bluuebunny/crossref_metadata_2025 huggingface dataset:
Автомобілі-роботи: можливості та наслідки для транспортної системи
Authors: ОНИЩУК Василь , СТЕЛЬМАЩУК Валерій , ДУБИЦЬКИЙ Олександр , БУЛІК Юрій
Published: October 2020

У цьому дослідженні досліджуються проблеми та можливості, пов'язані з транспортною політикою, які можуть виникнути внаслідок нових технологій автомобілів-роботів(А-Р). Ці технології можуть знизити транспортні витрати та збільшити доступність для осіб з проблемами мобільності. Ця нова технологія також має далекосяжні застосування та наслідки, що перевищують усі поточні очікування. Неодмінною частиною перспективного розвитку А-Р є зв’язок між автомобілями та інфраструктурою (підключені транспортні засоби). Існує великий розрив знань в технологіях щодо маршрутизації поведінки. Технологія підключення автомобіля дає чудову можливість впровадити ефективну та інтелектуальну систему маршрутизації. З цією метою пропонується концептуальна навігаційна модель на основі флоту А-Р, які централізовано відправляються по мережі, що прагнуть оптимізувати систему.
В роботі досліджено такі основні фактори: майбутні можливості, а також на можливі перешкоди, пов'язані з технологією А-Р; оптимізація навігаційної моделі А-Р для покращення маршрутизації і дорожньої обстановки.
Ключові слова: автомобіль-робот, автономний транспортний засіб, підключений транспортний засіб,     навігація автомобіля, оптимальність системи, розумна транспортна система.
Pengaruh Penguasaan Materi Matematika dan Pengetahuan Evaluasi terhadap Kualitas Tes Matematika Buatan Guru 2013
Authors: Irwansyah Asep
Published: October 2020

Dalam proses pembelajaran, seorang guru pada prinsipnya dapat menggunakan alat testing buatan guru itu sendiri atau testing baku. Alat testing baku pada umumnya difokuskan untuk melengkapi butir-butir acuan normatif, berisi daftar skor sejenis yang diambil dari sampel siswa yang diasumsikan merepresentasikan populasi dimana tes direncanakan dapat digunakan. Sedangkan alat testing buatan sendiri digunakan jika guru ingin memperoleh informasi yang unik dan spesifik tentang para siswa. Namun pada umumnya tes buatan guru, baik tes formatif maupun sumatif belum dianalisis tingkat validitasnya, reliabilitas, daya beda dan tingkat kesukarannya. Sehingga tidak beralasan untuk mengatakan bahwa tes tersebut berkualitas atau tidak, meskipun telah diisusun berdasarkan pokok bahasan yang telah diajarkan dan tujuan intruksional yang telah ditetapkan. Guru sebagai dasar untuk memperbaiki proses belajar mengajar, dan sebagai dasar untuk memperbaiki program siswa pengukuran dan penilaian yang diberikan setelah selesai mengajar suatu satuan pelajaran akan dapat memberi informasi tentang kekurangan-kekurangan atau kesalahan yang ada, hingga guru dapat mengadakan perbaikan setepat-tepatnya.
Pelatihan Pengelolaan Limbah Medis Padat
Authors: Suhermi Suhermi , Zulaika Zulaika , Narjati Nina
Published: September 2020

Pengelolaan Kesehatan lingkungan rumah sakit adalah upaya pencegahan penyakit dan/atau gangguan kesehatan dari faktor risiko lingkungan. baik dari aspek fisik, kimia, biologi, maupun social. Upaya yang dilakukan rumah sakit dalam rangka pengelolaan kesehatan lingkungan yaitu menyelenggarakan pelayanan sanitasi rumah sakit, salah satunya adalah pengelolaan limbah. Pengelolaan limbah merupakan salah satu aspek strategis dari rumah sakit, karena dengan pengelolaan limbah yang baik dan benar akan menekan biaya pengolahan, mencegah infeksi dan menciptakan citra yang baik bagi rumah sakit. Pengelolaan limbah medis padat di mulai dari pemilahan, pewadahan, pengumpulan, pengangkutan, transportasi dan berakhir di tempat penyimpanan sementara untuk menunggu pembakaran. Timbulan Jumlah limbah medis padat seperti : bekas perban, sisa-sisa kapas, jarum suntik, infus set, ampul/vial obat, kaca preparat dan lain-lainnya sebanyak Â± 16 - 55 kg per hari, yang dihasilkan dari unit rawat jalan dan rawat inap selanjutnya akan disimpan di Tempat Penyimpanan Sementara Limbah Medis Padat. Adapun lokasi Tempat Penyimpanan Sementara limbah medis padat di Rumah Sakit Azra berada dalam satu ruanganÂ  dengan mesin insenerator dan ruangan petugas limbah medis. tempat penyimpanan sementara limbah medis padat yang ada di Rumah Sakit AZRA Bogor disarankan terpisah dengan ruangan petugas sanitasi. Petugas sanitasi sebaiknya mendapatkan ruangan tersendiri,dan tidak menjadiÂ  dalam satu ruangan dengan mesin insenerator, limbah medis padat dan limbah B3.
Resultados audiológicos y de calidad de vida en pacientes con transición del sistema Baha Connect® a Baha Attract®
Authors: Leonardo Elías Ordóñez-Ordóñez , GE Corredor-García , SC Vanegas , ES Angulo-Martínez
Published: October 2020

Introducción: los implantes auditivos de conducción ósea percutáneos han sido usados de forma exitosa. Sin embargo, un número importante de pacientes reportan reacciones en piel repetitivas. Los implantes auditivos transcutáneos son una alternativa que pueden solventar estas complicaciones. Con este estudio queremos describir los resultados audiológicos y de calidad de vida en pacientes que requirieron transición del sistema percutáneo a transcutáneo.Metodología: estudio observacional descriptivo, se incluyeron pacientes con implante auditivo percutáneo que requirieron transición a sistema transcutáneo. Se evaluó el desempeño auditivo utilizando una prueba con fondo ruidoso y se aplicó la escala de calidad de vida “Glasgow Benefit Inventory”-GBI.
Pendekatan Etnografis dan Psikologis dalam Studi Islam
Authors: Fadil Achmad
Published: October 2020

Abstract
            In order to get better understanding about Islamic Study is a knowladge for those who seek and wants to get better about Islamic as a religion in a deeper context which its consist of several aspects, because itâ€™s not enough to getting understand about Islam as a religion with only relying to Alqurâ€™an and alsa hadits, which it means theres also some sources that act as intermediary to tell us about Islam as a religion. One of the method is to take a look into the etnography and psychology of Islam. Etnography is a knowladge that telling us about the culture of muslim in Islamic way, while psychology enclousure is the knowladge that discuss about the psychology and mind of a human in Islam perspective.
            Keyword: Culture, Psychology/Mind, Islam
An Analysis of Lexical and Grammatical Cohesion of Six Feet Apart Song by Alec Benjamin
Authors: Sholah Hanif Maulaniam , Yunus Ahmad
Published: October 2020

Abstract
This paper shows the linguistic aspect in term of discourse analysis in the lyrics of song. Those aspects are cohesion device and grammatical cohesion. Cohesion devices divided into two descriptions, those are; grammatical and lexical cohesion devices. Grammatical cohesion contains reference, ellipsis, substitution, and conjunction while lexical cohesion contains collocation and reiteration. This research analyzes the lyrics from the soloist band namely Alec Benjamin entitle â€œSix feet apartâ€. After analyzing grammatical and lexical cohesion of six feet apartâ€™s lyric, the result shows that the kinds of grammatical and lexical cohesion exist in the lyric. The first kind of grammatical cohesion which is found is reference. The kinds of references namely personal, adverbial demonstrative, selective nominal demonstrative, and comparative reference are found in the lyric. The most frequent reference which is used in the lyric is personal reference. The usage of cohesive devices is so important to make meaningful language to the lyrics of the song. The cohesion devices make the text united.. The function of lexical cohesion within the stanza in the lyric of six feet apart song is making a relationship and also it is used to express and to stress the singerâ€™s idea.
 
Key word: Discourse analysis, Lexical Cohesion, Grammatical Cohesion
Implementasi Pembelajaran Perkembangan Mental Anak Berkebutuhan Khusus (ABK) di Sekolah Alam Mi Bilingual Al-Ikhlas Kepanjen Malang
Authors: Husni Muhammad
Published: October 2020

ABSTRAK
The Implementation of the learning is the process of implementing learning in implementing a structured plan or program in carrying out the learning process. For the application of learning, there are there  companion teachers who handle children of heaven experts. When students are about to the start learning, they are always given finger test therapy, so that the companion teacher can find out which part of the brain is more active. The learning approach uses an individual approach and uses an individual curriculum combined with the 2013 curriculum.
This study used a qualitative approach with qualitative descriptive research. The proof obtained were written proof in accordance with the interview guidelines. The use of documentation Proof a collection techniques includes: principal proof, educator proof, student proof, learning programs for children with special needs
The application of learning to the power  development of children with special needs (ABK) is to use an individual curriculum combined with the 2013 curriculum and the learning uses an individual approach. Before learning begins, the companion teacher always provides finger test therapy for children before starting learning. The teacher's effort in improving children's the power  development is to provide opportunities to answer questions / work on questions given by the teacher and give Stars / Rewards.
Keywords: the Learning Implementation, the power of the Development
Penggunaan Media Alat Peraga Nasyid Sebagai Pembelajaran Inovatif Guna Memahami Konsep Agama Islam di SMA Negeri 1 Ambunten
Authors: Shiddiq L. Qodri
Published: October 2020

ABSTRACT
            Success of learning is determined by many factors, including the teacher's factor in carrying out the teaching and learning process because the teacher can directly affect Maintaining and improving intelligence and skills of the students solve the above problems and to achieve the education to the maximum the teacher's role is very important and teachers are expected to have a way of models of good teaching and being able to select appropriate learning models and in accordance with the concepts of subjects that will be presented
            While the goal from the research is a to determine the significance of differences in learning acquisition between learning using songs that breathe Islam and learning without using songs that breathe Islam on the subject matter of Islamic religion on the subject of the journey of Ra. sulullah, b to find out the significance of the difference in learning acquisition based on the learning styles of SMA Negeri 1 students, know between the use of Islamic learning songs with the learning acquisition of students in SMA Negeri 1 ambunten.
            From the analysis, it is found that there is a significant difference in learning acquisition between Islamic religious learning. the subject matter of the Prophet's journey by using Islamic-breathed songs to students of SMA Negeri 1 ambunten means that the use of songs with Islamic breaths to organize the learning environment can increase the acquisition of learning and learning will be meaningful and successful when learning or students are free from pressure and tension, songs breathing Islam that is played can determine the mood of the listener and the lover, the sound of relaxing Islamic breathing songs with the right rhythm can help release all forms of tension,  
            There is a real interaction between the use of Islamic-inspired songs Learning with learning acquisition in SMA Negeri 1 students provides an indication that between learning Islamic songs and learning outcomes have a close relationship, Islamic-breathed songs and learning styles have a significant influence in increasing learning acquisition
 
For keywords using media, tools nasyid display, innovative learning.
Kim Knott; Studi Agama Perspektif Insider/Outsider
Authors: Jannah Uswatul , Effendi Ahmad
Published: October 2020

AbstractThis paper is the result of a study of Kim Knott's insider / outsider perspective in religious studies.The discussion methodology used in this paper is literature study. This insider / outsider conceptwas born in order to obtain objective and accountable science of religion. According to Knott,religious researchers must be able to position themselves and understand their position, both asinsiders and outsiders. By doing so, it is also hoped that they will choose the relevant partialapproach methodology. The options Kim Knott offered to insider researchers were a completeparticipant or participant as observer. Meanwhile, an outsider observer is a complete observer oran observer as a participant. Look at the following schematic:Kata Kunci: Insider/Outsider, Studi Agama, Metodologi.
The Importance Of Listening In Foreign Language Learning
Authors: Shariyevna Karimova Jamila
Published: October 2020

This article is devoted to the role of listening skill and it’s different types in terms of obtaining new language. The stages which are typically used in order to do listening  are given with their instructions in the article.
Text analysis of DNS queries for data exfiltration protection of computer networks
Authors: Bubnov Ya. V. , Ivanov N. N.
Published: October 2020

The paper proposes effective method of computer network protection from data exfiltration by the system of domain names. Data exfiltration by Domain Name System (DNS) is an approach to conceal the transfer of confidential data to remote adversary using data encapsulation into the requesting domain name. The DNS requests that transfer stolen information from a host infected by malicious software to an external host controlled by a malefactor are considered. The paper proposes a method of detecting such DNS requests based on text classification of domain names by convolutional neural network. The efficiency of the method is based on assumption that domain names exploited for data exfiltration differ from domain names formed from words of natural language. To classify the requests in convolutional neural network the use of character embedding for representing the string of a domain name is proposed. Quality evaluation of the trained neural network used for recognition of data exfiltration through domain name system using ROC-analysis is performed.

The paper presents the software architecture used for deployment of trained neural network into existing infrastructure of the domain name system targeting practical computer networks protection from data exfiltration. The architecture implies creation of response policy zones for blocking of individual requests, classified as malicious.
Cryoglobulinemia and sensorimotor polyneuropathy
Authors: Sedlić Marija , Sičaja Gordana , Luetić Krešimir , Budinčević Hrvoje
Published: October 2020

Secondary cryoglobulinemia is the most common extrahepatic manifestation of hepatitis C. There are different genotypes of hepatitis C, and the ones that are most frequently associated with cryoglobulinemia are genotypes 1b and 2a. Cryoglobulinemia affects various organs and can cause vasculitis, arthralgia, skin changes, glomerulonephritis and neurological manifestations, including peripheral neuropathy. The aim of this report was to emphasize the importance of early diagnosis of hepatitis C infection in patients who are presenting with sensomotor polyneuropathy.
STEM Eğitim Yaklaşımının 2018 Fen Bilimleri Öğretim Programı Kapsamında Uygulanabilirliğinin İncelenmesi
Authors: ELMAS Rıdvan , GÜL Merve
Published: October 2020

Bu çalışmada STEM eğitim yaklaşımı ve 2018 Fen Bilimleri Dersi Öğretim Programı arasındaki ilişkinin STEM eğitim yaklaşımı bağlamında incelenmesi hedeflenmektedir. Bu çalışma bir doküman analizi çalışmasıdır ve bu kapsamda güncel fen bilimleri programı beş farklı boyutta incelenmiştir. Analiz birimi olarak güncel fen bilimleri programında yer alan kazanımlar, kazanımların içeriğindeki ifadeler kullanılmıştır. STEM eğitim yaklaşımının uygulanabilirliği açısından programın amaçları, öğretim yaklaşımı, kazanımları, öğretmenin ve öğrencinin rolleri değerlendirilmiştir. Ayrıca 2017 yılında yayınlanan programın yapısı ile 2018 yılında yapılan güncelleme de bu kapsamda ele alınmıştır. Yapılan doküman analizi sonucunda amaçları, desteklediği öğretim (öğrenme) yaklaşımları, öğretmenin ve öğrencinin rolleri açısından program değerlendirildiğinde; STEM eğitim yaklaşımı bu program kapsamında uygulanabilir bulunmuştur. Kazanımlar boyutuyla bakıldığında fen bilimleri öğretim programının, STEM eğitim yaklaşımının özellikle mühendislik tasarım sürecini belirli kazanımlar aracılığıyla ve özellikle “tasarlama” eylemi kullanılarak sunmaya çalıştığı sonucuna varılmıştır. Bu kapsamda; 2017 programındaki kazanımların mühendislik tasarım süreçlerinin bütün basamaklarını içerdiği, 2018’de güncellenen programda yer alan kazanımların ise mühendislik tasarım sürecinin bir basamağı olan “tasarım” boyutuna yönelik olduğu saptanmıştır. STEM eğitim yaklaşımı açısından ele alındığında, güncel programın mühendislik tasarım sürecindeki bütün aşamalara yönelik kazanımları içermemesi ve değinilen kazanımları uygun sırada sunmaması bir eksiklik olarak değerlendirilmiştir.
Fintek Hizmetlerinin Finans Sektörüne Etkileri ve Sağlanan Devlet Teşvikleri
Authors: SEZAL Levent
Published: October 2020

Fintek kavramı (Finansal Teknoloji), sözlük anlamıyla finansal hizmetleri iyileştirmek, insanların teknoloji ile entegrasyonunu sağlamak adına teknolojiden büyük ölçüde yararlanan yeni finans endüstrisi olarak tanımlamak mümkündür. Bünyelerinde bulundurdukları teknolojik güç ile geleneksel finansal hizmetlerle rekabet eden fintek girişimleri dünya genelinde insanların hayatlarını kolaylaştırmak, zaman ve mekân tasarrufu sağlamak felsefesiyle hareket etmektedir. Başlangıçta geleneksel finans hizmetlerinin daha çok teknolojik versiyonu olarak görülen fintek uygulamaları, bugün gelinen noktada beklentilerin çok daha ötesinde bir etkiye sahip hale gelmişlerdir. Dünya genelinde internet ve mobil uygulama alanlarının yaygınlaşması ile birlikte etki alanlarını daha da genişleten fintek girişimlerinin aldığı yatırımlar da bu durumu kanıtlamaktadır. Bu çalışmada öncelikli olarak fintek kavramı, dünyada ve Türkiye’de fintek uygulama alanları, fintek girişimlerine sağlanan devlet destekleri hakkında bilgi verilmesi amaçlanmaktadır.
Distinguishing between Knowledge Visualization and Knowledge Rrpresentation in Legal Informatics
Authors: Čyras Vytautas
Published: September 2020

Knowledge visualization (KV) and knowledge representation (KR) are distinguished, though both are knowledge management processes. Knowledge visualization is subject to humans, whereas knowledge representation – to computers. In computing, knowledge representation leverages reasoning of software agents. Thus, KR is a branch of artificial intelligence. The subject matter of KR is representation methods. They are classified into (1) knowledge level and symbol level representations; (2) procedural and declarative representations; (3) logic-based, rule-based, frame- or object-based representations (supporting inference by inheritance); and (4) semantic networks. In legal informatics, methods of legal knowledge representation (LKR) are dealt with. An essential feature of LKR is the representation of deep knowledge, which is mainly tacit. It is easily understood by professional jurists and hardly by amateurs from outside law. This knowledge comprises the teleology of law and a whole implicit framework of legal system. The paper focuses on (1) identifying key features of KV and KR in the legal domain; and (2) distinguishing between visualization, symbolization, formalisation and mind mapping.
CLINICAL CASE OF NON-COMPACTION CARDIOMYOPATHY IN A PATIENT WITH PKP2 GENE MUTATION
Authors: Komissarova S. , Rineiskaya N. , Chakova N. , Niyazova S. , Dolmatovich T.
Published: October 2020

The features of the clinical course of non-compaction cardiomyopathy, its prognosis and even its diagnosis are still the subject of discussion. The variety of phenotypes of this disease and genetic heterogeneity dictates the need for detailed clinical and molecular genetic examination of patients with this pathology. The article presents a clinical observation of a patient with a dilated phenotype of left ventricular non-compaction, progression of chronic heart failure, as well as the presence of ventricular rhythm and conduction disorders that required the implantation of cardiac resynchronization therapydefibrillator (CRT-D). The patient was found to have a missense mutation c. 1892A>G (p.Tyr631Cys, rs1060501183) in PKP2 gene in a heterozygous state. The issues of differential diagnostics with arrhythmogenic right ventricular cardiomyopathy and treatment strategies for the disease were discussed.
Federal Policy for Lowering Prescription Drug Prices
Authors: Hurley Amanda , Sheftel Celeste M. , Canales Alejandra
Published: October 2020

Both Republicans and Democrats are determined to lower the escalating cost of prescription drug prices, which is projected to reach $605 billion/yr by 2026 (Committee on Ways and Means 2019). In this memorandum, we explore the possible outcomes of,

1) linking U.S. drug prices to the international median incentivized by re-importation of the U.S.-made drugs from other countries,
2) allowing the Secretary of Health and Human Services (HHS) to negotiate Medicare part D drugs incentivized through patent exemption and,
3) funding drug discovery through prizes instead of market-exclusive patents.

We recommend that the next presidential candidate approve Option 2 and advocate for HHS Secretary negotiation powers with patent exemptions for non-compliant companies.
Digitization as an innovative segment of enterprise financial security management
Authors: Volodymyr Kotkovskyi , Zaluzhny Vitalii , Kadala Vitalii , Guzenko Olena , Bohatyrova Maryna , Leskova-Hodlevska Julia
Published: October 2020

Today, the global trend of the digital world economy is entering an active phase of its development. In the leading countries of the world, the development of digital technologies, both at the state and corporate levels, has been begun to advance massively in government programs and business strategies. The substantiation of the role aspect of introduction of the process of digitization as an innovative element of improvement of the system of financial security management of representatives of the business sector of the economy is relevant. It is to investigate the impact of the digitalization system on improving the financial security management of enterprises in the process of improving the conceptual apparatus and develop an economic and mathematical model for evaluating financial security based on innovative proposals.

To achieve this goal, we used the method of theoretical generalization to determine the conceptual apparatus of digitization and economic-statistical methods to substantiate the economic and mathematical model of assessing the financial security of enterprises. It is proposed to expand the conceptual apparatus of the system of financial security management of enterprises by introducing such definitions as «digitization of financial security», «digital base of financial storage» and «regulator of financial security». The authors’ position of the essential characteristic of the definitions is given and the advantages of their adaptation in the management cycle are stated. The feasibility of introducing the principle of «digitization of financial security» as one of the key elements of the innovative proposal of the system of financial security management of enterprises in the future is argued. An economic and mathematical model of financial security assessment based on the profitability criteria is developed and substantiated. A number of proposals have been made to improve the financial security management of enterprises based on individual segments of the digitization system.
Allergic Contact Dermatitis due to Methacrylates in a Dental Technician – a Clinical Case
Authors: Chonin Atanas , Stoeva Iliyana
Published: September 2020

Introduction: Methacrylate-based materials are used daily in dental practice. Specialized publications report these materials as allergens with a high sensitizing potential.

Aim: To draw the attention of dental doctors and personnel to risk factors of developing occupational allergies.

Materials and methods: History and dermatological status of the patient were taken and he was given an epicutaneous test.

Results: The allergy testing revealed a strong positive allergic reaction to methacrylates which persisted and was observed at 72 hours as well as on day 7. A diagnosis of allergic contact dermatitis was made on the basis of the patient’s history, the clinical examination and the results of the epicutaneous test.

Conclusion: The presented clinical case shows that early identification of the specific causative agents allows clinicians to take adequate measures and achieve results without having to use a medicine, and stop the progression of the occupational disease and the development of complications.
Global Cognitive Performance and Assessment of Memory Functions in Obstructive Sleep Apnea
Authors: Dimitrova Maria , Genov Krasimir
Published: September 2020

Abstract: Since the 1980s, cognitive problems in patients with obstructive sleep apnea have been suspected. Different studies examine different cognitive domains. In the Bulgarian population, such a widespread survey has not been done. The purpose of this study is to evaluate global cognitive functioning and memory function in patients with obstructive sleep apnea.
Indigeneity, Gender, and Resistance: Critique and Contemporaneity of Bolivian Anarchism in the Historical Imagination of Silvia Rivera Cusicanqui
Authors: de Laforcade Geoffroy
Published: September 2020

From the 1920s to the 1940s, Bolivia was a hub of Andean transnational solidarities rooted in artisanal trades, and spearheaded by migrant workers whose cultural, educational and social activism reflected a mosaic of influences from older militant traditions in neighbouring countries.
Virtually absent from existing overviews of Latin American anarchism in English, Bolivian anarchism engaged extensively with autonomous indigenous and communal movements, and is therefore a distinctly revealing case from which to evaluate the engagement of anarchists with indigenous majorities
in the Andean space where they lived. This article explores the work of sociologist Silvia Rivera Cusicanqui, whose dense tapestry of pioneering scholarship on the intertwining horizons of conquest, rebellion, republicanism, resistance and populism in Bolivia over five hundred years includes
profound and nuanced assessments of indigeneity and gender, pointing to the need for a more nuanced understanding of how racialised identities are defined in society, and the ways in which they are deployed discursively by revolutionary movements. From the rebellions Tupac Katari and Pablo
Zárate Willka in the late 19th century, the subsequent quest of Aymara 'caciques apoderados' for allies among organized artisans and the urban poor, struggles of anarchist women, independent agrarian trade unionism, and the Katarista movement of the 1960s and 1970s to the
popular insurgencies of the past three decades, Cusicanqui's work threads together archival, oral and iconographic history while enlisting the participation of popular movements in an ongoing critique of the legacies of internal colonialism, racialization, patriarchal inheritances, and languages
of resistance in Bolivia; as well as the lessons of struggles for autonomy, freedom and decolonization in which anarchists and the movements they subsequently influenced took part.
Tofacitinib Persistence in Patients with Rheumatoid Arthritis: A Retrospective Cohort Study
Authors: Fisher Anat , Hudson Marie , Platt Robert W. , Dormuth Colin R.
Published: October 2020

Objective.

To compare medication persistence of tofacitinib with persistence of injectable biological disease-modifying antirheumatic drugs (bDMARD) in patients with rheumatoid arthritis (RA).

Methods.

We performed a retrospective new-user cohort study of patients with RA in the IBM MarketScan Research Databases. New users of tofacitinib or bDMARD were identified between November 2012 and December 2016. Persistence, in number of years, was the time between treatment initiation and the earliest occurrence of discontinuation or switching from the medication prescribed at cohort entry. Persistence of tofacitinib was compared with bDMARD persistence using Cox proportional hazards regression with adjustment for high-dimensional propensity scores. Similar methods were used for an analysis of post first-line therapy in patients who switched to tofacitinib from a bDMARD.

Results.

New tofacitinib users (n = 1031) were 56 years of age, on average, and 82% were women. New bDMARD users (n = 17,803) were 53 years of age, on average, and 78% were women. New tofacitinib users had shorter medication persistence (median 0.81 yrs) compared to bDMARD patients (1.02 yrs). After adjustment, the HR for discontinuation of tofacitinib compared with bDMARD was 1.14 (95% CI 1.05–1.25). Patients who switched to tofacitinib from a bDMARD had longer persistence than patients who switched to a bDMARD (adjusted HR for discontinuation 0.90, 95% CI 0.83–0.97).

Conclusion.

Further research is warranted to understand the reasons for discontinuation of tofacitinib despite its ease of administration and to understand the observed differences between switchers and new users.
STRATUS: A Phase II Study of Abituzumab in Patients With Systemic Sclerosis–associated Interstitial Lung Disease
Authors: Khanna Dinesh , Tashkin Donald P. , Wells Athol U. , Seibold James R. , Wax Stephen , Vazquez-Mateo Cristina , Fleuranceau-Morel Patricia , Damian Doris , Denton Christopher P.
Published: October 2020

Objective

To investigate the effects of abituzumab in systemic sclerosis–associated interstitial lung disease (SSc-ILD).

Methods

STRATUS was a phase II, double-blind, parallel-group, multicenter trial (ClinicalTrials.gov: NCT02745145). Adults (≤ 75 yrs) with SSc-ILD on stable mycophenolate were randomized (2:2:1) to receive intravenous abituzumab 1500 mg, abituzumab 500 mg, or placebo every 4 weeks for 104 weeks. The primary endpoint was the annual rate of change in absolute forced vital capacity.

Results

STRATUS was terminated prematurely due to slow enrollment (n = 75 screened, n = 24 randomized), precluding robust analysis of efficacy. Abituzumab was well tolerated; no new safety signals were detected.

Conclusion

Further investigation of abituzumab for treatment of SSc-ILD is required.
Clinical Phenotyping of Primary Sjögren Syndrome Patients Using Salivary Gland Ultrasonography: Data From the RESULT Cohort
Authors: Mossel Esther , van Nimwegen Jolien F. , Stel Alja J. , Wijnsma Robin F. , Delli Konstantina , van Zuiden Greetje S. , Olie Lisette , Vehof Jelle , Los Leonoor I. , Vissink Arjan , Kroese Frans G.M. , Arends Suzanne , Bootsma Hendrika
Published: October 2020

Objective

To investigate salivary gland ultrasound (SGUS) abnormalities in relation to clinical phenotype and patient characteristics, disease activity, and disease damage in patients with primary Sjögren syndrome (pSS).

Methods

Consecutive outpatients included in our REgistry of Sjögren Syndrome LongiTudinal (RESULT) cohort were selected. Patients with pSS who were included were classified according to the American College of Rheumatology/European League Against Rheumatism (EULAR) criteria and underwent full ultrasonographic examination (Hocevar score 0–48) at baseline. Total SGUS scores of ≥ 15 were considered positive. Patient characteristics, disease activity, and disease damage were compared between the different SGUS groups.

Results

In total, 172 of 186 patients with pSS were eligible, of whom 136 (79%) were SGUS positive. Compared with patients who were SGUS negative, SGUS-positive patients had significantly longer disease duration, higher EULAR Sjögren Syndrome Disease Activity Index, higher Sjögren Syndrome Disease Damage Index, and were more likely to have a positive parotid gland biopsy, anti-SSA/SSB antibodies, and abnormal unstimulated whole saliva (UWS) and ocular staining score (OSS), and higher levels of IgG and rheumatoid factor. Regarding patient-reported outcome measurements (PROM), patients who were SGUS positive scored significantly lower on the EULAR Sjögren Syndrome Patient-Reported Index for fatigue and pain, and more often found their disease state acceptable compared with patients who were SGUS negative. SGUS total score showed significant associations with various clinical and serological variables, and with PROM. Highest associations were found for UWS (ρ = –0.551) and OSS (ρ = 0.532).

Conclusion

Patients who were SGUS positive show a distinct clinical phenotype in all aspects of the disease compared with patients who were SGUS negative: clinical, functional, serological, and PROM. SGUS could be a helpful tool in selecting patients for clinical trials and estimating treatment need.
Interaction of age and temperature on heat shock protein expression, sperm count, and sperm viability of the adult black soldier fly (Diptera: Stratiomyidae)
Authors: Malawey A.S. , Zhang H. , McGuane A.S. , Walsh E.M. , Rusch T.W. , Hjelmen C.E. , Delclos P.J. , Rangel J. , Zheng L. , Cai M. , Yu Z. , Tarone A.M. , Zhang J. , Tomberlin J.K.
Published: October 2020

Information regarding black soldier fly (Diptera: Stratiomyidae) adult biology is vital as this is the life stage that produces eggs and thus drives population size. The goal of this study was to determine key biological characteristics of adult black soldier flies as they age in relation to: (1) the thermal preferences (Tsel) of males and females; (2) the impact of temperature on heat shock protein expression in males and females; as well as (3) the sperm count; and (4) the sperm viability in males. Aging significantly impacted male and female temperature preferences. Young males (<24-h-old) preferred warmer temperatures (median=24.3 °C, range=19.3-28.2 °C) compared to females of the same age (median=20.2 °C, range=15.4-26.2 °C). However, in older adults (i.e. 72-h-old males and 48-h-old females), temperature preferences converged between 21 and 24 °C. Temperatures tested did not impact hsp expression in males or females. However, aging males, but not females, had increased expression of the heat shock proteins (hsp) hsp70 and hsp90. Furthermore, age impacted sperm count but not sperm viability in males. In particular, 48-h-old males had the greatest sperm count (322.5/sample) and sperm viability (60-78%) compared to all other aged males. Thermal data in conjunction with sperm data potentially explain why early thermal segregation behaviour between males and females occurs. Once adult males and females reached 72-h-old and 48-h-old, respectively, they exhibited a common thermal preference, which coincided with the greatest number of viable sperm in males. Forcing adults into environments (i.e. cages) outside these selected preferences could result in premature or delayed mating or low fertilisation rates. Future research exploring cage design and conditions are needed to optimise black soldier fly colony maintenance and fertile egg production, and can leverage information such as the results described here.
Cannibalism, oviposition and egg development in the edible long-horned grasshopper, Ruspolia differens (Orthoptera: Tettigoniidae) under laboratory conditions
Authors: Egonyu J.P. , Miti M.M. , Tanga C.M. , Leonard A. , Subramanian S.
Published: October 2020

Reliance on seasonal wild harvests of the edible long-horned grasshopper Ruspolia differens (Serville) (Orthoptera: Tettigoniidae) needs to be broken through developing efficient mass rearing protocols. This study aimed at boosting productivity of laboratory colonies of R. differens through understanding ways of minimising cannibalism, selecting suitable oviposition substrates and enhancing egg development and hatchability. Firstly, we investigated the extent of cannibalism in a colony of R. differens relative to total mortality, sex, diurnality, growth stage, body parts eaten and visual barriers (presence/absence of cardboard egg trays). R. differens cadavers recovered from cages with/without the egg trays were scored for cause of death (cannibalism/other), time of death (night/day), sex, growth stage and body part devoured. Secondly, cotton wool and leaf sheaths of Pennisetum sp., maize and Panicum sp. were evaluated for oviposition preference by R. differens. Eggs oviposited in each substrate were incubated to determine developmental duration and hatchability. Thirdly, we tested effect of moistening R. differens eggs on incubation period and hatchability in intact and opened leaf sheaths against unmoistened eggs in intact sheaths as a control. We found that cannibalism accounted for 49% of R. differens deaths with 83% of victims being adults. Males and females were equally susceptible to cannibalism. Over 97% of cannibalism occurred at night and presence of egg trays almost doubled incidence of cannibalism. The thorax was the most preferred body part, which was consumed in 77% of cannibalised individuals. Maize and Panicum sp. were preferred for oviposition over Pennisetum sp. and cotton wool. Opening of egg-laden leaf sheaths reduced incubation period by 0.4 days. Unmoistened eggs didn’t hatch after incubation for 25 days, but 65% of them hatched within 11 days upon moistening. These findings offer guidelines for improvement of protocols for mass rearing of R. differens for human consumption and other uses.
Delay to Arthroscopic Rotator Cuff Repair Is Associated With Increased Risk of Revision Rotator Cuff Surgery
Authors: Fu Michael C. , O'Donnell Evan A. , Taylor Samuel A. , Aladesuru Oluwatobi M. , Rauck Ryan C. , Dines Joshua S. , Dines David M. , Warren Russell F. , Gulotta Lawrence V.
Published: October 2020

The purpose of this study was to determine the association between time from the diagnosis of rotator cuff tear to repair and the rate of subsequent revision surgery for re-tear. A national insurance database was queried from 2007 to 2016 for patients who underwent arthroscopic rotator cuff repair after a diagnosis of rotator cuff tear with minimum 5-year follow-up. On the basis of time from diagnosis to repair, patients were stratified into an early (<6 weeks), a routine (between 6 weeks and 12 months), or a delayed (>12 months) repair cohort. The rates of subsequent revision rotator cuff repair were compared pairwise between cohorts with Pearson's chi-square tests. Multivariate logistic regression was used to adjust for patient demographics and comorbidity burden. A total of 2759 patients were included, with 1510 (54.7%) undergoing early repair, 1104 (40.0%) undergoing routine repair, and 145 (5.3%) having delayed repair. The overall revision rate at 5-year follow-up was 9.6%. The revision rate was higher in the delayed group (15.2%) relative to the early (9.9%) and routine (8.3%) groups (
P
=.048 and
P
=.007, respectively). On multivariate analysis, delayed repair was associated with increased odds of revision surgery (odds ratio, 1.97;
P
=.009) compared with routine repair. Delayed rotator cuff repair beyond 12 months of diagnosis was associated with an increased risk of undergoing subsequent revision rotator cuff repair while controlling for age and comorbidity burden. [
Orthopedics
. 2020;43(6):340–344.]
Outcomes Following Double-Row and Medial Double-Pulley Rotator Cuff Repair
Authors: Noyes Matthew P. , Denard Patrick J.
Published: October 2020

Multiple arthroscopic double-row repair techniques have been developed to treat full-thickness rotator cuff tears. However, healing rates and functional outcomes vary among these repair methods. A suture tape and medial double-pulley (STDP) technique that incorporated 2-mm suture tape for a knotless double-row with a broad double-mattress suture medially was developed as an alternative method to other double-row repair techniques. This prospective study reviewed the functional outcomes and healing rates of full-thickness supraspinatus tendon tears repaired using an STDP technique. Of 33 consecutive patients who underwent arthroscopic rotator cuff repair with an STDP construct, 24 patients with a minimum of 1 year of follow-up were included in the study. Preoperative fatty atrophy was recorded. Ultrasound imaging was used to assess rotator cuff healing at a minimum of 6 months postoperatively. Range of motion and functional outcome scores were evaluated at final follow-up. Mean active forward elevation improved from 124° preoperatively to 160° postoperatively. Comparing preoperative and postoperative values, the American Shoulder and Elbow Surgeons score improved from 45.9 to 90.8, the Single Assessment Numeric Evaluation score improved from 34.6 to 87.1, and the visual analog scale score decreased from 5.3 to 1.3. Twenty-one of 24 patients (88%) were satisfied with their outcomes. Ultrasound evaluation demonstrated complete healing in 88% of the cohort. The STDP technique is a technically efficient method of obtaining medial fixation in a double-row repair and appears to demonstrate clinically acceptable results. Healing was observed in 88% of cases, and functional outcome showed a statistically significant improvement. [
Orthopedics
. 2021;44(1):e125–e130.]
Interprofessional Student Quality Improvement Project in a Federally Qualified Health Center
Authors: Durham Marianne L. , Town Emily
Published: October 2020

Background:

Quality improvement (QI) and interprofessional competencies are needed to adequately prepare the health care workforce. A nurse-led, federally qualified health center provided university students from multiple health care programs a volunteer opportunity to collaborate on a QI project influenced by social determinants of health.

Method:

Working in dyads, students surveyed patients to understand what they want to learn while waiting to see their provider. Analysis prioritized healthy lifestyles and nutrition topics. Students identified, provided, and evaluated culturally appropriate educational materials, including language and literacy in their preferred modality. A healthy lifestyles/nutrition video, recipes in English and Spanish, and a pamphlet were delivered.

Results:

Patients deemed some materials helpful, and patients and staff provided feedback for the next project phase. Students achieved basic interprofessional and QI competencies and described project satisfaction.

Conclusion:

The hands-on approach allowed students to develop beginning interprofessional and QI competencies for their future professional practice.

[
J Nurs Educ
. 2020;59(10):585–588.]
Stability of general pathogen dynamic models with two types of infectious transmission with immune impairment
Authors: Alofi B. S. , Azoz S. A.
Published: September 2020

In this paper, we investigate the global properties of two general models of pathogen infection with immune deficiency. Both pathogen-to-cell and cell-to-cell transmissions are considered. Latently infected cells are included in the second model. We show that the solutions are nonnegative and bounded. Lyapunov functions are organized to prove the global asymptotic stability for uninfected and infected steady states of the models. Analytical expressions for the basic reproduction number $\mathcal{R}_{0}$ and the necessary condition under which the uninfected and infected steady states are globally asymptotically stable are established. We prove that if $\mathcal{R}_{0}$ < 1 then the uninfected steady state is globally asymptotically stable (GAS), and if $\mathcal{R}_{0}$ > 1 then the infected steady state is GAS. Numerical simulations are performed and used to support the analytical results.
Atypical Unilateral Sacroiliitis Secondary to Mechanical Stress Injury
Authors: YOUNAN Tonine , ZIBAWI Mohamed , ABS Leila , FAYAD Fouad
Published: September 2020

We report for the first time a case of atypical unilateral sacroiliitis secondary to mechanical stress injury. Unilateral sacroiliitis can be caused by a variety of etiologies. The first diagnosis to rule out is infection since it requires urgent treatment to avoid its serious consequences. Spondyloarthritis can be manifested by unilateral sacroiliitis in its early stage. Sacral fractures should always be looked for on the imaging modalities performed. In our case, no signs of infection or systemic disease were found. No fracture was seen on the imaging examinations and we had negative cultures on the computed tomography-guided biopsy realized. A history of mechanical stress was the only clue found suggesting the diagnosis of a probable stress related sacroiliitis. A thorough review of the literature will be provided stating the different causes of sacroiliitis described till now, with discussion of this new reported entity.
El protonotario Lucena en su entorno sociopolítico. Nuevos datos sobre su biografía
Authors: Diago Máximo
Published: October 2020

El autor aporta en este artículo algunas noticias inéditas sobre la biografía de Juan Ramírez de Lucena y trata de encuadrar su figura en el contexto político y social de la Castilla del siglo XV: en primer lugar, da cuenta de los orígenes familiares del protonotario y en particular de la actividad económica y posición política de su padre, arrendador judeoconverso vecino de Soria; a continuación se centra en el análisis de su biografía, poniendo de manifiesto su papel como colaborador político de los Reyes Católicos; y por último, analiza su enfrentamiento con la Inquisición y las consecuencias que esto tuvo para él y para su familia. El autor aporta también noticias inéditas sobre los últimos años de vida del protonotario y sobre la trayectoria de sus parientes en el siglo XVI.
Exégesis e ideología en el judaísmo del s. I. Héroes, heroínas y mujeres
Authors: Fernández Marcos N.
Published: October 2020

En el período helenístico el judaísmo dedicó un enorme esfuerzo a la reescritura de la historia y a la reinterpretación de las tradiciones bíblicas. El autor se centra en la nueva interpretación de la figura de algunas mujeres bíblicas tal como aparece en escritos del siglo primero, en especial la Vida Griega de Adán y Eva, los Testamentos de los Doce Patriarcas, el Testamento de Job y 4Q184. Intenta indagar en el trasfondo de dicha interpretación tal como se manifiesta en la literatura sapiencial y el pensamiento apocalíptico, e insiste en las consecuencias que dicha exégesis ideológica ha tenido para la antropología judeo-cristiana.
La villa aragonesa de Épila en el siglo XV: sus judíos
Authors: Marín Padilla Encarnación
Published: October 2020

No disponible.
Shem Tob ibn Falaquera e la filologia ebraica medievale. A proposito di due libri recenti
Authors: Zonta Mauro
Published: October 2020

La reciente publicación de dos libros ofrece la ocasión de profundizar en algunos aspectos de la función de Shem Tob ben Yosef ibn Falaquera, filósofo sefardí del siglo XIII, como divulgador y traductor de las obras filosóficas y científicas árabes. Se trata de las ediciones (acompañadas de traducción inglesa) del ’Iggereṯ ha-Wikuaḥ, a cargo de S. Harvey, y de la sección del Sefer De‛ôṯ ha-Filosofîm dedicada al De plantis de Nicolás de Damasco, a cargo de H. J. Drossaart Lulofs. Se examinan los criterios editoriales y las bases adoptadas en cada una de las ediciones, y se hacen algunas sugerencias sobre correcciones y adiciones que podrían incorporarse.
Cristóbal Colón, descubridor mesiánico y compilador de profecías
Authors: Kenig Evelyne
Published: October 2020

No disponible.
Paradox. Ein Fachbegriff der griechischen Logik im Midrasch
Authors: Nador Georg
Published: October 2020

No disponible.