bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and Epidemiological characterization of an outbreak by carbapenemase-producing Klebsiella pneumoniae. January-March, 2017, Portoviejo, Ecuador.
Authors: Silva Eduardo , Milanés Diana , Fors Martha
Published: May 2020

Infection Control reported three cases of Kpn-KPC with a probable relation among them in the adult intensive care unit UCI-A in the hospital “Dr. Verdi Cevallos Balda” from Portoviejo, Manabi, Ecuador. This observational and descriptive study aims to characterize this outbreak, according time, space and person. Laboratory tests are analyzed, and the correlation between cases and positive result of the study is shown. Clinical epidemiological aspects of patients with Kpn-KPC carbapenemases producing Klepsiella pneumoniae infection were recorded (January to March 2017). The ICU-A Adult Intensive Care Unit and family environment are a probable factor of dissemination of the disease. The isolation of KPC is an alternative to clinical suspicion. The implementation of infection control measures is essential to reduce nosocomial transmission of Kpn-KPC.
Relationship Between Age and Weight Loss in Noom: Quasi-Experimental Study
Authors: DeLuca Laura , Toro-Ramos Tatiana , Michaelides Andreas , Seng Elizabeth , Swencionis Charles
Published: May 2020

Background

The prevalence of obesity and diabetes among middle-aged and older adults is on the rise, and with an increase in the world population of adults aged 60 years and older, the demand for health interventions across age groups is growing. Noom is an mHealth behavior change lifestyle intervention that provides users with tracking features for food and exercise logging and weighing-in as well as access to a virtual 1:1 behavior change coach, support group, and daily curriculum that includes diet-, exercise-, and psychology-based content. Limited research has observed the effect of age on a mobile health (mHealth) lifestyle intervention.

Objective

The goal of the research was to analyze engagement of middle-aged and older adults using a mobile lifestyle or diabetes prevention intervention.

Methods

A total of 14,767 adults (aged 35 to 85 years) received one of two curricula via an mHealth intervention in a quasi-experimental study: the Healthy Weight program (HW) by Noom (84%) or the Noom-developed Diabetes Prevention Program (DPP), recognized by the US Centers for Disease Control and Prevention (CDC). The main outcome measure was weight over time, observed at baseline and weeks 16 and 52.

Results

Linear mixed modeling found age to be a significant predictor of weight at week 16 (F2,1398.4=9.20; P<.001; baseline vs week 16: β=–.12, 95% CI –0.18 to –0.07), suggesting that as age increases by 1 year, weight decreased by 0.12 kg. An interaction between engagement and age was also found at week 52 (F1,14680.51=6.70; P=.01) such that engagement was more strongly associated with weight for younger versus older adults (age × engagement: β=.02, 95% CI 0.01 to 0.04). HW users lost 6.24 (SD 6.73) kg or 5.2% of their body weight and DPP users lost 5.66 (SD 7.16) kg or 8.1% of their body weight at week 52, meeting the CDC standards for weight loss effects on health.

Conclusions

Age and engagement are significant predictors of weight. Older adults lost more weight using an mHealth evidence-based lifestyle intervention compared with younger adults, despite their engagement. These preliminary findings suggest further clinical implications for adapting the program to older adults’ needs.
The Development of a Web-Based, Patient-Centered Intervention for Patients With Chronic Myeloid Leukemia (CMyLife): Design Thinking Development Approach (Preprint)
Authors: Ector Geneviève ICG , Westerweel Peter E , Hermens Rosella PMG , Braspenning Karin AE , Heeren Barend CM , Vinck Oscar MF , de Jong Jan JM , Janssen Jeroen JWM , Blijlevens Nicole MA
Published: May 2020

BACKGROUND

With the global rise in chronic health conditions, health care is transforming, and patient empowerment is being emphasized to improve treatment outcomes and reduce health care costs. Patient-centered innovations are needed. We focused on patients with chronic myeloid leukemia (CML), a chronic disease with a generally good long-term prognosis because of the advent of tyrosine kinase inhibitors. However, both medication adherence by patients and guideline adherence by physicians are suboptimal, unnecessarily jeopardizing treatment outcomes.

OBJECTIVE

The aim of this study was to develop a patient-centered innovation for patients with CML using a design thinking methodology.

METHODS

The 5 phases of design thinking (ie, empathize, define, ideate, prototype, and test) were completed, and each phase started with the patient. Stakeholders and end users were identified and interviewed, and observations in the care system were made. Using tools in human-centered design, problems were defined and various prototypes of solutions were generated. These were evaluated by patients and stakeholders and then further refined.

RESULTS

The patients desired (1) insights into their own disease; (2) insights into the symptoms experienced, both in terms of knowledge and comprehension; and (3) improvements in the organization of care delivery. A web-based platform, CMyLife, was developed and pilot-tested. It has multiple features, all targeting parts of the bigger solution, including a website with reliable information and a forum, a guideline app, personal medical records with logs of symptoms and laboratory results (including a molecular marker and linked to the guideline app), tailored feedback based on the patients’ symptoms and/or results, screen-to-screen consulting, delivery of medication, and the collection of blood samples at home.

CONCLUSIONS

The multifeatured innovation, CMyLife, was developed in a multidisciplinary way and with active patient participation. The aim of developing CMyLife was to give patients the tools to monitor their results, interpret these results, and act on them. With this tool, they are provided with the know-how to consider their results in relation to their personal care process. Whether CMyLife achieves its goal and the evaluation of the added value will be the focus of future studies. CML could become the first malignancy for which patients are able to monitor and manage their disease by themselves.
Assessment Practices of Albanian & Italian Teachers in English Classrooms
Authors: Roseni Dr. Emilda , (Shano) Koroshi Dr. Alnida
Published: May 2020

Language assessment policies in Albania and Italy have impact on assessment practices of English teachers. This study describes Albanian and Italian secondary school English teachers’ classroom assessment practices in ELL classes. It was conducted using qualitative method design with 48 secondary school English teachers as respondents, practically 24 from Albania and 24 from Italy who participated in an interview and observation to clarify their practices on classroom assessment. The study found that secondary school English teachers in both countries Albania and Italy used assessment for learning as the main purpose of assessment. The majority of secondary school English teachers in Italy prepared and made their own assessment, while secondary school English teachers in Albania used items from published textbooks as their primary sources for constructing assessment items. English teachers of both countries used written comments for providing feedback. Total score test and a letter grade were the highest percentage methods for providing summative assessment for both secondary school English teachers in Albania and Italy.
A Systems Approach and Notional Response Model for Preserving the Health System during the COVID-19 Pandemic
Authors: Goss James F. , Berkshire Steven , Wilson Asa B. , Jordan Kathleen M.
Published: May 2020

During any pandemic, it has long been known that local jurisdictions would need to be self-sufficient with little or no outside assistance, particularly from the federal government. While all eyes have been on California, New York, and Massachusetts, the capacities of health systems in other states have yet to be put to the test. If there are subsequent waves of COVID-19 and other jurisdictions see significant increases in disease spread, the systems used to respond will become critical.Using a review and synthesis approach, this article explores our collective experience and knowledge as it pertains to use of alternate care sites for dealing with the patient surge created by a disease outbreak. Probing the concept of alternate care site (ACS) systems reveals various types of alternate care sites that may be employed during an outbreak. The historical value of ACS models used during outbreak response are discussed. This culminates in the development of a notional response model and list of actions that should be taken by all jurisdictions as we prepare for additional waves of disease.
Sobre a intolerância: percursos semióticos
Authors: Bueno Alexandre Marcelo
Published: May 2020

Como fenômeno da significação, a intolerância continua fortemente presente na contemporaneidade. O objetivo deste trabalho é o de examinar o discurso intolerante a partir das propostas desenvolvidas pela semioticista Diana Luz Pessoa de Barros a partir do quadro teórico da semiótica discursiva de linha francesa, desenvolvida por Algirdas Julien Greimas. Por meio de diversos exemplos, veremos as características que denotam esse tipo de discurso, assim como analisaremos casos concretos do uso da intolerância no campo político, tal como propõe a semioticista brasileira. Por fim, mostraremos como esta pesquisa revela, além de sua importância atual para combater tal fenômeno, um estilo de pesquisa, ou seja, um ritmo e uma maneira de refletir sobre a significação em geral.
A festa do discurso: discurso e contexto sócio-histórico
Authors: Fiorin José Luiz
Published: May 2020

Este trabalho apresenta os conteúdos tratados na tese de livre-docência de Diana Luz Pessoa de Barros, intitulada A festa do discurso. Teoria do discurso e análise de redações de vestibulandos, ressaltando e analisando sua principalcontribuição teórica: o exame das relações entre discurso e contexto sócio-histórico, ou seja, sua proposta deintegração do que era chamado análise interna e análise externa. A questão central da tese é, portanto, a proposta dedesenvolvimento de uma teoria do discurso capaz de conciliar a análise do texto, como sistema de regras capazesde explicar sua organização imanente – uma abordagem interna -, com o exame da inclusão contextual do texto – umaabordagem externa. A inserção numa classe social é, segundo a autora, o elemento central para estabelecer as relaçõesentre discurso e contexto sócio-histórico. Na análise de redações de vestibulandos, Diana Pessoa de Barrosmostra como se concretiza sua proposta teórica.
Contribuições da semiótica para a análise dos discursos na internet
Authors: Teixeira Lucia
Published: May 2020

O artigo apresenta a contribuição da linguista e semioticista Diana Luz Pessoa de Barros aos estudos sobre o discurso produzido na internet. Com base em artigos da autora, comenta não só a ideia central de suas análises, mas também a exemplaridade de um percurso de pesquisador(a) no campo da linguística. O discurso produzido na internet apresenta, segundo a autora, características de complexidade, compreendida como conceito semiótico que abriga a coexistência de termos contrários. O discurso da internet é complexo em relação às oposições entre língua oral e língua escrita e entre os domínios público e privado. Para formular suas conclusões, a autora percorre trajetória de pesquisa que tem caráter de exemplaridade, seja articulando saberes já sedimentados a novas contribuições teóricas, seja guiando-se por dados observados em corpora variados, seja ainda formulando e sistematizando conceitos ou indicando metodologias que se tornaram referência para a semiótica produzida no Brasil e no mundo.
Uma semioticista: entre a teoria e a paixão
Authors: Discini de Campos Norma
Published: May 2020

O Dicionário de Semiótica (GREIMAS; COURTÉS, 2008, p. 324), após definir o mundo natural como uma “estrutura ‘discursiva’” que se apresenta no quadro da relação sujeito/objeto, acrescenta que esse mundo “é o enunciado construído pelo homem e decifrável por ele [o próprio homem]”. Há uma semioticista brasileira que leva os leitores de sua obra a um desvelamento peculiar do que “está aí” feito semiose. Queremos homenagear essa intelectual, cuja obra desbastou campos inimagináveis para nossa percepção, e cujo comportamento nos levou a querer passar “além do Bojador”. Falamos de Diana Luz Pessoa de Barros. O desejo de reverenciar a pensadora e de reconhecer sua força moral em nossas vidas sempre será maior do que o poder de nossas palavras. Entretanto, movidos pela memória do brilho que vem de lá, ou do lugar da própria Diana, procuraremos falar sobre alguns dos princípios que fundamentam sua obra, como a atenção à figuratividade e à ideologia concebidas como não separadas das tensões do afeto. Enquanto isso, tentamos entrar em conjunção com o objeto de valor que ela oferece a quem dela se aproxima: a vontade de viver articulada por um “querer extenso”. É um querer que, longe de recuar diante de alguma impossibilidade, alimenta-se pelo próprio não-poder, como está previsto por Greimas e Fontanille (1993) em estudo feito sobre a obstinação.
El uso de subtítulos en los videos como estrategia de inclusión
Authors: Gaillard Rivero Iván , Aguilar Vera María Luisa
Published: May 2020

Hasta el día de hoy se han realizado muy pocas investigaciones formales que aborden el tema de la discapacidad auditiva con relación a la educación en línea, a pesar de ser una modalidad que ofrece amplios beneficios de inclusión, especialmente con la incorporación de las nuevas tecnologías de la información y la comunicación (TIC) en la sociedad. Particularmente, en los centros educativos a distancia está transformando las relaciones y las formas tradicionales de enseñanza.Bajo estas circunstancias, y frente al reto de aprovechar las TIC, la labor del docente a distancia es llevar a cabo tanto propuestas de mejora continua en las metodologías propias de la educación virtual, como ofrecer un mejor servicio académico para todos los estudiantes y facilitar el acceso a aquellos con discapacidad auditiva.El presente artículo resalta la importancia de crear subtítulos en cualquier recurso multimedia para personas con discapacidad auditiva como estrategia de inclusión, con el fin de que comprendan mejor lo que visualizan y, así, suprimir en lo posible impedimentos y barreras de accesibilidad.
El proceso de construcción del instrumento de evaluación de asesores de un bachillerato en línea
Authors: Díaz Barahona María Edith , Martín Pavón Mario José
Published: May 2020

La evaluación docente es una herramienta importante para mejorar los procesos formativos, más en ambientes virtuales en donde hay separación de espacio y tiempo entre estudiante y profesor. Este artículo describe la metodología de elaboración de un instrumento de evaluación docente de un bachillerato virtual. La población en estudio la conformaron los asesores activos en el 2º periodo académico de 2019. Entre las características psicométricas del instrumento destaca la capacidad de discriminación de los ítems y su confiabilidad que es de 0.984. El análisis de factores reportó dos: desempeño pedagógico y habilidades tecnológicas, explicando 72% de la variación del desempeño de los asesores.
Habilidades del siglo XXI con la robótica educativa
Authors: Sierra Rativa Alexandra
Published: May 2020

Alexandra Sierra, estudiante del Doctorado en Ciencias Cognitivas de la Inteligencia Artificial, en la Universidad de Tilburg, Holanda, comenta dos temas en este video: por qué es relevante la robótica educativa y cómo puede enseñarse a los jóvenes aplicando las habilidades para pensar en el siglo XXI: la creatividad, el pensamiento crítico, la colaboración y la comunicación, mediante una estrategia pedagógica basada en la resolución de problemas y el conectivismo.
Repensar las universidades abiertas: ¿qué las hace únicas?
Authors: Jeong Hanmo
Published: May 2020

Este artículo considera el estado actual de la Open University del Reino Unido (UKOU) y las implicaciones para la evolución de la educación superior, sea en instituciones abiertas o tradicionales. A pesar de que han pasado 50 años desde el establecimiento de UKOU, la primera universidad abierta, tales instituciones parecen estar perdiendo terreno, especialmente porque se enfrentan a desafíos para crear una identidad clara para sí mismas. Por definición, se les ha distinguido de las universidades tradicionales por ofrecer tanto acceso abierto como admisión abierta. Sin embargo, algunos casos de acceso abierto (es decir, enseñanza a distancia a través de la adopción de diversas tecnologías) se han dado en China, Sudáfrica, la URSS y Estados Unidos. Aun así, la introducción de políticas de admisión abierta puede considerarse una característica central de las universidades abiertas. Dichas políticas han sido criticadas por generar la así llamada “puerta giratoria”, donde los estudiantes reprueban casi de inmediato. Para contrarrestarlo, la UKOU desarrolló un sistema particular de aseguramiento de calidad, que le permitió ser una institución reconocida de educación superior. Específicamente, establecieron redes regionales con responsabilidades compartidas para ofrecer todos los elementos que integran a una universidad, incluyendo oficinas centrales y regionales e incluso espacio para estudiantes. Esta forma de universidad en red diferencia a las universidades abiertas de las que siguen un modelo tradicional y constituye una característica distintiva de este tipo de educación.
Bachillerato a distancia, una experiencia de vida
Authors: Rivera Martínez Lucila , Martínez Barrios Sandra Olivia , Hernández Pérez Rommy Florencia
Published: May 2020

El aprendizaje en línea se flexibiliza al atender las necesidades de tiempo, espacio y entorno de cada estudiante. Volver la mirada a ellos y a sus experiencias durante su tránsito por el bachillerato contribuye a analizar las acciones que suman y merecen ser replicadas. También permite conocer las áreas de oportunidad que se definen con las historias contadas por los propios estudiantes que cursan o egresaron de la Red de Bachilleratos Universitarios Públicos a Distancia.En este artículo, se comentan varios videos cortos producidos por cada universidad. En ellos, los estudiantes comparten su experiencia individual a través de su trayectoria estudiantil, ya sea durante o al finalizar su bachillerato. Dar voz a los principales actores de este proceso es una acción que permite identificar tanto en ellos, como en sus docentes, características que solidifican y fortalecen su participación y formación en el nivel medio superior.
Changes to Environmental Policy: A Plea to Turn Passion into Action
Authors: Jackson Leland J
Published: May 2020

No abstract
Recurrence Relations for Marginal and Joint Moment Generating Functions of Topp-Leone Generated Exponential Distribution based on Record Values and its Characterization
Authors: Anwar Zaki , Gupta Neetu , Khan Mohd. Akram Raza , Jamal Qazi Azhad
Published: May 2020

The exact expressions and some recurrence relations are derived for marginal and joint moment generating functions of kth lower record values from Topp-Leone Generated (TLG) Exponential distribution. This distribution is characterized by using the recurrence relation of the marginal moment generating function of kth lower record values.
Sunil Yapa’s Your Heart is a Muscle the Size of a Fist: Protest, Fiction and the Ethics of Care
Authors: Alonso-Breto Isabel
Published: May 2020

Sunil Yapa’s politically engaged first novel vindicates the massive pacific protests that occurred during five days in Seattle in November-December 1999. These protests were summoned against the World Trade Organization summit. The novel responds to the wish to inscribe in the history of fiction a crucial event which would inspire and inflect the later anti-globalization movement and protests, and which according to some has not yet received the attention it deserves by media or criticism. This article discusses Yapa’s work in the light of the Ethics of Care, and develops an exegesis, which, incorporating elements of Hardt and Negri’s ideas about the Multitude, understands the novel mainly as a reflection of the crucial preoccupation thathumans have for other human beings, and the innate wish to actively take care of the Other and improve his or her life conditions.
Opposing the Strategic Arms Reduction Treaty in the U.S. Congress: Ideological analysis of Senate Armed Services and Foreign Relations Committee Hearings
Authors: Mäkinen Teemu
Published: May 2020

The United States Senate voted to ratify the New Strategic Arms Reduction Treaty with Russia in 2010 by 74-26, all 26 voting against being Republicans. The change in the voting outcome compared to the 95-0 result in the 2003 SORT vote was dramatic. Using inductive frame analysis, this article analyzes committee hearings in the Senate Foreign Relations and the Armed Services committees in order to identify competing narratives defining individual senators’ positions on the ratification of the New START. Building on conceptual framework introduced by Walter Russel Mead (2002), it distinguishes four schools of thought: Jacksonian, Hamiltonian, Jeffersonian, and Wilsonian. The argumentation used in the hearings is deconstructed in order to understand the increase in opposition to the traditionally bipartisan nuclear arms control regime. The results reveal a factionalism in the Republican Party. The argumentationin opposition to ratification traces back to the Jacksonian school, whereas argumentation supporting the ratification traces back to Hamiltonian, Jeffersonian and Wilsonian traditions. According to opposition, the Obama administration was pursuing its idealistic goal of a world-without-nuclear-weapons and its misguided Russia reset policy by any means necessary – most importantly by compromising with Russia on U.S. European-based missile defense.
“I Take Everything Back That I Said”: Ambivalence and Motherhood in Mildred Pierce
Authors: Sommer Tine
Published: May 2020

This article discusses motherhood in James M. Cain’s Mildred Pierce (1941). It argues that academic criticism so far has neglected the important contribution Cain’s text makes to debates concerning motherhood norms in the post-Depression years. The article takes as its central concern the fraught relationship between Mildred and her daughter, Veda. Building on Sianne Ngai’s theory of “ugly feelings,” the article claims that Mildred’s ambivalent emotional responses to her daughter reveal how social norms obstruct mothers’ agency. Rather than categorically rejecting Veda’s bad behavior, Mildred’s anger, pain, fear, and jealousy are retracted immediately after they surface. As such, Mildred’s maternal emotions are ambivalent and should be perceived as ugly feelings that have the potential to diagnose situations of obstructed agency. This article thus argues for the complexity of Cain’s representation of motherhood and shows how mothers’ ambivalent emotions reveal limited agency in their navigation of social norms.
Diversidad de peces de agua dulce en la zona costera de los distritos Bahía Ballena y Puerto Cortés del cantón de Osa, zona sur de Costa Rica
Authors: Villegas Arguedas Juan Carlos
Published: May 2020

Con el objetivo de conocer la diversidad de peces de agua dulce, se determinó su estructura y composición taxonómica, en ríos cercanos a la costa, en Bahía Ballena y Puerto Cortés, en el Pacífico Sur de Costa Rica. Mediante la pesca eléctrica, se colectaron 162 individuos pertenecientes a 12 especies y a 7 familias en cuatro estaciones de muestreo. La talla mínima (longitud estándar, LS) correspondió a un individuo de Sicydium salvini en el Río Morete (1,70 mm). La talla máxima correspondió a un individuo de la especie Awaous transandeanus en el Río Coronado (22,60 mm). Cinco especies fueron dominantes con 86,42% del total de las capturas. Tanto el Río Coronado como la Quebrada Ballena registraron 8 especies; el Río Morete, 6; mientras que el Río Tortuga registró 7 especies. La mayor cantidad de individuos se colectaron en el Río Coronado (n = 53), seguido por Quebrada Ballena (n = 41), el Río Morete o Higuerón (n = 35), mientras que el menor número de individuos se registró en el Río Tortuga (n = 33). El reemplazo de especies entre sitios puede considerarse alto; se registró la compartición en los ensamblajes taxonómicos entre sitios en 76,31% (Quebrada Ballena y Río Morete) –estos dos sitios son los más similares‒ y 35,29% (Río Morete y Río Tortuga). La diversidad alfa por sitios de muestreo fue baja; la mayor se registró en el Río Tortuga (H´ = 1,81), mientras que la más baja se registró en el Río Morete (H´ = 1,19). En general, la ictiodiversidad de estos ríos, y en esta región, es relativamente homogénea, con dominancia de especies estuarinas (periféricas) y dulceacuícolas secundarias.
Low-temperature hydrothermal synthesis of hierarchical flower-like CuB2O4 superstructures
Authors: Ursu Daniel , Dabici Anamaria , Miclau Marinela , Miclau Nicolae
Published: May 2020

We report for the first time the fabrication of hierarchical ordered
superstructure CuB2O4 with flower-like morphology via a one-step, low
temperature hydrothermal method. The tetragonal structure of CuB2O4 was
determined by X-ray diffraction and high-resolution transmission electron
microscopy. Optical measurements attested of the quality of the fabricated
CuB2O4 and high temperature X-ray diffraction confirmed its thermal
stability up to 600 ?C. The oriented attachment growth and the hierarchical
self-assembly of micrometer-sized platelets producing hierarchical
superstructures with flower-like morphology are designed by pH of the
hydrothermal solution. The excellent band gap, high thermal stability and
hierarchical structure of the CuB2O4 are promising for the photovoltaic and
photocatalytic applications.
Preparation and characterization of porous Al2O3 based on nano-Al2O3 powders and PLA template by microwave sintering
Authors: He Zhenhua , Zhu Shifei , Liu Canhui
Published: May 2020

Macroporous and mesoporous Al2O3 body was prepared using mesh screening
shaped polylactic acid (PLA) template. The mesh screening shaped PLA
template was made from 3D cylindrical model by adjusting the PLA filling
rate at 30 vol.%. After 3D printing, the PLA template was filled with Al2O3
nano-powders and microwave sintered at 1673K for 20min. During the
sintering, the PLA template was decomposed and left large pores which could
promote sintering of Al2O3. The Al2O3 sintered body showed macroporous
structure with the pore size of 100 to 300 nm and also mesoporosity with
local single crystal structure. The average pore diameter of mesoporous
structures in the Al2O3 sintered body was about 7.6 nm. The Vickers hardness
of the porous Al2O3 is 1.254 ? 0.039GPa. The obtained results confirmed that
3D-printed PLA template assisted microwave sintering is a promising
technical processing for the fabrication of macroporous and mesoporous Al2O3
with local single crystal structure.
Natural Language Processing Improves Detection of Nonsevere 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 nonsevere 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 to 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 NSH was found in 7,035 (3.4%) of patients using NLP. We reviewed 1,200 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 with diagnosis code–only NSH.

CONCLUSIONS

Detection of NSH improved with NLP in patients with type 2 diabetes without improving SH prediction.
Vanderbilt Health Affiliated Network Statin Outreach Service
Authors: Terry Christopher , Neal Erin B. , Daly Katelynn , Skupien Donna , Griffith Michelle L.
Published: May 2020

The Vanderbilt Health Affiliated Network (VHAN)
is a collaborative alliance of physicians, health systems, and employers
driving a new level of clinical innovation and teamwork to enhance patient
care, contain costs, and improve the health of communities in Tennessee and
surrounding states. The network includes more than 5,000 clinicians, 60
hospitals, 12 health systems, and hundreds of physician practices and clinics
who work together to strengthen communities and improve quality of life across
the Southeast through better health. The statin outreach service was piloted in
one VHAN practice, the Vanderbilt Medical Group, a large primary care group at
Vanderbilt University Medical Center (VUMC). VUMC is a tertiary care academic
center. VUMC primary care providers (PCPs) are located in several practice
locations, and one location was chosen to pilot this intervention. The PCPs
included internal medicine residents and attending physicians. Before this
project, there was no clinical pharmacy presence in this practice.
Design and Implementation of an Electronic Tool to Measure Medication Adherence at the Point of Care
Authors: Alvarez Kristin , Townsend Clasy , McNulty Jacqueline Nicole , Kubik Matthew , Gunasekaran Uma , Ahmed Farhan , Rodriguez Kellie , Moran Brett , McManus Jon , Meneghini Luigi F.
Published: May 2020

“Quality Improvement Success Stories” are
published by the American Diabetes Association in collaboration with the
American College of Physicians and the National Diabetes Education Program.
This series is intended to highlight best practices and strategies from
programs and clinics that have successfully improved the quality of care for
people with diabetes or related conditions. Each article in the series is
reviewed and follows a standard format developed by the editors of Clinical
Diabetes. The following article describes a project to build a point-of-care
tool for assessing patients’ adherence to their prescribed medications.
PENGENDALIAN TRACKING POSISI PURWARUPA AUTONOMOUS LAND VEHICLE DENGAN MENGGUNAKAN METODE PID DAN MODEL KINEMATIK
Authors: Istiqphara Swadexi
Published: May 2020

Intisari ˗ Teknologi sistem autonomous saat ini mulai banyak dikembangkan untuk berbagai aplikasi seperti industri dan transportasi umum. Berbagai metode telah banyak dikembangkan untuk mengendalikan suatu wahana secara otomatis baik dengan kombinasi sistem kendali cerdas (AI) atau dengan metode kendali nonlinear. Salah satu kendala dalam kendali autonomous ini adalah akurasi GPS yang kurang akurat. Dalam jurnal ini, akan implementasi metode kontrol berbasis model kinematik wahana untuk memperbaiki akurasi GPS, sehingga akan meminimalisir terjadinya tabrakan atau lintas jalur. Wahana yang digunakan berupa purwarupa mobil mainan bertenaga baterai yang dimodifikasi agar dapat dikendalikan secara autonomous, dimana wahana ini bernavigasi menggunakan sistem steering pada dua roda depan. Pengujian akan dilakukan pada area jalan ITERA, dimana wahana akan diberikan lintasan yang diberikan melalui perangkat lunak komputer dan dipantau secara nirkabel. Sumber daya wahana diperoleh dengan dua cara yaitu dengan menggunakan sumber listrik dari panel surya dan dari baterai.
Substraksi RGB untuk Identifikasi Jenis Daging Konsumsi Berbasis Pengolahan Citra
Authors: Yudamson Afri , Sulistiyanti Sri Ratna , Alam Syaiful , Setyawan FX Arinto , Yulianti Titin
Published: May 2020

Intisari — Kesenjangan nilai ekonomis yang cukup tinggi yang terjadi pada komoditas beberapa jenis daging konsumsi menjadi penyebab utama terjadinya kecurangan pada proses penjualannya. Secara kasat mata, beberapa jenis daging akan terlihat sama sehingga sulit untuk diidentifikasi. Dengan menggunakan pengolahan citra, data matriks dari beberapa jenis daging konsumsi akan menampilkan kecenderungan tertentu sehingga dapat dijadikan ciri identifikasi. Sampel pada penelitian ini adalah daging Kambing, daging Anjing, daging Babi, dan daging Celeng. Metode Substraksi RGB merupakan turunan dari matriks citra RGB. Dengan menggunakan metode ini, citra masing-masing jenis daging konsumsi dapat diidentifikasi. Hasil penelitian menunjukkan bahwa daging Kambing dan daging Celeng dapat diidentifikasi menggunakan substraksi GB, sedangkan daging Anjing dan daging Babi dapat diidentifikasi menggunakan substraksi GB yang dilanjutkan dengan substraksi RB.Kata kunci — kecurangan penjualan daging, identifikasi daging, pengolahan citra, substraksi RGBAbstract — High gap of the economic values that occurs in several types of meat commodities is a major cause of fraud of the meat sales. In plain view, several types of meat will be look similar so these were difficult to identify. By using image processing, matrix data from several types of meat will display certain trends so that it can be used as an identification feature. Samples in this study were goat meat, dog meat, pork meat, and boar meat. The RGB Substraction Method is a derivative of an RGB image matrix. Using this method, images of each type of meat can be identified. The results showed that goat meat and boar meat could be identified using GB substraction, while dog meat and pork meat could be identified using GB substraction followed by RB subtraction.Keywords — meat sales fraud, meat identification,image processing, RGB substraction
Learning to Become an FSC Auditor
Authors: Cook William Clark , Turnhout Esther , Van Bommel Severine
Published: May 2020

This paper aims to open up the black box of auditing for the Forest Stewardship Council (FSC) forest management standard. Specifically, we delve into the early steps of becoming an FSC auditor by examining two auditor training sessions in northern Europe. Using a mix of participant observation and unstructured interviews, the paper subjects the trainings to analysis focusing on the ways in which trainees are taught to become FSC experts. Alongside being an exploratory piece on the nature of FSC auditor training, we show how auditing expertise is a matter of performing objectivity and how interpretation is a key aspect of these performances. Learning how to do interpretation, and what values should guide this interpretation, is part of the training but also poses a challenge to the teachers because these aspects cannot be seen to impinge on the objectivity of auditing. We suggest that the mitigation of these tensions during the performance of objectivity is the hallmark of auditing expertise. We conclude our analysis by discussing expertise as a matter of reflecting on and aligning objectivity, values, and interpretation.
Sensory Science in Tension
Authors: Daniel François-Joseph
Published: May 2020

For the last 15 years, sensory science has frequently been recommended to industrial actors to monitor odours, assess the quality of the environment and improve their factories’ functioning. Resident “sniffing teams” have been put in place in different contexts to assess odorous pollution. These teams are groups of local residents living in the neighbourhoods of industrial facilities, who have been trained to report pollution emissions. This article describes these teams as sensory devices and argues that their functioning relies on the consent of the residents to allow themselves to “be affected differently” by smells – from annoyance to interest and curiosity about odour recognition and reporting activity. This consent, which is based on an ‘ethic’ of sensing, centered on the sniffers’ own feelings, is delicate, tense and reversible, given the emotionally-loaded contexts of odorous pollution.
Connections between Tatars in Petrograd-Leningrad and Finland during the 1920s and 1930s
Authors: Bekkin Renat
Published: May 2020

Saint Petersburg served from the end of the nineteenth century as a transit point for Mishär Tatarsmoving to the Grand Duchy of Finland. At the beginning of the twentieth century, a small communityhad already formed in Finland, but its members maintained regular contacts with their relativesand connections in the Sergach district (Nizhny Novgorod province), Saint Petersburg andother regions. Contrary to common belief, these ties were not interrupted even after the OctoberRevolution of 1917. Throughout most of the 1920s, Tatars and others crossed the Soviet-Finnishborder illegally. Tatars living in independent Finland also sent considerable financial aid to theircontacts in Leningrad with the help of couriers.

The nature of the ties between the Tatar emigrants in Finland and the Tatars of Leningrad can beillustrated by the materials of one criminal case. This case was instituted by the Soviet politicalpolice against representatives of the Tatar Muslim community in Leningrad in 1931. Only afterseveral arrests and tightening border control was communication between the Tatars in Finlandand Leningrad interrupted. I suggest that the Mishär Tatars in Leningrad and Finland constituted asingle social and cultural space until the 1930s, when the connections between them were blocked.The ensuing divide had a large impact on the identity of the Tatars living in Finland, who begandeveloping a separate Finnish Tatar identity just a few years after the termination of contacts.
"Our Religious Mentor": Musa Bigeev and the Tatars in Finland
Authors: Zaripov Islam , Belyaev Ramil
Published: May 2020

The influence of progressive Muslim theologian Musa Jarullah Bigeev (1875–1949) on the Tatarcommunity in Finland during the first half of the twentieth century is the focus of this article. Bigeevwas very popular among the Tatar bourgeoisie in Russia and the diaspora abroad. Already at anearly stage of his career he became widely known as the “Muslim Luther”. We briefly describe thescientific biography of this theologian, his relations with the Tatars in Finland and personal memoriesfrom visiting the country. The main part of the study presents an analysis of the perceptionof his ideas by a few important community leaders in Finland, Weli-Ahmed Hakim, ZinnetullahAhsen Böre and Habibur-Rahman Shakir, as reflected in their correspondence and publications.This article also provides examples of Bigeev’s recommendations to the community on variousissues of their ethno-confessional life, transmitted through letters to its leaders. The recommendationsinclude a range of aspects from the establishment of an organization and development of thecommunity’s education system to questions of religious practice and personal spiritual growth.His ideas contributed to the adaptation of the Tatars to Finnish society and simultaneously to thepreservation of Tatar culture, language and identity.
Demonstratives in Nivkh: A Semantic and Pragmatic Analysis
Authors: Gruzdeva Ekaterina
Published: May 2020

This paper offers a comprehensive analysis of the morphosyntactic, semantic and pragmatic features of Nivkh demonstratives, which represent a typologically interesting example of an exceptionally elaborated speaker-anchored deictic system. The deictic properties of the demonstratives can be described either in terms of a binary system with the opposition between ‘proximal’ and ‘non-proximal’ areas as viewed from the deictic centre, or in terms of a multiple system that is organised hierarchically and may be divided into primary and secondary systems, which together define fifteen spatial zones around the deictic centre. Beyond spatial proximity, the demonstratives may also encode a number of non-deictic features such as quality, quantity, dimension, preciseness of location, and visibility. This paper distinguishes between six morphosyntactic classes of demonstratives and shows how the different deictic and non-deictic features correlate with their pragmatic uses.
The Ergonomic Elderly Gym Improving Physical Fitness and Increasing The Bone Mass of The Elderly
Authors: Ariati N.N. , Adiputra N. , Tirtayasa K. , Adiatmika I.P.G. , Pangkahila A. , Sutjana I.D.P , Bakta I.M. , Manuaba I.B.P , Sutajaya I.M.
Published: May 2020

The public is increasingly aware of the importance of exercise for the elderly because exercise is an option to reduce complaints due to setbacks and improve the health of the elderly. In fact the implementation in the field is often wrong as in Banjar Benaya which implements routine exercises only once a week with a duration less than 30 minutes, does not pay attention to nutritional needs, does not use sports clothing, and displays that are not clear. The measurement of elderly physical fitness is still relatively low. Based on these problems, improvements were made to the application of ergonomic elderly gymnastics due to improve elderly’s physical fitness and increase the bone mass.  This study used a treatment by subject design conducted in April 2017-August 2018. The target population was all elderly in Denpasar and the affordable population was determined by multistage random sampling then selected Banjaya Benaya Peguyangan Village with a sample of 20 people who met the inclusion criteria. The data collection were physical fitness and bone mass. The difference in treatment effects were analyzed using a Paired Sample t-Test with α = 0.05 for data with normal distribution and Wilcoxon test, α = 0.05 for data with abnormal distribution. Data showed that there were differences in physical fitness improvement in Period I and Period II after 8 weeks of gymnastics at 43.43% with very bad categories being bad, the difference in increase in whole body bone mass was 16.76% and leg bone mass 68.67%. Analysis of Paired Sample-t-Test physical fitness data and Wilcoxon test for bone mass data in Period I and Period II after gymnastics for 8 weeks, found that there was a significant difference (p <0.05). It can be concluded that ergonomic elderly gym can significantly improve physical fitness and increase bone mass of the elderly. It is recommended that the elderly continue to exercise with a duration of 30-45 minutes, the frequency of 3 times a week to maintain elderly’s physical fitness.
Different Impact of Critic’s and Fellow Customer’s Score at Online Review Aggregator on Customer Purchase Intention in Motion Picture Industry
Authors: Laheba T.R.
Published: May 2020

The Motion picture industry is somehow a unique industry when compared to other industries. Ticket prices for all films are the same, because of that price is not the main variable in decision making for watching a film. A review can become one of the most powerful variable when choosing which film to watch by the customer. Other than that, different from other industries and products, reviews that come in the form of narrative and detailed expositions tend to be avoided by customers because it will ruin the satisfaction of watching films activity due to leakage of information from the film plot and storyline. One that can be an aid for film customer is online review aggregator’s score that accumulated from a bunch of scores that are given from either critics or fellow customer and it made online review aggregator viewed as a more objective reviewer. This study aims to find whose review at the online review aggregator website will be more influential on customer purchase intention of Indonesia’s moviegoers. Data of 220 Indonesia’s millennial generation were retrieved and analyzed during the research. This research finds out that customers in Indonesia can be influenced by score or rating that comes from online review aggregator, an equally good review from critics and customer can increase customer purchase intention and vice versa. Furthermore, customer’s score or rating is the one more influential by a small margin compared to the score from critics.
Хирургическое лечение пациентов с приобретенными пороками клапанов сердца в сочетании с ишемической болезнью сердца
Authors: Kakabaev D.B.
Published: May 2020

Сочетание пороков клапанного аппарата и ишемической болезни сердца (ИБС) является значимой проблемой современной кардиохирургии. Накопленный клинический опыт свидетельствует о том, что хирургическая коррекция клапанных пороков у пациентов с ИБС без одновременного выполнения реваскуляризации миокарда нередко сопровождается развитием интраоперационного инфаркта миокарда и высокой летальностью. Патология коронарных артерий расценивается как важный фактор риска при протезировании аортального клапана и имеет высокую прогностическую значимость для исхода оперативного вмешательства. Протезирование аортального клапана в сочетании с аортокоронарным шунтированием стандартная стратегия лечения пациентов с тяжелыми симптомами аортального стеноза и ишемической болезни сердца. Однако, несмотря на многочисленные усилия, госпитальная летальность после выполнения сочетанных операций по-прежнему остается достаточно высокой и варьирует от 5 до 11. Кроме того, до конца не решенным остается еще целый ряд вопросов, связанных с этапностью вмешательства, определением оптимального метода реваскуляризации миокарда, способов его защиты, особенно у больных со сниженной фракцией выброса левого желудочка, многососудистым поражением коронарного русла, наличием сопутствующей патологии. В статье представлены обзор различных подходов и результаты хирургической коррекции при сочетанной патологии клапанов сердца и коронарных артерий, особенности выполнения этапа реваскуляризации миокарда.
Выдвижение передней створки трикуспидального клапана при органическом и функциональном пороках
Authors: Muratov R.M. , Kazumian B.V. , Akbutaeva G.M.
Published: May 2020

Цель исследования. В ряде случаев аннулопластика трикуспидального клапана недостаточна для обеспечения хороших отдаленных результатов при лечении трикуспидальной недостаточности (ТН). Предложен метод, заключающийся в выдвижении передней створки трикуспидального клапана c целью увеличения длины коаптации створок и тем самым улучшения функции клапана в отдаленном периоде. Цель исследования провести сравнительный анализ непосредственных и отдаленных результатов выдвижения передней створки трикуспидального клапана при его органическом и функциональном пороках. Материал и методы. С 2010 по 2017 г. маневр выдвижения передней створки трикуспидального клапана выполнен у 18 пациентов с тяжелой трикуспидальной недостаточностью. Поэтиологии трикуспидальной недостаточности пациенты были разделены на две группы: 1-я группа пациенты с органическим пороком трикуспидального клапана (ревматизм 10, врожденный порок сердца 2) 2-я группа с функциональной ТН (6). Во 2-й группе показанием к операции явились тяжелая ТН с втяжением створок трикуспидального клапана более 8 мм, в 1-й группе тяжелая трикуспидальная недостаточность. Результаты. В послеоперационном периоде умерли 3 пациента (госпитальная летальность составила 16,7). У 14 пациентов на момент выписки была трикуспидальная недостаточность до I степени, у 1 пациента с ревматическим поражением трикуспидального клапана ТН II степени. Среднеотдаленная выживаемость составила 86,7 Свобода от трикуспидальной регургитации II степени и более в среднеотдаленном периоде составила 100 в группе функционального порока и 60 в группе органического порока (p0,27963). Реопераций не было. Средний функциональный класс по NYHA снизился с 3,6 до 1,1 в общей популяции (p0,0015). Заключение. Результаты выдвижения передней створки трикуспидального клапана являются удовлетворительными и позволяют расширить показания к реконструктивной хирургии при функциональной трикуспидальной недостаточности. Однако при органическом пороке трикуспидального клапана возврат трикуспидальной регургитации II и более степени составил 40. Учитывая развитие эндоваскулярной клапанной хирургии, возможно, при органическом пороке предпочтение cледует отдать более надежной операции протезированию трикуспидального клапана.