bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinación microbiológica y molecular mediante PCR en tiempo real de dos bacterias del género Bacillus de interés agro biotecnológico
Authors: Chiluisa-Utreras Viviana , Campaña Verdesoto Michelle , Daniel Acurio Ramiro
Published: May 2020

Se efectuó la comparación de curvas de crecimiento a diferentes rangos de pH, salinidad y temperatura, además se determinó el tamaño, forma y posición de endospora de dos diferentes cepas del género Bacillus. Para la identificación molecular se realizó la extracción de ácidos nucleicos, utilizando el kit High Pure PCR Template Preparation Kit de Roche® y posteriormente se analizaron las curvas de amplificación producto de la PCR en Tiempo Real. Se realizaron cinéticas de crecimiento a cada uno de los cultivos de bacterias durante 72 horas y se analizaron estadísticamente las curvas mediante los métodos estadísticos ANOVA y Tukey para determinar significancia (p˂0.001). El análisis factorial para la variable “temperatura” no mostró una diferencia significativa entre cepas y tampoco con los valores fijados (28, 32, 37 °C), la variable “pH” si presentó una interacción con valores (p<0.0001) entre cepas; la variable “salinidad” también presentó diferencia significativa entre cepas y con sus respectivas interacciones. En el análisis del área bajo la curva, la variable “temperatura” no mostró diferencia significativa, mientras que las variables “pH y salinidad” presentaron valores correspondientes a (p<0.0001). Para la determinación molecular, se analizaron las curvas de amplificación, confirmando la presunción bioquímica de la cepa BM como B. megaterium mediante el análisis del gen phaC, así como también se pudo corroborar que la cepa BL corresponde a B. licheniformis al analizar el gen lchAA. La cinética bacteriana permitió establecer las horas clave para el análisis del crecimiento, confirmando que las características analizadas corresponden a especies pertenecientes a la familia Bacillaceae, con aplicación como controladores biológicos en la agricultura.
Hipertensión arterial, diabetes mellitus tipo 2 y su asociación con el estado nutricional en adultos ecuatorianos.
Authors: Espín-Capelo Concepción , Gonzalez-Pardo Secundino , Lechón-Sandoval Aníbal , Mili-Alfonso Tatiana , Salazar-Saa Santiago , Ortiz-Sandoval Erika
Published: May 2020

La hipertensión arterial (HTA) y diabetes mellitus tipo 2 (DM2) representan las mayores causas de mortalidad mundial. El estado nutricional está fuertemente asociación con alteraciones en la composición corporal que influyen en el desarrollo de estas patologías, por ello el objetivo del estudio fue determinar la asociación de la hipertensión arterial y diabetes mellitus tipo 2 con el estado nutricional de pacientes que asisten al Servicio de Nutrición del Hospital San Vicente de Paúl, Ibarra-Ecuador. Presentamos un estudio descriptivo, transversal en pacientes adultos con diagnóstico médico de HTA o DM2. Se comparó el índice de masa corporal (IMC), porcentaje grasa corporal (%GC), circunferencia de cintura (Cc) y edad con la presencia o no de HTA o DM2. Se identificaron 198 adultos con edad de 47.28 ± 10.57 años; 87.10% fueron mujeres. El 30.80% presentaban HTA y el 27.27% DM2. El IMC (p=0.002), %GC y Cc (p<0.001) presentaron diferencias estadísticamente significativas entre pacientes con y sin HTA, no así con la presencia o ausencia de DM2. La edad fue significativamente distinta entre sujetos con y sin presencia de HTA o DM2, mientras que, el sexo no mostró asociación significativa con ninguna de las patologías. Tres de cada diez pacientes que acuden al Servicio de Nutrición padecen de HTA o DM2, existen diferencias significativas en el IMC, %GC y Cc entre hipertensos y no hipertensos. No se encontraron diferencias significativas en el estado nutricional de pacientes con o sin diabetes.
Real-Time Monitoring of Blood Pressure Using Digitalized Pulse Arrival Time Calculation Technology for Prompt Detection of Sudden Hypertensive Episodes During Laryngeal Microsurgery: Retrospective Observational Study (Preprint)
Authors: Park Yong-Seok , Kim Sung-Hoon , Lee Yoon Se , Choi Seung-Ho , Ku Seung-Woo , Hwang Gyu-Sam
Published: May 2020

BACKGROUND

Laryngeal microsurgery (LMS) is often accompanied by a sudden increase in blood pressure (BP) during surgery because of stimulation around the larynx. This sudden change in the hemodynamic status is not immediately reflected in a casual cuff-type measurement that takes intermittent readings every 3 to 5 min.

OBJECTIVE

This study aimed to investigate the potential of pulse arrival time (PAT) as a marker for a BP surge, which usually occurs in patients undergoing LMS.

METHODS

Intermittent measurements of BP and electrocardiogram (ECG) and photoplethysmogram (PPG) signals were recorded during LMS. PAT was defined as the interval between the R-peak on the ECG and the maximum slope on the PPG. Mean PAT values before and after BP increase were compared. PPG-related parameters and the correlations between changes in these variables were calculated.

RESULTS

BP surged because of laryngoscopic manipulation (mean systolic BP [SBP] from 115.3, SD 21.4 mmHg, to 159.9, SD 25.2 mmHg; P<.001), whereas PAT decreased significantly (from mean 460.6, SD 51.9 ms, to 405.8, SD 50.1 ms; P<.001) in most of the cases. The change in SBP showed a significant correlation with the inverse of the PAT (r=0.582; P<.001). Receiver-operating characteristic curve analysis indicated that an increase of 11.5% in the inverse of the PAT could detect a 40% increase in SBP, and the area under the curve was 0.814.

CONCLUSIONS

During LMS, where invasive arterial catheterization is not always possible, PAT shows good correlation with SBP and may, therefore, have the potential to identify abrupt BP surges during laryngoscopic manipulations in a noninvasive manner.

CLINICALTRIAL
Recommendations for Developing Support Tools With People Suffering From Chronic Obstructive Pulmonary Disease: Co-Design and Pilot Testing of a Mobile Health Prototype (Preprint)
Authors: Davies Alan , Mueller Julia , Hennings Jean , Caress Ann-Louise , Jay Caroline
Published: May 2020

BACKGROUND

Gaps exist between developers, commissioners, and end users in terms of the perceived desirability of different features and functionalities of mobile apps.

OBJECTIVE

The objective of this study was to co-design a prototype mobile app for people with chronic obstructive pulmonary disease (COPD). We present lessons learned and recommendations from working on a large project with various stakeholders to develop a mobile app for patients with COPD.

METHODS

We adopted a user-centered, participatory approach to app development. Following a series of focus groups and interviews to capture requirements, we developed a prototype app designed to enable daily symptom recording (experience sampling). The prototype was tested in a usability study applying the think aloud protocol with people with COPD. It was then released via the Android app store, and experience sampling data and event data were captured to gather further usability data.

RESULTS

A total of 5 people with COPD participated in the pilot study. Identified themes include familiarity with technology, appropriate levels for feeding back information, and usability issues such as manual dexterity. Moreover, 37 participants used the app over a 4-month period (median age 47 years). The symptoms most correlated to perceived well-being were tiredness (r=0.61; P<.001) and breathlessness (r=0.59; P<.001).

CONCLUSIONS

Design implications for COPD apps include the need for clearly labeled features (rather than relying on colors or symbols that require experience using smartphones), providing weather information, and using the same terminology as health care professionals (rather than simply lay terms). Target users, researchers, and developers should be involved at every stage of app development, using an iterative approach to build a prototype app, which should then be tested in controlled settings as well as in the wild (ie, when deployed and used in real-world settings) over longer periods.
Use of Smartphones to Detect Diabetic Retinopathy: Scoping Review and Meta-Analysis of Diagnostic Test Accuracy Studies (Preprint)
Authors: Tan Choon Han , Kyaw Bhone Myint , Smith Helen , Tan Colin S , Tudor Car Lorainne
Published: May 2020

BACKGROUND

Diabetic retinopathy (DR), a common complication of diabetes mellitus, is the leading cause of impaired vision in adults worldwide. Smartphone ophthalmoscopy involves using a smartphone camera for digital retinal imaging. Utilizing smartphones to detect DR is potentially more affordable, accessible, and easier to use than conventional methods.

OBJECTIVE

This study aimed to determine the diagnostic accuracy of various smartphone ophthalmoscopy approaches for detecting DR in diabetic patients.

METHODS

We performed an electronic search on the Medical Literature Analysis and Retrieval System Online (MEDLINE), EMBASE, and Cochrane Library for literature published from January 2000 to November 2018. We included studies involving diabetic patients, which compared the diagnostic accuracy of smartphone ophthalmoscopy for detecting DR to an accurate or commonly employed reference standard, such as indirect ophthalmoscopy, slit-lamp biomicroscopy, and tabletop fundus photography. Two reviewers independently screened studies against the inclusion criteria, extracted data, and assessed the quality of included studies using the Quality Assessment of Diagnostic Accuracy Studies–2 tool, with disagreements resolved via consensus. Sensitivity and specificity were pooled using the random effects model. A summary receiver operating characteristic (SROC) curve was constructed. This review is reported in line with the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies guidelines.

RESULTS

In all, nine studies involving 1430 participants were included. Most studies were of high quality, except one study with limited applicability because of its reference standard. The pooled sensitivity and specificity for detecting any DR was 87% (95% CI 74%-94%) and 94% (95% CI 81%-98%); mild nonproliferative DR (NPDR) was 39% (95% CI 10%-79%) and 95% (95% CI 91%-98%); moderate NPDR was 71% (95% CI 57%-81%) and 95% (95% CI 88%-98%); severe NPDR was 80% (95% CI 49%-94%) and 97% (95% CI 88%-99%); proliferative DR (PDR) was 92% (95% CI 79%-97%) and 99% (95% CI 96%-99%); diabetic macular edema was 79% (95% CI 63%-89%) and 93% (95% CI 82%-97%); and referral-warranted DR was 91% (95% CI 86%-94%) and 89% (95% CI 56%-98%). The area under SROC curve ranged from 0.879 to 0.979. The diagnostic odds ratio ranged from 11.3 to 1225.

CONCLUSIONS

We found heterogeneous evidence showing that smartphone ophthalmoscopy performs well in detecting DR. The diagnostic accuracy for PDR was highest. Future studies should standardize reference criteria and classification criteria and evaluate other available forms of smartphone ophthalmoscopy in primary care settings.
Characterizing and Visualizing Display and Task Fragmentation in the Electronic Health Record: Mixed Methods Design (Preprint)
Authors: Senathirajah Yalini , Kaufman David R , Cato Kenrick D , Borycki Elizabeth M , Fawcett Jaime Allen , Kushniruk Andre W
Published: May 2020

BACKGROUND

The complexity of health care data and workflow presents challenges to the study of usability in electronic health records (EHRs). Display fragmentation refers to the distribution of relevant data across different screens or otherwise far apart, requiring complex navigation for the user’s workflow. Task and information fragmentation also contribute to cognitive burden.

OBJECTIVE

This study aims to define and analyze some of the main sources of fragmentation in EHR user interfaces (UIs); discuss relevant theoretical, historical, and practical considerations; and use granular microanalytic methods and visualization techniques to help us understand the nature of fragmentation and opportunities for EHR optimization or redesign.

METHODS

Sunburst visualizations capture the EHR navigation structure, showing levels and sublevels of the navigation tree, allowing calculation of a new measure, the Display Fragmentation Index. Time belt visualizations present the sequences of subtasks and allow calculation of proportion per instance, a measure that quantifies task fragmentation. These measures can be used separately or in conjunction to compare EHRs as well as tasks and subtasks in workflows and identify opportunities for reductions in steps and fragmentation. We present an example use of the methods for comparison of 2 different EHR interfaces (commercial and composable) in which subjects apprehend the same patient case.

RESULTS

Screen transitions were substantially reduced for the composable interface (from 43 to 14), whereas clicks (including scrolling) remained similar.

CONCLUSIONS

These methods can aid in our understanding of UI needs under complex conditions and tasks to optimize EHR workflows and redesign.
Pre operative fitness score accurately predicts uneventful post operative course in gastrointestinal and hepatobiliary surgery. (Preprint)
Authors: VASAVADA BHAVIN , Patel Hardik
Published: May 2020

BACKGROUND

Aim of our study was to analyze if we can acuratly predict uneventful post operative course pre operatively in gastrointestinal and HPB surgery patients so that we can better explain risk benefit ratio to the patients and prognostify the results.

OBJECTIVE

Aim of our study was to analyze if we can acuratly predict uneventful post operative course pre operatively in gastrointestinal and HPB surgery patients so that we can better explain risk benefit ratio to the patients and prognostify the results.

METHODS

We retrospectively evaluated patients who have undergone gastrointestinal and hepatobiliary surgery at our institute in last 3 years and analyzed 90 days mortality and morbidity rates among these patients. We described any 90 day morbidity and mortality as an event. We performed univariate and multivariate analyses for factors predicting an event. Then based on pre operative factors that predicted an event we formulated a score and then evaluated sensitivity, specificity, positive predictive and negative predictive value of that score and also evaluated ROC curve. We also performed kaplan-meier analysis for 90 days event free survival. Statistical analysis was done using SPSS version 23.

RESULTS

Total 264 patient operated for gastrointestinal and HPB surgeries between april 2016 to may 2019 were evaluated .Total 45 (17%) events occurred. On univariate analysis CDC grade, ASA score,Operative time,Blood products used, emmergency surgeries and open surgeries predicted an event.We developed score based on pre operative factors like ASA score, CDC grade of surgery,open surgery and emmergency surgeries included in the score. Each variable was given 1 point.We proposed score grater than 2 was associated with 90 day event. This score had sensitivity of 77.78%, specificity of 81.65%. low positive predictive value of 46.67% but very high negative predictive value of 94.68%. AUROC showed AUROC of 0.797 (p < 0.0001, 95 % confidence interval 0.721-0.874). Pre operative fitness score, Open Surgery and operative time independently predicted an event on multivarious analysis. (p =0.003 and 0.026 respectively.)

CONCLUSIONS

Pre operative fitness score accurately predicts uneventful post operative course in gastrointestinal and hepatobiliary surgery.
Chronic Kidney Disease in Tasmania: Protocol for a Data Linkage Study (Preprint)
Authors: Saunder Timothy , Kitsos Alex , Radford Jan , Jose Kim , McKercher Charlotte , Raj Rajesh , Wiggins Nadine , Stokes Brian , Jose Matthew D
Published: May 2020

BACKGROUND

Chronic kidney disease (CKD) is a significant and growing health burden globally. Tasmania has the highest state prevalence for non-Indigenous Australians and it has consistently had the lowest incidence and prevalence of dialysis in Australia.

OBJECTIVE

To examine the gap between the high community prevalence of CKD in Tasmania and the low use of dialysis.

METHODS

This is a retrospective cohort study using linked data from 5 health and 2 pathology data sets from the island state of Tasmania, Australia. The study population consists of any person (all ages including children) who had a blood measurement of creatinine with the included pathology providers between January 1, 2004, and December 31, 2017. This study population (N=460,737) includes within it a CKD cohort, which was detected via pathology or documentation of kidney replacement therapy (KRT; dialysis or kidney transplant). Kidney function (estimated glomerular filtration rate [eGFR]) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. Individuals with 2 measures of eGFR<60 mL/min/1.73 m2, at least 90 days apart, were identified as having CKD and were included in the CKD cohort. Individuals treated with dialysis or transplant were identified from the Australia and New Zealand Dialysis and Transplant Registry.

RESULTS

The study population consisted of 460,737 people (n=245,573 [53.30%] female, mean age 47.4 years) who were Tasmanian residents aged 18 years and older and were followed for a median of 7.8 years. During the later 5 years of the study period, 86.79% (355,622/409,729) of Tasmanian adults were represented. The CKD cohort consisted of 56,438 people (ie, 12.25% of the study population; 53.87% (30,405/56,438) female, mean age 69.9 years) followed for a median of 10.4 years with 56,039 detected via eGFR and 399 people detected via documentation of KRT. Approximately half (227,433/460,737, 49.36%) of the study population and the majority of the CKD cohort (41,448/56,438, 73.44%) had an admission episode. Of the 55,366 deaths recorded in the study population, 45.10% (24,970/55,366) had CKD.

CONCLUSIONS

Whole-of-population approaches to examine CKD in the community can be achieved by data linkage. Over this 14-year period, CKD affected 12.25% (56,438/460,737) of Tasmanian adult residents and was present in 45.10% (24,970/55,366) of deaths.

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/20160
Improving Patient Prioritization During Hospital-Homecare Transition: Protocol for a Mixed Methods Study of a Clinical Decision Support Tool Implementation (Preprint)
Authors: Zolnoori Maryam , McDonald Margaret V , Barrón Yolanda , Cato Kenrick , Sockolow Paulina , Sridharan Sridevi , Onorato Nicole , Bowles Kathryn , Topaz Maxim
Published: May 2020

BACKGROUND

Homecare settings across the United States provide care to more than 5 million patients every year. About one in five homecare patients are rehospitalized during the homecare episode, with up to two-thirds of these rehospitalizations occurring within the first 2 weeks of services. Timely allocation of homecare services might prevent a significant portion of these rehospitalizations. The first homecare nursing visit is one of the most critical steps of the homecare episode. This visit includes an assessment of the patient’s capacity for self-care, medication reconciliation, an examination of the home environment, and a discussion regarding whether a caregiver is present. Hence, appropriate timing of the first visit is crucial, especially for patients with urgent health care needs. However, nurses often have limited and inaccurate information about incoming patients, and patient priority decisions vary significantly between nurses. We developed an innovative decision support tool called Priority for the First Nursing Visit Tool (PREVENT) to assist nurses in prioritizing patients in need of immediate first homecare nursing visits.

OBJECTIVE

This study aims to evaluate the effectiveness of the PREVENT tool on process and patient outcomes and to examine the reach, adoption, and implementation of PREVENT.

METHODS

Employing a pre-post design, survival analysis, and logistic regression with propensity score matching analysis, we will test the following hypotheses: compared with not using the tool in the preintervention phase, when homecare clinicians use the PREVENT tool, high-risk patients in the intervention phase will (1) receive more timely first homecare visits and (2) have decreased incidence of rehospitalization and have decreased emergency department use within 60 days. Reach, adoption, and implementation will be assessed using mixed methods including homecare admission staff interviews, think-aloud observations, and analysis of staffing and other relevant data.

RESULTS

The study research protocol was approved by the institutional review board in October 2019. PREVENT is currently being integrated into the electronic health records at the participating study sites. Data collection is planned to start in early 2021.

CONCLUSIONS

Mixed methods will enable us to gain an in-depth understanding of the complex socio-technological aspects of the hospital to homecare transition. The results have the potential to (1) influence the standardization and individualization of nurse decision making through the use of cutting-edge technology and (2) improve patient outcomes in the understudied homecare setting.

CLINICALTRIAL

ClinicalTrials.gov NCT04136951; https://clinicaltrials.gov/ct2/show/NCT04136951

INTERNATIONAL REGISTERED REPORT

PRR1-10.2196/20184
Prognostic Modeling of COVID-19 Using Artificial Intelligence in the United Kingdom: Model Development and Validation (Preprint)
Authors: Abdulaal Ahmed , Patel Aatish , Charani Esmita , Denny Sarah , Mughal Nabeela , Moore Luke
Published: May 2020

BACKGROUND

The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak is a public health emergency and the case fatality rate in the United Kingdom is significant. Although there appear to be several early predictors of outcome, there are no currently validated prognostic models or scoring systems applicable specifically to patients with confirmed SARS-CoV-2.

OBJECTIVE

We aim to create a point-of-admission mortality risk scoring system using an artificial neural network (ANN).

METHODS

We present an ANN that can provide a patient-specific, point-of-admission mortality risk prediction to inform clinical management decisions at the earliest opportunity. The ANN analyzes a set of patient features including demographics, comorbidities, smoking history, and presenting symptoms and predicts patient-specific mortality risk during the current hospital admission. The model was trained and validated on data extracted from 398 patients admitted to hospital with a positive real-time reverse transcription polymerase chain reaction (RT-PCR) test for SARS-CoV-2.

RESULTS

Patient-specific mortality was predicted with 86.25% accuracy, with a sensitivity of 87.50% (95% CI 61.65%-98.45%) and specificity of 85.94% (95% CI 74.98%-93.36%). The positive predictive value was 60.87% (95% CI 45.23%-74.56%), and the negative predictive value was 96.49% (95% CI 88.23%-99.02%). The area under the receiver operating characteristic curve was 90.12%.

CONCLUSIONS

This analysis demonstrates an adaptive ANN trained on data at a single site, which demonstrates the early utility of deep learning approaches in a rapidly evolving pandemic with no established or validated prognostic scoring systems.
ONTOLOGY-BASED GENERATION OF MULTILINGUAL QUESTIONS FOR ASSESSMENT IN MEDICAL EDUCATION
Authors: Radović Maja , Petrović Nenad , Tošić Milorad
Published: May 2020

The requirements of state-of-the-art curricula and teaching processes in medical education have brought both new and improved the existing assessment methods. Recently, several promising methods have emerged, among them the Comprehensive Integrative Puzzle (CIP), which shows great potential. However, the construction of such questions requires high efforts of a team of experts and is time-consuming. Furthermore, despite the fact that English language is accepted as an international language, for educational purposes there is also a need for representing data and knowledge in native language. In this paper, we present an approach for automatic generation of CIP assessment questions based on using ontologies for knowledge representation. In this way, it is possible to provide multilingual support in the teaching and learning process because the same ontological concept can be applied to corresponding language expressions in different languages. The proposed approach shows promising results indicated by dramatic speeding up of construction of CIP questions compared to manual methods. The presented results represent a strong indication that adoption of ontologies for knowledge representation may enable scalability in multilingual domain-specific education regardless of the language used. High level of automation in the assessment process proven on the CIP method in medical education as one of the most challenging domains, promises high potential for new innovative teaching methodologies in other educational domains as well.
Editorial
Authors: Cavazos Salazar Rosario Lucero
Published: May 2020

En el editorial del número 23 de la RMBD la doctora Lucero Cavazos Salazar, de la Universidad Autónoma de Nuevo León, aborda los contenidos sobre los recursos con la temática propia de esta edición para utilidad de los asesores, tutores, diseñadores, desarrolladores, gestores, directivos, investigadores y estudiantes que participan de las actividades de la educación en línea del nivel medio superior.
Bachillerato policial: completo, dual y basado en MOOC
Authors: Vadillo Guadalupe , Bucio Jackeline , Hidalgo Alberto , Posada David , Valencia Pilar Valencia , Terrazas Omar
Published: May 2020

Se presenta el modelo educativo, innovaciones, proceso de diseño curricular participativo y descripción de la atención académica que permite un muy bajo costo para la gestión del programa por parte del gobierno de la Ciudad de México. Se describe el proceso de definición de restricciones de diseño que permiten cumplir con tiempos curriculares y de desarrollo del plan, programas de estudio y materiales en línea; formación docente; normatividades educativas y de formación policial; y presupuesto disponible. Además, se describen las asignaturas que incluyen todos los contenidos fundamentales del nivel medio superior, a partir de temáticas policiales, así como los proyectos comunitarios que representan una derrama de aprendizajes y beneficios para la sociedad.
Ramsey interferometry with generalized one-axis twisting echoes
Authors: Schulte Marius , Martínez-Lahuerta Victor J. , Scharnagl Maja S. , Hammerer Klemens
Published: May 2020

We consider a large class of Ramsey interferometry protocols which are enhanced by squeezing and un-squeezing operations before and after a phase signal is imprinted on the collective spin of N particles. We report an analytical optimization for any given particle number and strengths of (un-)squeezing. These results can be applied even when experimentally relevant decoherence processes during the squeezing and un-squeezing interactions are included. Noise between the two interactions is however not considered in this work. This provides a generalized characterization of squeezing echo protocols, recovering a number of known quantum metrological protocols as local sensitivity maxima, thereby proving their optimality. We discover a single new protocol. Its sensitivity enhancement relies on a double inversion of squeezing. In the general class of echo protocols, the newly found over-un-twisting protocol is singled out due to its Heisenberg scaling even at strong collective dephasing.
Innovación y competitividad: dónde se ubica Latinoamérica comparativamente según los indicadores
Authors: Quesada Espinoza Francisco Javier
Published: May 2020

Es común asociar la innovación con el nivel de desarrollo y competitividad de un país. El Índice Mundial de Innovación elabora una clasificación en este ámbito. Para los países latinoamericanos se estudió la producción de patentes, la influencia de las variables que contempla el índice en su evaluación y la clasificación final, además del comportamientointerno de la región y su comparación con el grupo de los 7 (G7). Los resultados muestran que no existe una variable que se correlacione con el índice de innovación y hay diferencias muy marcadas entre los dos grupos de estudio e incluso al interno de la región latinoamericana. Esto plantea retos muy importantes para mejorar este aspecto, pues también se demostró una correlación entre la innovación y la competitividad para los países industrializadosque no se presenta para la región.
Natural Language Processing Improves Detection of Non-Severe Hypoglycemia in Medical Records versus Coding Alone in Patients with Type 2 Diabetes but does not Improve Prediction of Severe Hypoglycemia Events: An Analysis Using the Electronic Medical Record in a Large Health System
Authors: Misra-Hebert Anita D. , Milinovich Alex , Zajichek Alex , Ji Xinge , Hobbs Todd D. , Weng Wayne , Petraro Paul , Kong Sheldon X. , Mocarski Michelle , Ganguly Rahul , Bauman Janine M. , Pantalone Kevin M. , Zimmerman Robert S. , Kattan Michael W.
Published: May 2020

Objective:
To determine if natural language processing (NLP) improves detection of
non-severe hypoglycemia (NSH) in patients with type 2 diabetes and no NSH documentation
by diagnosis codes, and to measure if NLP detection improves the prediction of future
severe hypoglycemia (SH).

Research
Design and Methods: From 2005-2017, we identified NSH events by diagnosis codes
and NLP. We then built an SH prediction model.

Results:
There were 204,517 patients with type 2 diabetes and no diagnosis codes for NSH.
Evidence of of NSH was found in 7035 (3.4%) using NLP. We reviewed 1200 of the
NLP-detected NSH notes and confirmed 93% to have NSH. The SH prediction model (C-statistic
0.806) showed increased risk with NSH (Hazard Ratio=4.44, p<0.001). However the
model with NLP did not improve SH prediction compared to diagnosis code-only
NSH.

Conclusions:
Detection of NSH improved with NLP in patients with type 2 diabetes without
improving SH prediction.
Review of Associations Between Type 2 Diabetes and Cancer
Authors: Bonagiri Pranay R. , Shubrook Jay H.
Published: May 2020

Type 2 appears to be a contributor to higher rates of
some types of cancer. Rates of
endometrial, liver, pancreatic, breast, colorectal cancers are most
closely associated with type 2 diabetes. Obesity and insulin resistance appear to be major mechanisms of this
link; therefore, reduction of these factors should be a focus of treatment.
Online Expert Mediators
Authors: Egher Claudia
Published: May 2020

Using Collins and Evans’ concept of interactional expertise, this article examines the online activities of three bloggers diagnosed with bipolar disorder. It argues that by combining medical knowledge with their situated experiences, and by utilizing the affordances of blogs, these bloggers have become a new type of stakeholder, the online expert mediator. Collins and Evans’ concept is extended by taking into consideration the role of the medium through which interactional expertise is displayed and by showing that its bi-directional character is more substantial than they had envisaged. The rise of this new stakeholder category denotes a possible turn from community activism to exceptional entrepreneurial selves. Despite views that the internet would have broad democratizing effects, the findings show that the high standing of online expert mediators is not the result of a subversive use of this medium, but of a dynamic alliance with ‘traditional’ experts and of a strong media presence.
Collaborative Confusion among DIY Makers
Authors: Berglund Eeva , Kohtala Cindy
Published: May 2020

Eco-oriented makers and grassroots subcultures experimenting with digital fabrication technologies, and other activists designing sustainable futures, are increasingly the subject of research. As they address problems of environmental sustainability beyond institutional contexts, their work may appear vague, even confused, yet their activities are underpinned by intense and principled commitment. Working through their confusion, many maker communities build new understandings about what ‘sustainability’ could mean. We argue that herein lie important resources for new knowledge, and further that ethnography is the ideal way to track these processes of learning and knowledge production. The ethnographer participates in local confusion, over values and the definitions of sustainability, but also about what constitutes useful knowledge. Supported by STS (and other) literature on environmental expertise, we argue that maker communities' own acknowledgement of this vagueness actually makes possible a position from which epistemological authority can be reasserted.
English Speaker Acquisition of Topic and Subject in Multiple Clause Sentences in Japanese
Authors: Shoji Shinichi
Published: May 2020

This study investigated native English speakers’ acquisition of the constraint for topic-wa and the preference for subject-ga in multiple-clause sentences in Japanese. The constraint for topic-wa is that the topic-wa cannot appear in certain types of subordinate clauses, and the preference for subject-ga is that the overt subject-ga in a subordinate clause should not overlap the topic for a matrix clause. Two sentence-completion experiments were conducted with native English-speaking participants, who were considered advanced-level Japanese learners, as well as native Japanese-speaking participants (the control group). The results indicated that although English speakers followed the constraint for the topic-wa, they frequently used the topic-wa as non-subject topics (unlike native Japanese speakers) when an embedded subordinate clause intervened between the topic-wa and the rest of the matrix clause. Also, English speakers used the same subject-ga for both subordinate and matrix clauses, unlike the native Japanese speakers’ preference. The outcome implies that English speakers associated the topic-wa with English non-subject topics, and the subject-ga with English subjects.
Foreword: Tatars in Finland in the Transnational Context of the Baltic Sea Region
Authors: Stahlberg Sabira , Cwiklinksi Sebastian
Published: May 2020

The Tatar diaspora in Finland has attracted researchers for over a century, but studies traditionallyfocus on topics such as origins and general Tatar history, religion, identity or language. One of themost important aspects of research on Tatars both historically and today, however, is the transnationalcontext. Migrating from villages in Nizhny Novgorod province, often via the Russian capitalSaint Petersburg at the end of the nineteenth century, the forming Tatar diaspora communities inthe Baltic Sea region maintained, developed and extended their previous networks and also creatednew connections over national borders despite periods of political difficulties. New research aboutTatars in the Baltic Sea region – with the focal point of the Tatars in Finland and their connectionschiefly in Estonia, Russia and Sweden – was presented during a seminar called Tatars in Finland inthe Transnational Context of the Baltic Sea Region at the University of Helsinki in October 2018.Scholars from Finland, Sweden, Russia, Estonia and Hungary spoke about the past and present ofthe diaspora. A result of the seminar, this special issue of Studia Orientalia Electronica is dedicatedto new research on Tatars in a transnational context.
Острый аортальный синдром: организация хирургической помощи в мегаполисе
Authors: Hubulava G.G. , SHihverdiev N.N. , Peleshok A.S. , Kravchuk V.N. , Krivopalov V.A. , Volkov A.M. , Liubimov A.I. , Ushakov D.I. , Paivin A.A. , Gramatikov D.G. , Askerov M.A. , Kamal`dinov A.T.
Published: May 2020

Введение.Острый аортальный синдром (ОАС) является актуальной проблемой современной медицины. Всвязи сежегодным ростом первичной заболеваемости, крайне неблагоприятным естественным течением заболевания летальность данных пациентов остается очень высокой. Цель исследования улучшить непосредственные результаты лечения пациентов с ОАС за счет разработки и внедрения в практику клинико-организационного алгоритма, основанного на комплексной оптимизации тактики оказания медицинской помощи. Материал и методы. За период с 2010 по 2018 г. проанализированы завершенные случаи лечения 425 пациентов с признаками острой патологии грудной аорты. На основании опыта 6 кардиохирургических стационаров Санкт-Петербурга проведены разработка, внедрение в клиническую практику и статистическая оценка эффективности оригинального организационного алгоритма оказания медицинской помощи пациентам с ОАС. Результаты. Основу разработанного организационного алгоритма оказания медицинской помощи пациентам с ОАС составляли: экспресс-постановка первичного диагноза путем интерпретации характеристик болевого синдрома, особенностей анамнеза, данных объективного осмотра больных экстренная эвакуация пациентов в специализированный многопрофильный стационар в течение 2 ч использование централизованного принципа маршрутизации больных формирование специализированных дежурных аортальных бригад дифференцированный подход к верификации диагноза у гемодинамически стабильных инестабильных пациентов спервой линией использования ультразвуковых методов выполнение неотложной хирургической, рентгенэндоваскулярной или гибридной реконструкции аорты. Разработанный организационный алгоритм применялся при оказании помощи у 119 (28) пациентов с ОАС, не использовался у 306 (72) пациентов. Общая госпитальная летальность в группе применения алгоритма составила 17,6 и была статистически значимо ниже, чем в контрольной группе 49,3 (235,7 df1 р0,001). Заключение. Разработанный организационный алгоритм способствует повышению скорости и эффективности оказания медицинской помощи пациентам с ОАС на каждом из этапов, улучшению непосредственных результатов их лечения.
Результаты оперативного и эндоваскулярного лечения коарктации аорты
Authors: Bokeriia L.A. , Abdulgasanov R.A. , Ivanov A.V. , Arakelian V.S.
Published: May 2020

Коарктация аорты (КА) является одной из наиболее распространенных врожденных патологий сердца, и она может протекать самостоятельно или сочетаться с более сложными заболеваниями, например, гипоплазией дуги аорты или стенозом брюшной аорты. Другими сопутствующими патологиями могут быть двустворчатый аортальный клапан, дефект межжелудочковой перегородки, открытый артериальный проток, транспозиция магистральных артерий, дефекты атриовентрикулярного канала, синдром гипоплазии левых отделов сердца. КА составляет примерно 57 всех врожденных пороков сердца. Лечение врожденной коарктации аорты в настоящее время является стандартной и безопасной процедурой. Однако в отдаленном периоде осложнения, включая рекоарктацию и образование аневризмы, не редкость. Частота этих осложнений зависит от типа первичной операции. Как эндоваскулярные, так и оперативные вмешательства на открытом сердце играют важную роль в лечении осложнений в отдаленном периоде. Целью этой статьи является анализ частоты осложнений после лечения коарктации аорты.
Острый панкреатит после кардиохирургических вмешательств в условиях искусственного кровообращения
Authors: Garbuzenko D.V. , Belov D.V. , Fokin A.A. , Milievskaia E.B.
Published: May 2020

В обзоре рассматриваются современные представления об этиологии, патогенезе, факторах риска, диагностике и лечении острого панкреатита после операций на сердце в условиях искусственного кровообращения. Для поиска научных публикаций применяли базу данных PubMed, поисковую систему Google Scholar, а также при статейные списки литературы. Анализ литературы показал, что одной из причин острого панкреатита после кардиохирургических вмешательств является абдоминальная ишемия. При поздней диагностике и несвоевременно начатом лечении он ассоциируется с неблагоприятным прогнозом и высокой летальностью. Чтобы избежать неблагоприятных последствий, необходимы стратификация их риска и определение индивидуальной лечебной тактики. Разработка алгоритма ведения данной категории пациентов позволит стратифицировать их по группам риска и повысить эффективность лечебных мероприятий.
Выбор оптимальной оперативной тактики при сочетанном атеросклеротическом поражении коронарных и периферических артерий
Authors: Lysyi R.N. , Arakelian V.S. , Gagloeva A.S.
Published: May 2020

Несмотря на значительный прогресс современной медицины и положительную тенденцию в лечении заболеваний, смертность от сердечно-сосудистой патологии занимает главенствующую позицию. Наиболее частой причиной заболеваний сосудов является атеросклероз. Следует понимать, что атеросклероз не является болезнью. Это комплексный, системный процесс, который развивается на протяжении всей жизни и приводит к тяжелым последствиям. Поскольку заболевание имеет системный характер, во многих случаях поражение не ограничивается одним сосудистым руслом. Многообразие клинической картины при сочетанном поражении различных бассейнов, обусловленное преобладанием симптомов превалирующего поражения, часто мимикрирует под сопутствующую патологию. Изучение сочетанного атеросклеротического поражения коронарных и периферических артерий играет большую роль как для сосудистой хирургии, так и для медицины в целом.
Реконструкция левого желудочка по Дору на работающем сердце в условиях параллельной перфузии
Authors: ZHelihazheva M.V. , Merzliakov V.IU.
Published: May 2020

Одной из важных проблем при операциях аорторокоронарного шунтирования в сочетании с резекцией аневризмы левого желудочка (ЛЖ) является защита миокарда. Первым этапом осуществляют наложение дистальных анастомозов на пережатой аорте с применением интегрированной кардиоплегии или на работающем сердце. Вторым этапом выполняется резекция аневризмы с пластикой ЛЖ, также на работающем сердце. Такой подход позволяет осуществить реперфузию миокарда после этапа пережатия аорты и избежать послеоперационных нарушений сократительной функции ЛЖ, а также применения инотропной поддержки. Разработанная методика, уже на госпитальном этапе после операции, позволяет получить улучшенные показатели сократительной функции левого желудочка и показывает эффективность инадежность методики в восстановлении адекватной геометрии полости ЛЖ, приближении ее к естественной форме. В данном сообщении представлен клинический случай аортокоронарного шунтирования с резекцией аневризмы ЛЖ по методике Dor на работающем сердце в условиях параллельной перфузии. Клиническое наблюдение свидетельствуют об эффективности и безопасности метода.
Детерминанты эндоваскулярной реваскуляризации миокарда у больных моложе 40 лет с сопутствующим диабетом
Authors: Abdullaev F.Z. , Babaev N.M. , SHihieva L.S.
Published: May 2020

Цель: представить семиотику коронарных артерий и объем эндоваскулярной реваскуляризации миокарда у молодых больных с сопутствующим диабетом. Материал и методы. В группе больных ишемической болезнью сердца 40 лет и моложе (n208) доля пациентов с диабетом составила 7,2, из них 40 поступили с острым коронарным синдромом, 60 со стабильной стенокардией. Двенадцать (80) больных госпитализированы первично, 3 (20) повторно, после перенесенной эндоваскулярной/ хирургической реваскуляризации миокарда. Одиннадцати (73,3) молодым больным с диабетом выполнено эндоваскулярное вмешательство, 4 (26,7) коронарное шунтирование. Результаты. Соотношение числа пациентов с диабетом женского и мужского пола с ишемической болезнью сердца 40 лет и моложе составило 3:1. У 80 молодых больных с диабетом имелось двух- или трехсосудистое поражение, превалируя в соотношении 2:1 при остром коронарном синдроме, по сравнению со стабильной стенокардией. Поражение 1 коронарной артерии отмечено у 20 больных, превалируя в соотношении 3:1 также в группе острого коронарного синдрома. Доминирующими бассейнами поражения являлись правая коронарная и передняя межжелудочковая артерии. Пациенты с острым коронарным синдромом отличались идентичной частотой поражения правой коронарной и передней межжелудочковой артерии, с превалированием поражения огибающей ветви левой коронарной артерии, по сравнению с группой стабильной стенокардии, в соотношении 1,2:1. В группе стабильной стенокардии доминировало поражение передней межжелудочковой артерии, по сравнению с правой коронарной артерией, в соотношении 1,2:1. Поражение ствола левой коронарной артерии отмечено лишь у 13,4 больных стабильной стенокардией. Заключение. Возможность эндоваскулярной реваскуляризации у больных 40 лет и моложе с диабетом составила 73,3 с реваскуляризацией одной и двух коронарных артерий в 72,7 и 27,3 случаев соответственно. Ограничение объема реваскуляризации у больных с трехсосудистым поражением обусловлено умеренными стенозами одной из трех артерий либо их диффузным поражением и сопутствующими стенозами ствола левой коронарной артерии. Соотношение эндоваскулярной/хирургической реваскуляризации составило 2,7:1.
Хирургическое лечение пациента с расслоением аорты I типа, осложненным церебральной мальперфузией, с применением трифуркационного сосудистого протеза
Authors: Mironenko V.A. , Garmanov S.V. , Bakuleva N.P. , Grigor`eva IU.V.
Published: May 2020

Приводится вариант хирургического подхода к лечению пациента с I типом расслоения аорты, осложненного мальперфузией головного мозга. Больному с расслоенными брахиоцефальными артериями выполнено протезирование артерий, восходящего отдела и дуги аорты по методу хобот слона с применением сосудистого трифуркационного протеза в условиях адаптивной перфузии через правую подключичную и левую общую бедренную артерии. Протез создан на этапе планирования операции в лаборатории биологических протезов и биоматериалов НМИЦССХ им А.Н. Бакулева с учетом индивидуальных данных, полученных с использованием компьютерно-томографической панаортографии и мультиспиральной компьютерной томографии брахиоцефальных сосудов с контрастированием. Данная методика является хорошей альтернативой применения стандартного многобраншевого протеза при вмешательстве на дуге аорты, а проведение адаптивной перфузии позволяет сократить время искусственного кровообращения.
A Need Analysis of ESP for Physical Education Students in Indonesia
Authors: Pranoto Budi Eko , Suprayogi Suprayogi
Published: May 2020

This research aims at constructing the ideal English material for Physical Education students of universities in Lampung. Currently, students at university are taught about general English and it stimulates the writers to conduct a research to reveal their need of ESP as the answer of the current issues. This research is conducted in two universities, namely Universitas Teknokrat Indonesia and Universitas Lampung. The participants are 50 students, and 10 lecturers of Physical Education study program from both respective universities. The data are in the form of qualitative data which are taken from the interview and the questionnaire to students and lecturers which cover topics needed, and teaching method. The findings reveal the Physical Education students’ need of ESP in varied range of topics. The highly desired topics are English for sport journalism, English for professional athlete/referee/coach. Furthermore, based on the perspective of lecturers, they believe that students’ speaking, and writing must be well developed in order to compete in international level as professional athlete, coach, journalist, and etc. The result of analysis concludes the importance of ESP for Physical Education’s students. Further research shall be conducted to test the effectiveness of the English topics constructed based on this current research.