bluuebunny/crossref_metadata_2025 huggingface dataset:
A Clinical Teaching Blended Learning Program to Enhance Registered Nurse Preceptors’ Teaching Competencies: Pretest and Posttest Study
Authors: Wu Xi Vivien , Chi Yuchen , Panneer Selvam Umadevi , Devi M Kamala , Wang Wenru , Chan Yah Shih , Wee Fong Chi , Zhao Shengdong , Sehgal Vibhor , Ang Neo Kim Emily
Published: April 2020

Background

Clinical nursing education provides opportunities for students to learn in multiple patient care settings, receive appropriate guidance, and foster the development of clinical competence and professionalism. Nurse preceptors guide students to integrate theory into practice, teach clinical skills, assess clinical competencies, and enhance problem-solving and critical thinking skills. Previous research has indicated that the teaching competencies of nurse preceptors can be transferred to students’ clinical learning to enhance their clinical competencies.

Objective

This study aimed to develop a clinical teaching blended learning (CTBL) program with the aid of web-based clinical pedagogy (WCP) and case-based learning for nurse preceptors and to examine the effectiveness of the CTBL program on nurse preceptors’ clinical teaching competencies, self-efficacies, attitudes toward web-based learning, and blended learning outcomes.

Methods

A quasi-experimental single-group pretest and posttest design was adopted. A total of 150 nurse preceptors participated in the CTBL program, which was conducted from September 2019 to December 2019. A set of questionnaires, including the clinical teaching competence inventory, preceptor self-efficacy questionnaire, attitudes toward web-based continuing learning survey, and e-learning experience questionnaire, was used to assess the outcomes before and after the CTBL program.

Results

Compared with the baseline, the participants had significantly higher total mean scores and subdomain scores for clinical teaching competence (mean 129.95, SD 16.38; P<.001), self-efficacy (mean 70.40, SD 9.35; P<.001), attitudes toward web-based continuing learning (mean 84.68, SD 14.76; P<.001), and blended learning outcomes (mean 122.13, SD 14.86; P<.001) after the CTBL program.

Conclusions

The CTBL program provides a comprehensive coverage of clinical teaching pedagogy and assessment strategies. The combination of the WCP and case-based approach provides a variety of learning modes to fit into the diverse learning needs of the preceptors. The CTBL program allows the preceptors to receive direct feedback from the facilitators during face-to-face sessions. Preceptors also gave feedback that the web-based workload is manageable. This study provides evidence that the CTBL program increases the clinical teaching competencies and self-efficacies of the preceptors and promotes positive attitudes toward web-based learning and better blended learning outcomes. The health care organization can consider the integration of flexible learning and intellect platforms for preceptorship education.
Perception of the COVID-19 Pandemic Among Patients With Inflammatory Bowel Disease in the Time of Telemedicine: Cross-Sectional Questionnaire Study (Preprint)
Authors: Zingone Fabiana , Siniscalchi Monica , Savarino Edoardo Vincenzo , Barberio Brigida , Cingolani Linda , D'Incà Renata , De Filippo Francesca Romana , Camera Silvia , Ciacci Carolina
Published: April 2020

BACKGROUND

After the COVID-19 outbreak, the Italian Government stopped most regular health care activity. As a result, patients with inflammatory bowel disease (IBD) had limited access to outpatient clinics and hospitals.

OBJECTIVE

This study aimed to analyze the perception of the COVID-19 emergency among patients with IBD during the early weeks of the lockdown.

METHODS

We invited adult patients with IBD from the University of Salerno (Campania, South Italy) and the University of Padua (Veneto, North Italy) by email to answer an ad hoc anonymous survey about COVID-19. We also collected data on demographic and disease characteristics.

RESULTS

In total, 167 patients with IBD from Padua and 83 patients from Salerno answered the survey (age: mean 39.7 years, SD 13.9 years; female: n=116, 46.4%). We found that patients with IBD were particularly worried about the COVID-19 pandemic (enough: 77/250, 30.8%; much/very much: 140/250, 56.0%), as they felt more vulnerable to COVID-19 due to their condition (enough: 70/250, 28.0%; much/very much: 109/250, 43.6%). Patients with IBD from the red zone of Veneto were more worried than patients from Campania (P=.001), and men felt more susceptible to the virus than women (P=.05). Additionally, remote medicine was appreciated more by younger patients than older patients (P=.04).

CONCLUSIONS

The results of our survey demonstrate that the lockdown had a significant impact on the psychological aspects of patients with IBD and suggest the need for increasing communication with patients with IBD (eg, through telemedicine) to ensure patients receive adequate health care, correct information, and proper psychological support.
COVID-19 and Slums: A Pandemic Highlights Gaps in Knowledge About Urban Poverty (Preprint)
Authors: Friesen John , Pelz Peter F
Published: April 2020

UNSTRUCTURED

According to the United Nations, about 1 billion persons live in so-called slums. Numerous studies have shown that this population is particularly vulnerable to infectious diseases. The current COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, emphatically underlines this problem. The often high-density living quarters coupled with a large number of persons per dwelling and the lack of adequate sanitation are reasons why measures to contain the pandemic only work to a limited extent in slums. Furthermore, assignment to risk groups for severe courses of COVID-19 caused by noncommunicable diseases (eg, cardiovascular diseases) is not possible due to inadequate data availability. Information on people living in slums and their health status is either unavailable or only exists for specific regions (eg, Nairobi). We argue that one of the greatest problems with regard to the COVID-19 pandemic in the context of slums in the Global South is the lack of data on the number of people, their living conditions, and their health status.
Guiding Pay-As-You-Live Health Insurance Models Toward Responsible Innovation in Health (Preprint)
Authors: Alami Hassane , Rivard Lysanne , de Oliveira Robson Rocha , Lehoux Pascale , Cadeddu Stéphanie Bernadette Mafalda , Savoldelli Mathilde , Ag Ahmed Mohamed Ali , Fortin Jean-Paul
Published: April 2020

UNSTRUCTURED

While the transition toward digitalized health care and service delivery challenges many publicly and privately funded health systems, patients are already producing a phenomenal amount of data on their health and lifestyle through their personal use of mobile technologies. To extract value from such user-generated data, a new insurance model is emerging called Pay-As-You-Live (PAYL). This model differs from other insurance models by offering to support clients in the management of their health in a more interactive yet directive manner. Despite significant promises for clients, there are critical issues that remain unaddressed, especially as PAYL models can significantly disrupt current collective insurance models and question the social contract in so-called universal and public health systems. In this paper, we discuss the following issues of concern: the quantification of health-related behavior, the burden of proof of compliance, client data privacy, and the potential threat to health insurance models based on risk mutualization. We explore how more responsible health insurance models in the digital health era could be developed, particularly by drawing from the Responsible Innovation in Health framework.
Nomogram for Predicting COVID-19 Disease Progression Based on Single-Center Data: Observational Study and Model Development (Preprint)
Authors: Fan Tao , Hao Bo , Yang Shuo , Shen Bo , Huang Zhixin , Lu Zilong , Xiong Rui , Shen Xiaokang , Jiang Wenyang , Zhang Lin , Li Donghang , He Ruyuan , Meng Heng , Lin Weichen , Feng Haojie , Geng Qing
Published: April 2020

BACKGROUND

In late December 2019, a pneumonia caused by SARS-CoV-2 was first reported in Wuhan and spread worldwide rapidly. Currently, no specific medicine is available to treat infection with COVID-19.

OBJECTIVE

The aims of this study were to summarize the epidemiological and clinical characteristics of 175 patients with SARS-CoV-2 infection who were hospitalized in Renmin Hospital of Wuhan University from January 1 to January 31, 2020, and to establish a tool to identify potential critical patients with COVID-19 and help clinical physicians prevent progression of this disease.

METHODS

In this retrospective study, clinical characteristics of 175 confirmed COVID-19 cases were collected and analyzed. Univariate analysis and least absolute shrinkage and selection operator (LASSO) regression were used to select variables. Multivariate analysis was applied to identify independent risk factors in COVID-19 progression. We established a nomogram to evaluate the probability of progression of the condition of a patient with COVID-19 to severe within three weeks of disease onset. The nomogram was verified using calibration curves and receiver operating characteristic curves.

RESULTS

A total of 18 variables were considered to be risk factors after the univariate regression analysis of the laboratory parameters (P<.05), and LASSO regression analysis screened out 10 risk factors for further study. The six independent risk factors revealed by multivariate Cox regression were age (OR 1.035, 95% CI 1.017-1.054; P<.001), CK level (OR 1.002, 95% CI 1.0003-1.0039; P=.02), CD4 count (OR 0.995, 95% CI 0.992-0.998; P=.002), CD8 % (OR 1.007, 95% CI 1.004-1.012, P<.001), CD8 count (OR 0.881, 95% CI 0.835-0.931; P<.001), and C3 count (OR 6.93, 95% CI 1.945-24.691; P=.003). The areas under the curve of the prediction model for 0.5-week, 1-week, 2-week and 3-week nonsevere probability were 0.721, 0.742, 0.87, and 0.832, respectively. The calibration curves showed that the model had good prediction ability within three weeks of disease onset.

CONCLUSIONS

This study presents a predictive nomogram of critical patients with COVID-19 based on LASSO and Cox regression analysis. Clinical use of the nomogram may enable timely detection of potential critical patients with COVID-19 and instruct clinicians to administer early intervention to these patients to prevent the disease from worsening.
The problem of underdosing with direct-acting oral anticoagulants in elderly patients with nonvalvular atrial fibrillation
Authors: Fernández Carmen Suárez , Gullón Alejandra , Formiga Francesc
Published: April 2020

Unless contraindicated, anticoagulant therapy should be prescribed to elderly patients with atrial fibrillation. Direct-acting oral anticoagulants (DOACs) are superior to vitamin K antagonists for preventing stroke. This, together with their higher net clinical benefit, makes DOACs the treatment of choice in this population. However, due to the concerns about bleeding and the need for dose adjustment based on clinical variables, underdosing of DOACs is common and the risk of stroke high. Drugs with more easily adjusted doses are likely associated with a lower risk of dosing errors and, therefore, a greater protective effect. Correct dosing can ensure a maximal net benefit of DOACs in elderly patients with atrial fibrillation.
Pobreza y vulnerabilidad rural 2008-2018. Impacto de transferencias monetarias en la pobreza rural
Authors: Gaspar Olvera Selene , García Zamora Rodolfo
Published: April 2020

A pesar de la importancia que tiene la población de México en el ámbito rural y la actividad económica que realiza, ésta se ha caracterizado por su histórica condición de pobreza y limitadas oportunidades de desarrollo. En el ámbito rural y entre los no pobres las transferencias monetarias representan el 21.7% del ingreso monetario del hogar y el 28.9% entre la población en pobreza. Entre ellas, las transferencia monetarias vía remesas internas e internacionales y los ingresos monetarios de programas gubernamentales son los más importantes, sin esos recursos el número de pobres sería de poco más de 19 millones, 12.7% más que los estimados considerando ambos rubros y la pobreza extrema rural alcanzaría a 6.3 millones de personas, 26.2% más de los estimados; mientras que la pobreza moderada sería de 12.7 millones de personas en lugar de los estimados en 11.9 millones, 7% más, favoreciendo que los grupos que las reciben sean altamente vulnerable sin esos recursos.
Criminal Justice System Toward Children With Legal Conflict Seen In Justice Restorative Presfective
Authors: Daud Brian Septiadi , Cahyaningtyas Irma
Published: April 2020

The criminal justice system of children is very important in the effort to settle cases. Children are gifts of God that are entrusted to be cared for, guarded, and guided for a good future. In article 1 number 1 of Law no. 11 of 2012 states that what is meant by the juvenile justice system is the whole process of resolving cases of children dealing with the law from the investigation stage to the guidance stage after undergoing the crime. The aims of the study were to find out and analyze the juvenile justice system (SPPA) in conflict with the law and to examine the implementation of legal protection against children in conflict with the law based on Law Number 11 of 2012. The research method used to see the arrangement of this arrangement is juridical-normative legal research, this research is research that is attempted with the system reviewing applicable laws and regulations or applied to a particular legal case and concept. The method of collecting legal material with the document method is to collect library research contained in secondary legal materials, then analyzed deductively. The results of this study are to look at the process of the juvenile justice system based on subsystems, components, the process of achieving justice for restorative justice and the process of implementing child protection based on the applicable laws and regulations.
Preparation and Characterization of Celecoxib Entrapped Guar Gum Nanoparticles Targeted for Oral Drug Delivery against Colon Cancer: An In-Vitro Study
Authors: Chandel Deepika , Uppal Shivani , Mehta Surinder Kumar , Shukla Geeta
Published: April 2020

The present study is an attempt to synthesize nanosized guar gum carriers encapsulating celecoxib as the chemopreventive agent for experimental colorectal cancer (CRC).  Guar gum nanoparticles without celecoxib (eGGNPs) and celecoxib loaded guar gum nanoparticles (cGGNPs) were prepared by oil-in-water emulsification and in situ polymer crosslinking method. Electron microscopy, zeta potential and fourier transform infrared spectra analysis was used to affirm the size, stability and morphology of the nanoparticles. In-vitro drug release was investigated using dialysis method. Further, the effect of nanoparticles (eGGNPs & cGGNPs) was evaluated on Caco 2 colon cancer cell lines. Spherical guar gum nanoparticles were obtained in the size range of 200±6nm with zeta potential of -32.1mV indicating good stability of the GGNPs with drug loading of 30±3.2%, and drug release following zero order kinetics. The eGGNPs had no effect on Caco2 cell viability whereas the cGGNPs showed time and concentration dependent growth inhibition of Caco 2 cells. These findings suggest the successful preparation of chemopreventive nanoparticles that can be targeted as the prophylactic agent for experimental colorectal cancer.

Keywords: nanoparticles, guar gum, celecoxib, colorectal cancer, release kinetics, cytotoxicity
Biochemical and Toxicological Evaluations of Aqueous Extract of Parquetina nigrescens (Afzel.) leaves on Mifepristone-induced Polycystic Ovarian Syndrome in Rats
Authors: Femi-olabisi Fehintoluwa Joy , Faokunla Opeyemi , Agboola Anthonia Oluyemi , Olorunyolemi Imoleayo Moses
Published: April 2020

The biochemical and toxicological effects of aqueous extract of Parquetina nigrescens leaves (AEPNL) at the doses of 50, 100, and 200 mg/kg body weight on mifepristone-induced in Polycystic Ovarian Syndrome (PCOS) was investigated in female Wistar rats. Sixty female Wistar rats (190.00 ± 13.00 g) were assigned into 6 groups (A - F) of ten each: animals in group A received 0.5 ml of distilled water orally on daily basis for 30 days while the mifepristonized rats in groups B, C, D and E also received orally 0.5 ml of distilled water, 7.14mg/kg of metformin (reference drug) and same volume of the extract corresponding to 50, 100, and 200 mg/kg body weight of AEPNL respectively after which levels of some biochemical and toxicological indices were determined. AEPNL aggravated mifepristone-treatment related increases in albumin, total protein and liver aspartate aminotransferase activity and mitigated the increases in globulin, total bilirubin, urea, creatinine, liver and serum alkaline phosphatase and alanine aminotransferase activities, and no treatment-related histoarchitectural changes occurred in the liver, kidney and uterus of the female rats. Therefore, the aqueous extract of Parquetina nigrescens leaves attenuated and also aggravated some biochemical parameters in the serum, liver and kidney but with no histological changes in the liver, kidney and uterus of the mifepristonized female Wistar rats.

Keywords: Mifepristone, toxicology, Parquetina nigrescens, Polycystic Ovarian Syndrome, histology
Relation between low birth weight and Maternal blood lead levels in Sidi Bel Abbes, Algeria: a case-control study
Authors: Demmouche Abbassia , Moussaoui Faiza
Published: April 2020

Background: Several epidemiological studies have investigated high lead (Pb) exposure and pregnancy outcomes,but few studies have investigated the association of low lead exposure and low birth weight (LBW). The aims of this study were to estimate the maternal blood lead levels (BLL), to identify determinants for BLL among parturient woman and to evaluate the association of maternal BLL andLBW. Methods: From July 2017 to February 2018, we carried out a case control study in the genecology and obstetrics hospital of Sidi Bel Abbes, Algeria. Lead concentrations in maternal blood samples collected at delivery were measured in 29mother who delivered term LBW cases group and 29mother who give birth to a term normal weight baby matched controls.Blood lead levels were analyzed by inductively coupled plasma mass spectrometry. Results: Mean maternal BLLwere higher among normal groups than in mothers of LBW, but this difference was not significant (23,076 ±16,120, versus 18,086 ± 6,641 ug/l p=0.247).Our results indicate that the mean lead level was nothigher in LBW neonates, and the whole blood lead was not related to the birth weight. In addition,there was interaction of daily kohl use and maternal BLL. Conclusion:This study suggeststhat maternal BLL was not significantly associated with LBW. Mothers with daily use of kohl during pregnancy were more likely to have elevate blood lead concentrations.

Keywords: case-control study, low birth weight, Algeria, lead, kohl.
Current Trend in Performance of Forced Degradation Studies for Drug Substance and Drug Product’s
Authors: Bhaskar Rajveer , Ola Monika , Agnihotri Vinit , Chavan Arjun , Girase Harpalsing
Published: April 2020

The stability of a new drug substances and new drug products is a vital parameter which may affect purity, safety & potency. Changes in drug stability can threat patient safety by formation of toxic degradation products or deliver to lower dose than expected. Therefore it is to know the purity profile & behaviour of a drug substances under the various environmental condition.  Forced Degradation studies show the chemical behavior of the molecule which in turn helps in the  development of  new formulation & package . Degradation study is required to the design of a regulatory compliant stability program for the both drug substances & products, and formalized as a regulatory requirement in ICH Guideline Q1A in 1993. Forced degradation studies (chemical and physical stress testing) of new chemical entities and drug product which is required to develop and demonstrate the specificity i.e stability indicating method. Forced degradation studies used to determination of the degradation pathways and degradation product of drug substances i.e during storage, development, manufacturing and packaging Thus , this review discusses the current trends in performance of forced degradation studies by provide the information about strategy for conducting the studies of forced degradation

Keywords: - Regulatory Guidelines (ICH, FDA, EMA), Degradation condition, Forced degradation, Degradation product.
Features of the process of transnationalization of bank capital and its implications for host economies
Authors: Petrov Nikita A. , Abramov Dmitrii V.
Published: April 2020

The emergence of new factors affecting the dynamics of the number of branches of national banks, stricter financial policies of national economies aimed at controlling the performance of financing operations by transnational financial institutions, increasing the range of services provided by transnational banks are currently contributing to a change in the strategy for realizing the economic interests of transnational banks. It is economically inexpedient to compete with transnational banks of developed economies for banks in developing countries. The options for promoting their services and gaining market share can be the search for a certain category of customers who can’t afford the services of international banks, as well as the conclusion of transactions for joint project financing of the largest national industrial and infrastructure projects. In this paper, we study the process of transnationalization of bank capital in the face of changes in the institutional environment of countries - recipients of capital.
Technical efficiency of smallholder honey farmers in Jimma zone, Ethiopia
Authors: Legesse Hailemariam , Bekele Yadeta , Bayissa Mulubrihan , Lemma Tsega
Published: April 2020

This study analyzes technical efficiency and determinants of the efficiency of honey production in the Gomma and Gera districts of the Jimma zone. The data were obtained from 194 randomly selected honey-producing smallholder farmers. A Cobb - Douglas stochastic frontier production analysis with the inefficiency effect model was used to estimate technical efficiency and identify the determinants of efficiency variations among honey farmers. The study showed that several hives and supplementary feeds positively and significantly influenced honey yield. This shows that there is room to increase honey productivity from the current level if farmers can efficiently use these input variables. The result further showed that there were differences in technical efficiency among honey producers in the study area. The discrepancy ratio, γ, which measures the relative deviation of output from the frontier level due to inefficiency, was about 84%. This implies that about 84% of the variation in honey output among the farmers was attributed to technical inefficiency effects. The estimated mean level of technical efficiency of honey producers was about 74%. This reveals that there is a possibility to increase the level of honey output by about 26% through exploiting the existing local practices and technical knowledge of the relatively efficient farmers. The education level of the farmer, landholding, income, extension contact, and training were found to determine technical efficiency significantly. Therefore, the concerned sector should focus on the above variables to enhance the technical efficiency of honey producers in the study area.
Book review: “Innovation in financial restructuring: Focus on signals, process and tools”
Authors: Guido Max Mantovani
Published: April 2020

This review covers the book titled “Innovation in financial restructuring: Focus on signals, processes and tools”, which was written by Marco Tutino and Valerio Ranciaro (Virtus Interpress, 2020; ISBN: 978-6-177309-10-8). The review shortly outlines the fundamental questions researched in the book, pays attention to its strong sides and issues that will be, by the reviewer’s point of view, most interesting for the reader and focuses on the contribution of this book to the ongoing discussion on key questions relating to financial practices in restructuring processes.
The effect of injectable platelet-rich fibrin use in the initial treatment of chronic periodontitis
Authors: Vuckovic Mila , Nikolic Nadja , Milasin Jelena , Djordjevic Vladan , Milinkovic Iva , Asotic Jasminka , Jezdic Zoran , Jankovic Sasa , Aleksic Zoran
Published: April 2020

Introduction/Objective. The objective of the study was to investigate whether there are differences in therapeutic effect between initial treatments of chronic periodontitis [scaling and root planning (SRP)] alone and SRP in conjunction with injectable platelet-rich fibrin (I-PRF) application, comparing clinical parameters after three months. Methods. Twenty-four patients with chronic periodontitis who had at least two sites with probing pocket depth (PPD) ? 5 mm on contralateral side participated in the study. Using a split-mouth design, the patients were treated with SRP + I-PRF (study group) or SRP only (control group). The clinical parameters, clinical attachment level (CAL), gingival margin level (GML), PPD, bleeding on probing, and plaque index, were recorded on both sides. Results. Compared to baseline, both treatment modalities demonstrated an improvement in investigated clinical parameters. The mean value of CAL was reduced from 1.97 ? 0.75 (0.25?3.31) to 1.07 ? 0.44 (0.12?1.78) in the study group, whereas it decreased from 1.81 ? 0.66 (0.42?2.96) to 1.48 ? 0.55 (0.22?2.30) in the control group. Similarly, the corresponding values for GML and PPD showed statistically significant difference between the groups (p = 0.040 and p = 0.006, respectively). Conclusion. Regardless the limited number of patients in the study, initial periodontal therapy in conjunction with injectable platelet-rich fibrin proved to display significant improvement in all clinical parameters compared to initial periodontal therapy alone.
Cost and Cost-effectiveness of Large-scale Screening for Type 1 Diabetes in Colorado
Authors: McQueen R. Brett , Geno Rasmussen Cristy , Waugh Kathleen , Frohnert Brigitte I. , Steck Andrea K. , Yu Liping , Baxter Judith , Rewers Marian
Published: April 2020

OBJECTIVE

To assess the costs and project the potential lifetime cost-effectiveness of the ongoing Autoimmunity Screening for Kids (ASK) program, a large-scale, presymptomatic type 1 diabetes screening program for children and adolescents in the metropolitan Denver region.

RESEARCH DESIGN AND METHODS

We report the resource utilization, costs, and effectiveness measures from the ongoing ASK program compared with usual care (i.e., no screening). Additionally, we report a practical screening scenario by including utilization and costs relevant to routine screening in clinical practice. Finally, we project the potential cost-effectiveness of ASK and routine screening by identifying clinical benchmarks (i.e., diabetic ketoacidosis [DKA] events avoided, HbA1c improvements vs. no screening) needed to meet value thresholds of $50,000–$150,000 per quality-adjusted life-year (QALY) gained over a lifetime horizon.

RESULTS

Cost per case detected was $4,700 for ASK screening and $14,000 for routine screening. To achieve value thresholds of $50,000–$150,000 per QALY gained, screening costs would need to be offset by cost savings through 20% reductions in DKA events at diagnosis in addition to 0.1% (1.1 mmol/mol) improvements in HbA1c over a lifetime compared with no screening for patients who develop type 1 diabetes. Value thresholds were not met from avoiding DKA events alone in either scenario.

CONCLUSIONS

Presymptomatic type 1 diabetes screening may be cost-effective in areas with a high prevalence of DKA and an infrastructure facilitating screening and monitoring if the benefits of avoiding DKA events and improved HbA1c persist over long-run time horizons. As more data are collected from ASK, the model will be updated with direct evidence on screening effects.
Hospitalization for Lactic Acidosis Among Patients With Reduced Kidney Function Treated With Metformin or Sulfonylureas
Authors: Chu Patricia Y. , Hackstadt Amber J. , Chipman Jonathan , Griffin Marie R. , Hung Adriana M. , Greevy Robert A. , Grijalva Carlos G. , Elasy Tom , Roumie Christianne L.
Published: April 2020

OBJECTIVE

To compare the risk of lactic acidosis hospitalization between patients treated with metformin versus sulfonylureas following development of reduced kidney function.

RESEARCH DESIGN AND METHODS

This retrospective cohort combined data from the National Veterans Health Administration, Medicare, Medicaid, and the National Death Index. New users of metformin or sulfonylureas were followed from development of reduced kidney function (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2 or serum creatinine ≥1.4 mg/dL [female] or 1.5 mg/dL [male]) through hospitalization for lactic acidosis, death, loss to follow-up, or study end. Lactic acidosis hospitalization was defined as a composite of primary discharge diagnosis or laboratory-confirmed lactic acidosis (lactic acid ≥2.5 mmol/L and either arterial blood pH <7.35 or serum bicarbonate ≤19 mmol/L within 24 h of admission). We report the cause-specific hazard of lactic acidosis hospitalization between metformin and sulfonylureas from a propensity score–matched weighted cohort and conduct an additional competing risks analysis to account for treatment change and death.

RESULTS

The weighted cohort included 24,542 metformin users and 24,662 sulfonylurea users who developed reduced kidney function (median age 70 years, median eGFR 55.8 mL/min/1.73 m2). There were 4.18 (95% CI 3.63, 4.81) vs. 3.69 (3.19, 4.27) lactic acidosis hospitalizations per 1,000 person-years among metformin and sulfonylurea users, respectively (adjusted hazard ratio [aHR] 1.21 [95% CI 0.99, 1.50]). Results were consistent for both primary discharge diagnosis (aHR 1.11 [0.87, 1.44]) and laboratory-confirmed lactic acidosis (1.25 [0.92, 1.70]).

CONCLUSIONS

Among veterans with diabetes who developed reduced kidney function, occurrence of lactic acidosis hospitalization was uncommon and not statistically different between patients who continued metformin and those patients who continued sulfonylureas.
Clinical and Public Health Implications of 2019 Endocrine Society Guidelines for Diagnosis of Diabetes in Older Adults
Authors: Fang Michael , Echouffo-Tcheugui Justin B. , Selvin Elizabeth
Published: April 2020

OBJECTIVE

Screening for diabetes is typically done using hemoglobin A1c (HbA1c) or fasting plasma glucose (FPG). The 2019 Endocrine Society guidelines recommend further testing using an oral glucose tolerance test (OGTT) in older adults with prediabetic HbA1c or FPG. We evaluated the impact of this recommendation on diabetes prevalence, eligibility for glucose-lowering treatment, and estimated cost of implementation in a nationally representative sample.

RESEARCH DESIGN AND METHODS

We included 2,236 adults aged ≥65 years without known diabetes from the 2005–2016 National Health and Nutrition Examination Survey. Diabetes was defined using: 1) the Endocrine Society approach (HbA1c ≥6.5%, FPG ≥126 mg/dL, or 2-h plasma glucose ≥200 mg/dL among those with HbA1c 5.7–6.4% or FPG 100–125 mg/dL); and 2) a standard approach (HbA1c ≥6.5% or FPG ≥126 mg/dL). Treatment eligibility was defined using HbA1c cut points (≥7% to ≥9%). OGTT screening costs were estimated using Medicare fee schedules.

RESULTS

Diabetes prevalence was 15.7% (∼5.0 million) using the Endocrine Society’s approach and 7.3% (∼2.3 million) using the standard approach. Treatment eligibility ranged from 5.4% to 0.06% and 11.8% to 1.3% for diabetes cases identified through the Endocrine Society or standard approach, respectively. By definition, diabetes identified exclusively through the Endocrine Society approach had HbA11c <6.5% and would not be recommended for glucose-lowering treatment. Screening all older adults with prediabetic HbA1c/FPG (∼18.3 million) with OGTT could cost between $737 million and $1.7 billion.

CONCLUSIONS

Adopting the 2019 Endocrine Society guidelines would substantially increase the number of older adults classified as having diabetes, require significant financial resources, but likely offer limited benefits.
Özel Gereksinimli Çocuklar İçin Tasarlanan Elektronik Performans Destek Sisteminin Kâğıt Prototip Kullanılabilirliği
Authors: AKIN Tayfun , KOÇAK USLUEL Yasemin
Published: April 2020

Makalenin Erken çocukluk aşamasında gelişim ile ilgili kritik dönemler fazladır. Bu nedenle özel eğitime ihtiyaç duyan çocukların gelişimlerini desteklemek için çeşitli yollar arandığı bilinmektedir. Buradan hareketle erken çocukluk özel eğitiminde erken müdahaleyi desteklemek amacıyla 0-6 yaş arası çocukların gelişimlerini izleyip raporlamaya ve öğretmenlerin veya uygulayıcıların performanslarını desteklemeye yönelik bir Elektronik Performans Destek Sistemine (EPDS) gereksinim olduğu belirlenmiştir. Bu çalışmada, geliştirilmesi planlanan EPDS’nin kullanılabilirlik çalışmalarından ilki olan kâğıt prototip kullanılabilirlik çalışması, süreç ve sonuçlarıyla paylaşılmıştır. Bilindiği gibi tasarım sürecinin başında, kâğıt prototiplerin hızlıca üretilmesi, kullanıcı deneyimlerinin göz önünde bulundurularak bir sistemde değiştirilmesi gereken yerlerin hızlı ve ucuz bir şekilde öğrenilmesine katkı sağlamaktadır. Öncelikle, EPDS’nin tasarlanabilmesi için sekiz kişi ile ihtiyaç analizi çalışması yapılmıştır. Kâğıt üzerinde tasarlanan EPDS’nin kullanılabilirlik çalışması için beşi özel eğitim kurumu çalışanı bir tanesi de uzman tasarımcıdan oluşan altı kişi ile çalışılmıştır. Veriler yarı yapılandırılmış görüşme formu, video ve ses kayıtları ile toplanmıştır. Toplanan veriler, görev tamamlama durumu temel alınarak analiz edilmiştir. Analiz sonucunda görevlerin uygulanması ve tamamlanması için yapılması gereken değişiklikler belirlenerek, öneriler ortaya konulmuştur. Alanyazında da belirtildiği gibi, sistemde, danışman/uzman sistem, öğretimsel sistem ve kişiselleştirilmiş araçlar önemli bileşenler olarak ortaya çıkmıştır. Sonuç olarak bu çalışma ile gerçek kullanıcıların gereksinimleri doğrultusunda, erken çocukluk özel eğitimine yönelik erken müdahale konusunda geliştirilmesi düşünülen sistemin tasarım aşamasının temeli oluşturulmuştur.
Aile Özellikleri ve Mutluluk: Çanakkale’de Lise Öğrencileri Üzerine Bir Araştırma
Authors: DEMİR Ümit
Published: April 2020

Mutluluk çok eskiden beri merak edilen bir konudur. Mutluluğun tanımı ve mutluluğa nasıl ulaşılabileceği çok eski dönemlerden beri sorgulanmaktadır. Mutluluğun temelinde sosyal iletişim ve etkileşim düzeyinin olduğu belirtilmektedir. Kişilerin en temel etkileşim ve iletişim alanları aileleridir. Bu çalışmada, lise öğrencilerinin aile özelliklerine (aile yapısı, annebaba tutumu, aile gelir düzeyi, ailece geçirilen zaman) göre mutluluk düzeylerinin farklılaşma durumu araştırılmıştır. Araştırmanın örneklemini, Çanakkale merkez ilçesinde bir ortaöğretim kurumunda öğrenimlerine devam etmekte olan 489 öğrenci oluşturmaktadır. Araştırma kapsamında Hills ve Argyle tarafından geliştirilmiş ve Doğan ve Sapmaz (2012) tarafından Türkçeye uyarlaması gerçekleştirilen “Oxford Mutluluk Ölçeği” kullanılmıştır. Ölçeğin iç tutarlılığını belirleme amacıyla yapılan analizde Cronbach alfa güvenilirlik katsayısı 0,76 olarak hesaplanmıştır. Verilerin çözümlenmesinde betimsel istatistik çözümleme yöntemlerinden yararlanılarak SPSS istatistik programı kullanılmıştır. Araştırma sonucunda; ailenin yapısına, anne babanın çocuklarına yönelik tutumlarına, aile gelir düzeylerine göre mutluluk puanları anlamlı bir farklılık gösterirken, ailece geçirilen zamana göre ise mutluluk puanları anlamlı farklılık göstermemiştir. Geniş, demokratik, orta gelir düzeyine sahip ailelerin çocuklarının diğerlerine kıyasla çok daha mutlu oldukları bulunmuştur.
Sosyal Bilgiler Öğretimi Bağlamında İlkokul Öğrencilerinin Doğaya Yönelik Algılarının Metaforlar Yoluyla İncelenmesi
Authors: ŞEKERCİ Hanifi , DOĞAN Midrabi Cihangir
Published: April 2020

İlkokul düzeyinde doğa eğitimi bir ders olarak yer almamaktadır. Ancak doğa eğitimi ile ilgili konular Hayat Bilgisi, Sosyal Bilgiler ve Fen Bilimleri derslerinin ünite ve öğrenme alanlarına serpiştirilmiştir. Öğrencilerin doğa ile ilgili sorunlara duyarlılık göstermesi ve doğa sevgisi kazanması Sosyal Bilgiler öğretiminin vatandaşlık becerileri ve değerleri arasında yer almaktadır. Bu bakımdan öğrencilerin doğaya ilişkin algılarının belirlenerek öğretim sürecinde bunlardan yararlanılması önemli görülmüştür. Bundan dolayı araştırmada ilkokul öğrencilerinin doğaya ilişkin sahip oldukları algıların metaforlar aracılığı ile incelenmesi amaçlanmıştır. Araştırmada, nitel araştırma desenlerinden olgu bilim deseni ve örneklem seçiminde ölçüt örneklem tekniği kullanılmıştır. Buna göre 2018- 2019 eğitim öğretim yılında ilkokul 4. sınıfta öğrenim gören 151 öğrenci araştırmaya katılmıştır. Araştırmada veri toplama aracı olarak öğrencilere “doğa......... gibidir. Çünkü..........” ifadesinin yer aldığı form dağıtılarak onların doğaya ilişkin algıları belirlenmeye çalışılmıştır. Öğrenciler tarafından doldurulan formlar toplanmış ve elde edilen verilerin analizinde içerik analizi tekniğinden yararlanılmıştır. Araştırma bulgularına göre ilkokul öğrencileri “doğa” kavramı ile ilgili 54 geçerli metafor üretmiştir. Bu metaforlar özellikleri bakımında 12 kavramsal kategori altında toplanmıştır. Araştırmada elde edilen bulgular öğrencilerin doğaya yönelik algılarının belirlenmesinde metaforların oldukça işlevsel özelliklerinin olduğunu ve Sosyal Bilgiler öğretimi açısından önemli veriler sağladığını ortaya koymaktadır.
Pesquisar, ensinar, mas também divulgar
Authors: Bagno Marcos
Published: April 2020

Texto de popularização do conhecimento científico elaborado pelo professor Marcos Bagno.
Apresentação
Authors: Simões Neto Natival Almeida , Lopes Mailson Dos Santos
Published: April 2020

LaborHistórico - Volume 6, número 1 (Morfologia Histórica).Este número reúne relevantes artigos em torno de descrições morfológicas das línguas românicas, além de fontes primárias, resenha e um trabalho de popularização do conhecimento.
DEL PRIORE, Mary. D. Maria I: as perdas e as glória da rainha que entrou para a história como “a louca”. São Paulo: Benvirá, 2019, 224 p. ISBN: 978-85-5717-316-3
Authors: Módolo Marcelo , Belleza Negro Helena De Oliveira , Fernandes Nathalia Reis , Porto Narayan Pereira , Dias Fábio Garcia
Published: April 2020

Resenha crítica da obra DEL PRIORE, Mary. D. Maria I: as perdas e as glória da rainha que entrou para a história como “a louca”. São Paulo: Benvirá, 2019, 224 p. ISBN: 978-85-5717-316-3
Morfología polínica de Veronica L. (Scrophulariaceae) en el Suroeste de España
Authors: Fernández Inmaculada , Juan Rocío , Pastor Julio
Published: April 2020

Se estudia la morfología polínica, al microscopio óptico y electónico de barrido, de 13 taxones de Veronica L.: V. scutellata, V. anagallis-aquatica, V. anagalloides, V. thriphyllos, V. praecox, V. arvensis, V. peregrina, V. polita, V. agrestis, V. persica, V. cymbalaria, V. hederifolia subsp. hederifolia y V. hedertfolia subsp. triloba. Los resultados confirman el carácter euripolínico del género. Se establecen dos tipos polínicos basados en el modelo de ornamentación. Por último, se discuten los resultados obtenidos y la relación entre los datos palinológicos y otros datos morfológicos.
Teucriuin x carvalhoi (Lamiaceae) nuevo híbrido para el Sudeste Ibérico
Authors: Carrillo A. Félix , Hernández Antonio , Coy Ernesto , Güemes Jaime , Sánchez-Gómez Pedro
Published: April 2020

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A New Generalization of Pochhammer Symbol and Its Applications
Authors: Şahin Recep , Yağcı Oğuz
Published: April 2020

In this paper, we introduce a new generalization of the Pochhammer symbol by means of the generalization of extended gamma function (4). Using the generalization of Pochhammer symbol, we give a generalization of the extended hypergeo-metric functions one or several variables. Also, we obtain various integral representations, derivative formulas and certain properties of these functions.
TINJAUAN KELAYAKAN EKONOMI RENCANA PEMBANGUNAN JALAN KRUENG MEUSAGOP – TEUPIN MANE DARI ASPEK PENGEMBANGAN WILAYAH DAN PRODUCER SURPLUS
Authors: Marwan Marwan , M. Saleh Sofyan , Sugiarto Sugiarto
Published: April 2020

Economy of the community which will develop around the project sides that which on 7 sub-districts that are Simpang Mamplam, Pandrah, Jeunib, Peulimbang, Peudada, Jeumpa and Juli sub-district  that are the area  of superior commodity land on 7 sub-districts with surplus producer. The purpose of this research is to know how much benefit obtained from regional development and producer surplus of this road construction and and evaluate economic feasibility based on Benefit Cost Ratio (BCR). Scope of this research is scenario which covers plantation, agriculture, and farm sector that guided by plan of spatial pattern on Bireun District in 2012-2032 and this research was conducted in 7 sub-district which is in construction plan site of road Krueng Meusagop – Teupin Mane.  Scenario results for 20 years since the road opened (2020-2040) economic benefits and advantages gained on the plantation area is Rp. 790.074.000.000,-, in the agriculture sector is Rp. 753.843.376.000,- and in farm sector is Rp. 455.340.741.000,-. Based on the economic evaluation of this road construction with a 20-year analysis period is meet the economic feasibility standards on the discount rate of 10% BCR value is 1,32 and NPV value is Rp. 89.228.473.000,-, discount rate of 12%  BCR value is1,06 NPV value is Rp.  14.409.843.000,-.while on the discount rate 15% BCR value is 0,77.
PERENCANAAN LAPIS TAMBAH PERKERASAN PADA RUAS JALAN LAMBARO – BATAS PIDIE
Authors: Fachrun Rizaldi , Isya Muhammad , Saleh Sofyan M.
Published: April 2020

Lambaro - Batas Pidie is a highway that located in Aceh Besar District, and has important function as a national highway. This highway is connecting from Aceh Besar District to Pidie District, started from Ingin Jaya District to Lembah Seulawah District. There is pavement damage that needs overlay activity in the highway, so the pavement is needed to maintain. This study is performed to find the overlay thick of pavement by using Falling Weight Deflectometer (FWD) and Benkelman Beam (BB) tools. Overlay thick design is based on Design of Overlay Thick of Flexible Pavement by Deflection Method (Pd T-05-2005-B). The segment of this study is in Jalan Lambaro - Batas Pidie highway, the data that taken is from the same point between FWD and BB. This is from STA 14+250 to STA 16+300. To design the overlay, this investigation need the testing result deflection of FWD and BB, then the value result is corrected. After the obtain corrected deflection value, the next process is calculating uniformty factor (FK), representative deflection (Dsbl ov), design deflection (Dstl ov), overlay thick (Ho), factor of overlay thickness (Fo), and corrected overlay thick (HT). The result of this study is the overlay thick from FWD and BB, it is 7 cm for FWD and 9 cm for BB. From the study result, the conclution is the FK value is under 30% and used overlay pavement is concrete asphalt layer with 2,000 MPa Resilient Modulus and minimum stability of Marshall Value is 800 kg.
ANALISIS PENGHEMATAN NILAI WAKTU TEMPUH DAN BIAYA OPERASIONAL KENDARAAN PADA RENCANA PEMBANGUNAN JALAN KRUENG MEUSAGOP-TEUPIN MANE
Authors: Afrizal Afrizal , Saleh Sofyan M , Sugiarto Sugiarto
Published: April 2020

Growth and development of the city or region has implications for the increasing needs of the population. With the increase of population requirement, it will also increase the demand of travel in the form of increased movement activity of people and goods in a region or city, where the activity of this movement absolutely requires adequate transportation facilities and infrastructure both in quality and quantity. This study aims to determine the amount of time cost savings and operational costs of vehicles on alternative roads Krueng Meusagop-Teupin Mane. The data obtained in the form of primary data and secondary data. Primary data are traffic volume and speed data. While secondary data in the form of image data planning, location map, and cost budget plan data. Based on the result of the research, it is found that the operational cost savings of vehicle (BOK) if traffic flow passes Jalan Krueng Meusagop - Teupin Mane Rp 458 / vehicle for passenger car, Rp 1.723 / vehicle for bus and Rp 1.416 / vehicle for truck with BKBOK obtained in the 25th year is Rp. 1,009,412,291,578. while the savings of travel time value obtained if the traffic flow passes through Jalan Krueng Meusagop - Teupin Mane is Rp 21,877 / vehicle for passenger car, Rp 193.229 / vehicle for bus and Rp 24,048 / vehicle for truck with the value of time obtained in year the 25th of Rp. 993.214.592.528.Therefore, the construction of Krueng Meusagop - Teupin Mane Road is very feasible to be built for the achievement of regional development from isolation and also become an alternative way of society from the central region of Aceh if the road in Bireuen City will be congestion.
BIAYA OPERASIONAL KENDARAAN PADA DINAS PERUMAHAN RAKYAT KAWASAN PERMUKIMAN DAN DINAS PEKERJAAN UMUM PENATAAN RUANG PROVINSI ACEH
Authors: Maulana M. Aris , Anggraini Renni , Sugiarto Sugiarto
Published: April 2020

The employee transportation service is an application of traffic management using vanpooling. Vanpooling is an activity of using a vehicle together or sharing a car on the way so that more than one person is in the van in one travel route. Vanpooling is able to reduce the use of private vehicles to the center of the activity with a fleet of special transport employees. The potential for employee specific transport is enormous and 83% agree with the implementation of the traffic management. The employee specific operating freight operational systems are determinations with residential area corridors and passing major road routes at the address of each employee. In the operation of a transport both personal, general and special, not apart from the vehicles operating costs (VOC). Therefore, an analysis of the need for the development of special transportation of employees in the Dinas Perumahan Rakyat Kawasan Permukiman dan Dinas Pekerjaan Umum Penataan Ruang Province of Aceh. The method used in this study is descriptive - quantitative, by distributing questionnaires to obtain quantitative data in determining VOC. The results of the VOC of private and special vehicles are summarized in a descriptive conclusion. The result of the research shows that employee characteristics of the data are processed to determine vehicle operating cost of private vehicles as well as the special transport vehicles of employees. The overall VOC of private vehicles is Rp. 2.486.377.640, while the value VOC of employee specific transport vehicles is Rp. 685.043.840.
ANALISIS PENGARUH KERUSAKAN JALAN TERHADAP KECEPATAN PERJALANAN
Authors: Yusra Cut liliiza , Isya Muhammad , Anggraini Renni
Published: April 2020

Road damage that occurs in some road segments that cause huge losses, especially for road users. It is worth noting that there is no decrease in road quality due to road surface damage. The purpose of this study is to analyze the effect of the rate of damage with the speed of travel. This research took place on Lueng Mane - Tadu Raya Road segment, Kuala Tadu Sub-District, Nagan Raya District over 2000 meters divided into 20 segments with a segment length  of 100 meters. Primary data were collected by actual field survey that is road geometric data, extensive damage to roads and travel speed. The results show that road damage is very influential to the speed of travel, as seen in segment 11 with the value of 18 very ugly road conditions with travel speed reached 28,324 km/h, while in segment 6 PCI value of 100 perfect road conditions (Excellent) travel speed reaches 59,90 km/h, so the equation Y = 0,3202x + 21,264. This shows that the higher the level of damage the lower the speed of travel, the lower the level of damage the higher the speed of travel.