seat. Low parental education is not the only risk factor since some highly educated parents also have high odds of unsafe behaviour. All parents should therefore be included in individually tailored safety counselling programmes. SE inequalities could be further reduced with provision of free child car seats for eligible families.
Effects of resveratrol on diabetes-induced vascular tissue damage and inflammation in male rats
Authors: Pektaş Ayhan , Pektaş Mehmet Bilgehan , Koca Halit Buğra , Tosun Murat , Aslan Esra , Koca Selcan , Sadi Gökhan
Published: November 2016

Objective

The present study aims to investigate the short-term effects of resveratrol on histopathological characteristics and inflammatory cytokines of the heart and thoracic aorta tissues in animal models of streptozotocin (STZ)-induced diabetes.

Methods

Male Wistar rats were randomly divided into four groups; (1) control/vehicle, (2) control/20 mg/kg resveratrol, (3) diabetic/vehicle, (4) diabetic/20 mg/kg resveratrol. Heart and thoracic aorta were examined histopathologically and the levels of interleukin (IL)-1β, IL-18 and tissue necrosis factor (TNF)-α were analyzed by ELISA. Malondialdehyde (MDA) contents were determined with HPLC.

Results

Diabetes group had significantly higher vascular MDA content (p<0.05) as compared with the control and resveratrol treated groups. Resveratrol significantly reduced vascular MDA level in diabetic animals (p<0.05). Significant elevation in IL-1β and TNF-α contents in thoracic aorta and IL-18 contents in cardiac and arterial tissues with diabetes were almost normalized with resveratrol treatment. Additionally, diabetic animals demonstrated significant endothelial damage, irregularities in smooth muscle fibers and degeneration of elastic fibers in thoracic aortas together with significant irregularities and hypertrophy in cardiac muscle fibers. Resveratrol significantly improved most of these histopathological alterations.

Conclusion

Four-week-long intraperitoneal administration of resveratrol may restore the diabetes related inflammation and oxidative stress within the cardiovascular system.
Synthesis, in-vitro cytotoxicity of 1H-benzo[f]chromene derivatives and structure–activity relationships of the 1-aryl group and 9-position
Authors: Mohamed Hany M. , Fouda Ahmed M. , Khattab Essam S.A.E.H. , Agrody Ahmed M. El- , Afifi Tarek H.
Published: November 2016

A series of 1H-benzo[f]chromene-2-carbonitriles was synthesized and evaluated for their cytotoxic activities against MCF-7, HCT-116, and HepG-2 cancer cells. The SAR studies reported that the substitution in the phenyl ring at 1-position of 1H-benzo[f]chromene nucleus with the specific group, H atom, or methoxy group at 9-position increases the ability of the molecule against the different cell lines.
Clinical Research Informatics for Big Data and Precision Medicine
Authors: Kahn M.G. , Weng C.
Published: November 2016

Objectives: To reflect on the notable events and significant developments in Clinical Research Informatics (CRI) in the year of 2015 and discuss near-term trends impacting CRI.

Methods: We selected key publications that highlight not only important recent advances in CRI but also notable events likely to have significant impact on CRI activities over the next few years or longer, and consulted the discussions in relevant scientific communities and an online living textbook for modern clinical trials. We also related the new concepts with old problems to improve the continuity of CRI research.

Results: The highlights in CRI in 2015 include the growing adoption of electronic health records (EHR), the rapid development of regional, national, and global clinical data research networks for using EHR data to integrate scalable clinical research with clinical care and generate robust medical evidence. Data quality, integration, and fusion, data access by researchers, study transparency, results reproducibility, and infrastructure sustainability are persistent challenges.

Conclusion: The advances in Big Data Analytics and Internet technologies together with the engagement of citizens in sciences are shaping the global clinical research enterprise, which is getting more open and increasingly stakeholder-centered, where stakeholders include patients, clinicians, researchers, and sponsors.
Methods for Addressing Technology-induced Errors: The Current State
Authors: Dexheimer J. W. , Cossio C. Hullin Lucay , Gong Y. , Jensen S. , Kaipio J. , Kennebeck S. , Kirkendall E. , Kushniruk A. W. , Kuziemsky C. , Marcilly R. , Röhrig R. , Saranto K. , Senathirajah Y. , Weber J. , Takeda H. , Borycki E.
Published: November 2016

Objectives: The objectives of this paper are to review and discuss the methods that are being used internationally to report on, mitigate, and eliminate technology-induced errors.

Methods: The IMIA Working Group for Health Informatics for Patient Safety worked together to review and synthesize some of the main methods and approaches associated with technology-induced error reporting, reduction, and mitigation. The work involved a review of the evidence-based literature as well as guideline publications specific to health informatics.

Results: The paper presents a rich overview of current approaches, issues, and methods associated with: (1) safe HIT design, (2) safe HIT implementation, (3) reporting on technology-induced errors, (4) technology-induced error analysis, and (5) health information technology (HIT) risk management. The work is based on research from around the world. Conclusions: Internationally, researchers have been developing methods that can be used to identify, report on, mitigate, and eliminate technology-induced errors. Although there remain issues and challenges associated with the methodologies, they have been shown to improve the quality and safety of HIT. Since the first publications documenting technology-induced errors in healthcare in 2005, we have seen in a short 10 years researchers develop ways of identifying and addressing these types of errors. We have also seen organizations begin to use these approaches. Knowledge has been translated into practice in a short ten years whereas the norm for other research areas is of 20 years.
The Virtuous Circles of Clinical Information Systems: a Modern Utopia
Authors: Degoulet P.
Published: November 2016

Context: Clinical information systems (CIS) are developed with the aim of improving both the efficiency and the quality of care.

Objective: This position paper is based on the hypothesis that such vision is partly a utopian view of the emerging eSociety.

Methods: Examples are drawn from 15 years of experience with the fully integrated Georges Pompidou University Hospital (HEGP) CIS and temporal data series extracted from the data warehouses of Assistance Publique - Hôpitaux de Paris (AP-HP) acute care hospitals which share the same administrative organization as HEGP. Three main virtuous circles are considered: user satisfaction vs. system use, system use vs. cost efficiency, and system use vs quality of care.

Results: In structural equation models (SEM), the positive bidirectional relationship between user satisfaction and use was only observed in the early HEGP CIS deployment phase (first four years) but disappeared in late post-adoption (≥8 years). From 2009 to 2013, financial efficiency of 20 AP-HP hospitals evaluated with stochastic frontier analysis (SFA) models diminished by 0.5% per year. The lower decrease of efficiency observed between the three hospitals equipped with a more mature CIS and the 17 other hospitals was of the same order of magnitude than the difference observed between pediatric and non-pediatric hospitals. Outcome quality benefits that would bring evidence to the system use vs. quality loop are unlikely to be obtained in a near future since they require integration with population-based outcome measures including mortality, morbidity, and quality of life that may not be easily available.

Conclusion: Barriers to making the transformation of the utopian part of the CIS virtuous circles happen should be overcome to actually benefit the emerging eSociety.
Building a Privacy, Ethics, and Data Access Framework for Real World Computerised Medical Record System Data: A Delphi Study
Authors: Liyanage H. , Liaw S.-T. , Di Iorio C. T. , Kuziemsky C. , Schreiber R. , Terry A. L. , de Lusignan S.
Published: November 2016

Background: Privacy, ethics, and data access issues pose significant challenges to the timely delivery of health research. Whilst the fundamental drivers to ensure that data access is ethical and satisfies privacy requirements are similar, they are often dealt with in varying ways by different approval processes. Objective: To achieve a consensus across an international panel of health care and informatics professionals on an integrated set of privacy and ethics principles that could accelerate health data access in data-driven health research projects.

Method: A three-round consensus development process was used. In round one, we developed a baseline framework for privacy, ethics, and data access based on a review of existing literature in the health, informatics, and policy domains. This was further developed using a two-round Delphi consensus building process involving 20 experts who were members of the International Medical Informatics Association (IMIA) and European Federation of Medical Informatics (EFMI) Primary Health Care Informatics Working Groups. To achieve consensus we required an extended Delphi process.

Results: The first round involved feedback on and development of the baseline framework. This consisted of four components: (1) ethical principles, (2) ethical guidance questions, (3) privacy and data access principles, and (4) privacy and data access guidance questions. Round two developed consensus in key areas of the revised framework, allowing the building of a newly, more detailed and descriptive framework. In the final round panel experts expressed their opinions, either as agreements or disagreements, on the ethics and privacy statements of the framework finding some of the previous round disagreements to be surprising in view of established ethical principles.

Conclusion: This study develops a framework for an integrated approach to ethics and privacy. Privacy breech risk should not be considered in isolation but instead balanced by potential ethical benefit.
A Survey of the Literature on Unintended Consequences Associated with Health Information Technology: 2014–2015
Authors: Abraham J. , Novak L. L. , Reynolds T. L. , Gettinger A. , Zheng K.
Published: November 2016

Objective: To summarize recent research on unintended consequences associated with implementation and use of health information technology (health IT). Included in the review are original empirical investigations published in English between 2014 and 2015 that reported unintended effects introduced by adoption of digital interventions. Our analysis focuses on the trends of this steam of research, areas in which unintended consequences have continued to be reported, and common themes that emerge from the findings of these studies.

Method: Most of the papers reviewed were retrieved by searching three literature databases: MEDLINE, Embase, and CINAHL. Two rounds of searches were performed: the first round used more restrictive search terms specific to unintended consequences; the second round lifted the restrictions to include more generic health IT evaluation studies. Each paper was independently screened by at least two authors; differences were resolved through consensus development.

Results: The literature search identified 1,538 papers that were potentially relevant; 34 were deemed meeting our inclusion criteria after screening. Studies described in these 34 papers took place in a wide variety of care areas from emergency departments to ophthalmology clinics. Some papers reflected several previously unreported unintended consequences, such as staff attrition and patients’ withholding of information due to privacy and security concerns. A majority of these studies (71%) were quantitative investigations based on analysis of objectively recorded data. Several of them employed longitudinal or time series designs to distinguish between unintended consequences that had only transient impact, versus those that had persisting impact. Most of these unintended consequences resulted in adverse outcomes, even though instances of beneficial impact were also noted. While care areas covered were heterogeneous, over half of the studies were conducted at academic medical centers or teaching hospitals. Conclusion: Recent studies published in the past two years represent significant advancement of unintended consequences research by seeking to include more types of health IT applications and to quantify the impact using objectively recorded data and longitudinal or time series designs. However, more mixed-methods studies are needed to develop deeper insights into the observed unintended adverse outcomes, including their root causes and remedies. We also encourage future research to go beyond the paradigm of simply describing unintended consequences, and to develop and test solutions that can prevent or minimize their impact.
Some Innovative Approaches for Public Health and Epidemiology Informatics
Authors: Toubiana L. , Griffon N. ,   Section Editors for the IMIA Yearbook Section on Public Health and Epidemiology Informatics
Published: November 2016

Objectives: Summarize excellent current research published in 2015 in the field of Public Health and Epidemiology Informatics.

Methods: The complete 2015 literature concerning public health and epidemiology informatics has been searched in PubMed and Web of Science, and the returned references were reviewed by the two section editors to select 14 candidate best papers. These papers were then peer-reviewed by external reviewers to allow the editorial team an enlightened selection of the best papers.

Results: Among the 1,272 references retrieved from PubMed and Web of Science, three were finally selected as best papers. The first one presents a language agnostic approach for epidemic event detection in news articles. The second paper describes a system using big health data gathered by a statewide system to forecast emergency department visits. The last paper proposes a rather original approach that uses machine learning to solve the old issue of outbreak detection and prediction.

Conclusions: The increasing availability of data, now directly from health systems, will probably lead to a boom in public health surveillance systems and in large-scale epidemiologic studies.
Acute administration of acyl, but not desacyl ghrelin, decreases blood pressure in healthy humans
Authors: Zhang Cecilia J , Bidlingmaier Martin , Altaye Mekibib , Page Laura C , D’Alessio David , Tschöp Matthias H , Tong Jenny
Published: November 2016

Objective

To compare the effects of acyl ghrelin (AG) and desacyl ghrelin (DAG) on blood pressure (BP), heart rate (HR) and other autonomic parameters in healthy humans and to elucidate the hormonal mechanisms through which AG could exert its cardiovascular effects.

Design

Seventeen healthy participants underwent frequent monitoring of systolic (sBP) and diastolic blood pressure (dBP), HR, respiratory rate (RR) and body surface temperature (Temp) during continuous infusion of AG, DAG, combined AG + DAG or saline control before and during an IV glucose tolerance test on 4 separate days. Plasma catecholamines, renin and aldosterone levels were also measured. Differences in outcome measures between treatment groups were assessed using mixed-model analysis.

Results

Compared to the saline control, AG and combined AG + DAG infusions decreased sBP, dBP, mean arterial blood pressure (MAP), HR and Temp. In contrast, DAG infusion did not alter BP, RR or Temp, but did decrease HR. The AG and AG + DAG infusions also raised plasma aldosterone levels compared to saline (P < 0.001) without affecting renin or catecholamine levels.

Conclusions

The decrease in BP, HR, RR and Temp with AG infusion suggests mediation through the autonomic nervous system. The lack of response to DAG suggests that these autonomic effects require activation of the ghrelin receptor.