bluuebunny/crossref_metadata_2025_split huggingface dataset:
PEPA: Entwicklung eines Scoring-Modells zur Priorisierung von Prozessen für eine Automatisierung
Authors: Plattfaut Ralf , Koch Julian F. , Trampler Michael , Coners André 
Published: October 2020

ZusammenfassungRobotic Process Automation (RPA) bezeichnet eine Technologie, die die einfache Erstellung von Computerprogrammen (sogenannten Bots) zur Automatisierung von IT-gestützten Geschäftsprozessen über die graphische Benutzeroberfläche ermöglicht. Aktuelle Forschungsbemühungen im Themenfeld RPA haben gezeigt, dass der erfolgreiche Einsatz von RPA allem voran ein realistisches Erwartungsmanagement und eine ausgiebige Prozessaufnahme erfordert. Diese Resultate zeigen die Notwendigkeit von Bewertungsmethoden zur Bestimmung und Klassifizierung von Prozessen im Hinblick auf ihre Verwendbarkeit im Rahmen von RPA.In der Arbeit werden Ergebnisse eines mehrstufigen Design-Science-Research-Projekts im Kontext eines mittelständischen Industrieunternehmens vorgestellt. Genutzt werden dafür strukturierte mehrstufige qualitative Expertenbefragungen mit dem Ziel der Modellbildung. In diesem Projekt wird demnach ein neues Bewertungsmodell zur Messung der Eignung für eine RPA-Implementierung und eine detailliertere Potenzialanalyse entwickelt (PEPA, Prozesseignung und -Priorisierung für Automatisierung). Das PEPA-Modell, von der Konzeptualisierung bis zur Implementierung, konzentriert sich auf seine verallgemeinerbare Anwendung und bietet ein systematisches Vorgehen zur Eignungsanalyse von Prozessen. Es berücksichtigt dabei wirtschaftliche, technologische und prozessuale Kriterien und ermöglicht eine anschließende Priorisierung der Prozesse in Bezug auf ihre Eignung für eine RPA-Implementierung. Damit geht das vorgeschlagene PEPA-Modell über bestehende Modelle aus der Praxis hinaus.
Scoliotic disease: report to the teacher
Authors: Zaidman A. M. 
Published: October 2020

It is with gratitude that I dedicate my work to the teacher, Ya.L. Tsivyan, who not only provided a subject for research, but also, on his own example of a person devoted to his work, brought up a generation of scholars for whom life and science are inseparable.The paper presents the results of many years of research on idiopathic scoliosis in the form of a report to the teacher. Several fundamental topics were considered:1) for the first time in world practice, it was established, on the basis of a study of 50 patients with idiopathic scoliosis, that the etiological factor of scoliosis is ectopic localization of neural crest derivatives, which are not genetically determined to chondrogenic differentiation and the growth process, in the vertebral body growth plate;2) a local disturbance of chondrogenesis in the vertebral body growth plate is the cause of the growth asymmetry and formation of spinal deformity in idiopathic scoliosis;3) the degree of structural changes in the spine and the prognosis of the deformity progression depend on the level of disturbance of the morphogenetic processes in the vertebral body growth plate embedded in embryogenesis;4) it is supposed to confirm the proposed hypotheses by inhibition of thePAX3gene in the chick embryo model of idiopathic scoliosis and to get answers to many more unclear questions concerning scoliotic disease.
Neck and Trunk Strength Training to Mitigate Head Acceleration in Youth Soccer Players
Authors: Müller Carsten , Zentgraf Karen 
Published: October 2020

Abstract
Müller, C and Zentgraf, K. Neck and trunk strength training to mitigate head acceleration in youth soccer players. J Strength Cond Res 35(12S): S81–S89, 2021—Heading in soccer involves repetitive head accelerations that may be detrimental for brain health. One way to mitigate adverse effects may be to increase head-neck stabilization and thus reduce the kinematic response after intentional headers. This study aimed to (a) assess associations between neck strength and head kinematics and (b) evaluate an exercise intervention designed to increase strength and attenuate head acceleration during intentional heading in youth soccer players. In 22 athletes, we used accelerometers to assess associations between neck strength and peak linear acceleration (PLA). We attached the accelerometers to the occiput and sternum, allowing us to differentiate between total, trunk, and head PLA. Longitudinally, we evaluated the effects of a 14-week twice-weekly resistance training in a subsample of 14 athletes compared with regular soccer training (N = 13). Results showed that female athletes had lower isolated neck strength (p ≤ 0.004), lower functional neck strength (p ≤ 0.017), and higher total PLA during purposeful headers compared with males (17.2 ± 3.5 g and 13.0 ± 2.3 g, respectively, at 9.6 m·s−1 ball velocity during impact; p = 0.003). The intervention group showed moderate to large strength gains (

= 0.16–0.42), resulting in lower PLA (total −2.4 g, trunk −0.8 g, and head −1.5 g) during headers. We conclude that a resistance training focusing on cervical and trunk musculature is practicable in youth soccer, elicits strength gains, and helps to mitigate PLA during purposeful heading. Results should encourage youth strength and conditioning professionals to incorporate neck exercises as a risk reduction strategy into their training routine.
Influence of Early-Age Curing Regimes on Late-Age Hydration of UHPC
Authors: Mo Zongyun , Zhou Yunying , Bai Ligai 
Published: October 2020

Abstract
This paper investigates the influence of metakaolin (MK) as well as various early-age curing regimes on late-age hydration of ultrahigh-performance concrete (UHPC) immersed in hot water. To reduce the consumption of cement, we partially substitute cement by limestone (LS) in the UHPC mixture. After 24 h of hardening, UHPC specimens are demolded and exposed to different curing regimes, including standard water curing at 20°C for up to 28 days as well as steam curing at 55°C or 90°C for 24 or 48 h followed by standard water curing for up to 28 days. Afterward, the UHPC mortar and paste specimens are transferred into the water at 80°C and left for predesigned testing ages (7, 14, 21, and 28 d). We evaluate the compressive strength of UHPC mortar as well as hydration and microstructural properties of UHPC paste with the analysis of chemically bound water, differential thermal analysis, and mercury intrusion porosimetry. The results indicate that the compressive strength of the UHPC has an increasing tendency from 28 to 42 days and then a decreasing tendency. The addition of MK alleviates the late-age strength development tendency of the steam-cured UHPC specimens compared with the control mixtures without MK. The hydration results verify this strength development tendency of UHPC from 28–56 days. The ternary MK- and LS-blended UHPC exhibits similar strength development tendency and microstructure with binary paste incorporated with MK at later ages.
HbA1c in a primary care cohort with diabetes and chronic kidney disease: the East and North Hertfordshire Institute of Diabetes and Endocrinology (ENHIDE) Diabetes Renal Telehealth Project
Authors: Winocour Peter H , Moore-Haines Karen , Sullivan Keith , Currie Anne , Solomon Andrew , Hardy Dawn 
Published: October 2020

Aim: Diabetes mellitus and chronic kidney disease (CKD) commonly co-occur. Control of glycaemia is nuanced, and should be individualised. The Diabetes Renal Telehealth Project identified 2,356 adults with diabetes and CKD, and evaluated determinants and patterns of HbA1c in order to identify under-treatment or potential over-treatment of glycaemia.Method: Comprehensive review of GP diabetes registers by the clinical investigators.Results: The study subjects (52% male, 48% female) were aged 77 years (range 19–103) with median estimated glomerular filtration rate 52 (range 3–171) mL/min and median albumin to creatinine ratio 34 (range <0.05–1428) mg/mmol. 81% were solely managed in primary care. Median HbA1c was 57 (range 10–148) mmol/mol (7.4% (3.1–15.7%)) and at the 58 mmol/mol target in 64%. Anaemia was present in 31%. 22% were solely on dietary management, 29% on insulin therapy (6 in 10 of whom were also on additional agents) and 19% were on sulfonylurea (8 in 10 of whom were on additional agents excluding insulin). Patterns of HbA1c over 2 years were stable for 44%, variable in 19%, rising in 12% and improved in 8%. The 13% initially considered at increased hypoglycaemic risk based on HbA1c measures alone had worse renal function and were more frequently anaemic (both p<0.0005), and 83% were treated with insulin and/or sulfonylureas. Hypoglycaemia hospital admissions were low with 10 people admitted over the study period. There was a reduction in age with increasing quintiles of HbA1c, and those with HbA1c >75 mmol/mol (9.0%) were youngest (mean age 68 years, p<0.001).Conclusions: The majority of people with diabetes and CKD are elderly and managed in primary care, with anaemia in 31%, potentially affecting HbA1c interpretation. Iatrogenic hypoglycaemic risk was identified in 10%, with suboptimal glycaemic control (HbA1c >9% (75 mmol/mol)) through under-treatment in 9%. This study uncovered unmet clinical need, requiring both escalation and de-escalation of glycaemic therapies.
Successful remission of type B insulin resistance syndrome without rituximab in an elderly male
Authors: Concepción-Zavaleta Marcio José , Ildefonso-Najarro Sofía Pilar , Plasencia-Dueñas Esteban Alberto , Quispe-Flores María Alejandra , Armas-Flórez Cristian David , Luna-Victorio Laura Esther 
Published: October 2020

Summary
Type B insulin resistance syndrome (TBIR) is a rare autoimmune disease caused by antibodies against the insulin receptor. It should be considered in patients with dysglycaemia and severe insulin resistance when other more common causes have been ruled out. We report a case of a 72-year-old male with a 4-year history of type 2 diabetes who presented with hypercatabolism, vitiligo, acanthosis nigricans, and hyperglycaemia resistant to massive doses of insulin (up to 1000 U/day). Detection of anti-insulin receptor antibodies confirmed TBIR. The patient received six pulses of methylprednisolone and daily treatment with cyclophosphamide for 6 months. Response to treatment was evident after the fourth pulse of methylprednisolone, as indicated by weight gain, decreased glycosylated haemoglobin and decreased requirement of exogenous insulin that was later discontinued due to episodes of hypoglycaemia. Remission was eventually achieved and the patient is currently asymptomatic, does not require insulin therapy, has normal glycaemia and is awaiting initiation of maintenance therapy with azathioprine. Thus, TBIR remitted without the use of rituximab. This case highlights the importance of diagnosis and treatment in a timely fashion, as well as the significance of clinical features, available laboratory findings and medication. Large controlled studies are required to standardise a therapeutic protocol, particularly in resource-constrained settings where access to rituximab is limited.

Learning points:

Type B insulin resistance syndrome is a rare autoimmune disorder that should be considered in patients with dysglycaemia, severe insulin resistance and a concomitant autoimmune disease.

Serological confirmation of antibodies against the insulin receptor is not necessary in all cases due to the high associated mortality without timely treatment.

Although there is no standardised immunosuppressive treatment, a protocol containing rituximab, cyclophosphamide and steroids has shown a significant reduction in previously reported mortality rates.

The present case, reports successful remission in an atypical patient using cyclophosphamide and methylprednisolone, which is an effective therapy in countries in which rituximab is not covered by health insurance.

When there is improvement in the hypercatabolic phase, the insulin dose should be reduced and/or discontinued to prevent hypoglycaemia; a mild postprandial hyperglycaemic state should be acceptable.
Pedagogia freiriana e humanização: revisão de literatura da última década
Authors: Pedro Ketilin Mayra , Ogeda Clarissa Maria Marques , Adurens Fernanda Delai Lucas 
Published: October 2020

Paulo Freire ressignificou a maneira de olhar e ler o mundo, por meio da educação. A abordagem humanista foi um dos grandes legados da sua obra. Para o autor, a educação humanizadora envolve o olhar para pessoa como um sujeito, capaz de pensar, opinar, discordar, problematizar, e não como um objeto, passível de manipulação ou meramente de absorção de conhecimentos. Nesse contexto, o objetivo deste artigo consistiu em revisar sistematicamente a produção nacional stricto sensu relacionada à finalidade humanista da Educação proposta por Paulo Freire. Para tanto, realizou-se um levantamento na Biblioteca Digital Brasileira de Teses e Dissertações, utilizando-se os seguintes descritores: “paulo freire”, “educação” e “humaniza$”. Ao se revisar sistematicamente a literatura, encontraram-se 68 dissertações e teses publicadas na última década, com picos de publicação nos anos de 2012 e 2015, sendo a grande maioria defendida nos Programas de Pós-Graduação em Educação de universidades públicas, quer estaduais, quer federais. Constatou-se que a grande maioria das pesquisas discorre sobre a formação docente com vistas à humanização dos sujeitos formados e também dos próprios formadores. Assim, verificou-se o quanto as contribuições basilares da Pedagogia Freiriana são multidisciplinares, atemporais e se aplicam às problemáticas atuais, que marcam a desigualdade social e desconsideram a diversidade cultural do nosso país.
Determination of Antimicrobial Prescribing Practices in an Integrated Health System Emergency Department
Authors: Sartain Sarah , Price John , Bitner Brooke , Wolfe Elizabeth , Ortiz Daniel 
Published: October 2020

Introduction. Antibiotic stewardship utilizes interprofessional collaborative practices, including professionals from medicine, pharmacy, nursing, social services, and clinical laboratory science, to identify potential problems proactively. A tertiary care integrated health system’s Emergency Department (ED) aimed to identify antimicrobials prescribed to the outpatient community as part of a proactive antimicrobial stewardship project.
Methods. A pilot, prospective, snapshot of a tertiary community hospital’s outpatient antimicrobial prescribing habits was conducted. All subjects were identified via a daily report of patients discharged from the ED over 30 days in the summer of 2017 and individually reviewed for prescribed antimicrobial(s). Exclusions were hospital admission, antimicrobial sensitivity, and antimicrobial courses less than five days or more than 14 days. The primary goal was determining the number of antimicrobial oral tablets/capsule prescriptions to adult outpatients within a 5 to 14-day treatment window. Secondary goals were to include the diagnosis, non-capsule/tablet antimicrobial, pediatric patients, and prescriptions outside the treatment window.
Results. Total number of antimicrobial prescriptions over the 30-day period was 653 in 5,520 individual visits. Total number of adults prescribed oral antimicrobials was 467 (15.6 daily). Patients were diagnosed with infections including urinary tract, cellulitis, soft tissue injury, abscess, upper respiratory, dental caries, gastrointestinal, sexually transmitted, otitis media/externa, pneumonia, viral, pyelonephritis, tick-borne, fungal, Bell’s Palsy, and sepsis. The number of non-adult, non-oral, and outside window treatment antimicrobial prescriptions were 186 (6.2 daily). With an average 184 patients treated in the ED daily, approximately 11.8% received antimicrobial treatment on discharge.
Conclusion. Important aspects of the project were the evaluation of antimicrobial prescribing habits for a midwest ED and identification of potential complications requiring future interventions for follow-up or preventative measures to assist in patient care and community health. Areas of practice improvement were identified inadvertently as a result of this project. Potential future studies included seasonal variability, whether the patient obtained a prescription and complied with treatment, and differences between inpatient and outpatient antimicrobial prescribing practices.
Seizures in Pre-term Infants Less than 29 Weeks: Incidence, Etiology, and Response to Treatment
Authors: Raghuveer Talkad , Zackula Rosey , Gibson Logan , Martin Rebecca , Shah Subhash 
Published: October 2020

Introduction. Seizures are neurological emergencies with short- and long-term adverse effects in pre-term infants. They may present with or without abnormal movements (clinical versus subclinical). Thus, the true incidence of seizures may be under-reported. Current research indicates that most seizures occur in the first few days of life, are associated with intraventricular hemorrhage (IVH), and show low response to anticonvulsant drugs. The purpose of this study was to evaluate incidence, etiology, clinical antecedents, mortality, and response to treatment of seizures in extremely pre-term infants.
Methods. This is a retrospective cohort study of pre-term infants < 29 weeks gestation from January 2011 to December 2013. Presence or absence of seizure was the outcome. Data extraction included demographics, medications, co-morbidities, mortality, and details of seizures. A multivariable prediction model was developed to evaluate risk for seizures.
Results. Analysis included 269 pre-term infants. Incidence of EEG-confirmed seizures was 40% (108/269); 49% were clinical and 51% were subclinical. Seizures occurred in 72% of infants ≤ 24 weeks, 57% of those 25-26 weeks, and 23% of those 27-28 weeks. Most seizures (85%) occurred after day eight of life. Mortality was 14% in those with seizures versus 5% in those without (p = 0.019). The model showed seizures were associated significantly with gestational age and medications, while controlling for sex, APGAR score, and co-morbidities, including IVH. At discharge, anticonvulsants were continued in 66% (72/108) of infants with seizures.
Conclusion. The incidence of seizures was highest in infants born most premature. Contrary to previous research, nearly two-thirds of pre-term infants with seizures did not have IVH or cystic periventricular leukomalacia; apnea of prematurity was a common presentation of subclinical seizures; and the majority of treated infants responded to Phenobarbital. These findings need be explored in future research.
Effectiveness of a Pilot Breastfeeding Educational Intervention Targeting High BMI Pregnant Women
Authors: Jacobson Lisette , Zackula Rosalee , Lu Kelsey 
Published: October 2020

Introduction. Overweight and obesity during pregnancy are associated with adverse health outcomes leading to increased maternal and neonatal morbidity and mortality. Women with a high body mass index (BMI) also experience low breastfeeding rates. There is limited evidence of effective educational programs that aim to improve length of breastfeeding among this population. The main objective of this pilot educational intervention was to determine knowledge and skills retention at six weeks after completion of a breastfeeding class.
Methods. A two-hour breastfeeding class was offered during the second and third trimester of pregnancy targeting high BMI women. A longitudinal, survey study design was conducted using two data collection points. No comparator group was employed.
Results. Baseline mean age of respondents was 26.6 years (SD = 5.7). Respondents who completed post-intervention surveys were largely white (69.2%) followed by Hispanic (15.4%) and non-Hispanic black (15.4%), some college (57.1%), earned less than $50,000/year (64.3%), had employer-provided insurance (53.8%), and did not receive WIC benefits (78.6%). Most respondents had a pre-pregnancy BMI category of overweight (28.6%) or obese (57.1%). The intervention appeared to have some impact on responses. The following were observed: an increased understanding that baby may be fussy in the evening hours and wants to nurse more often (p < 0.002), how to bring baby to the breast (p = 0.004), knowing what to do if breastfeeding hurts (p = 0.031), and knowing what to do when baby has trouble breastfeeding (p = 0.021).
Conclusion. Consistent with previous findings, all participants in our study reported increased knowledge to breastfeed. Thus, women’s confidence to breastfeed their infant is enhanced through knowledge obtained from breastfeeding education. Additional studies are underway to assess breastfeeding behaviors.
Experience with the use of bendamustine (Rozustin®): safety and efficacy
Authors: Semenova A. A. , Arakelyan A. V. , Zeynalova P. A. , Tumyan G. S. , Larionova V. B. , Valiev T. T. , Abbasbeyli F. M. , Timofeeva O. L. , Antipova A. S. , Lopuhova O. A. 
Published: October 2020

Background. Bendamustine is one of the main drugs included in the arsenal of cytostatic agents that are used in oncohematology. In Russia, the drug was registered at the end of 2010 under the commercial name Ribomustin (company Astellas). At the end of 2018, two national generics of bendamustine appeared on the Russian market – Rozustin® (Rafarma) and Kovada (Biocad).Materials and methods. In 2019 the department of hemoblastosis chemotherapy of the N. N. Blokhin National Medical Research Center of Oncology received the drug bendamustin (Rozustin®) (Rafarma, Russia). This article presents the first experience of using Rozustin® in patients with various lymphoproliferative diseases. Most often, the drug was used for relapsed or refractory classical Hodgkin’s lymphoma.Results and conclusion. The high effectiveness, acceptable toxicity profile compared to alternative “salvage” regimens, ease of implementation, and the possibility of a full collection of hematopoietic stem cells followed by high-dose chemotherapy and autologous stem cell transplant, confirm the good potential of the combined program with the inclusion of the drug bendamustine (Rozustin®).
Evaluation of simulated drug dispensing and patient counseling in the course of pharmaceutical improvement: 2009 to 2015
Authors: Packeiser Priscila B. , Castro Mauro S. 
Published: October 2020

Background: Aiming to facilitate the drug dispensing process and patient counseling, specific professional skills are required. The knowledge, skills and attitudes involved in this process can be improved. From 2012 to 2015, a nationwide course was held, in partnership with the Ministry of Health and the Federal University of Rio Grande do Sul (UFRGS) – Brazil, to train pharmacists working in primary health care through the development of their clinical and communication skills. One of the steps in this process involved the simulation of the drug dispensing process and patient counseling.
Objective: To evaluate the performance of pharmacists in drug dispensing and counseling through patient simulation role-playing held in a face-to-face meeting at the end of a training course.
Methods: A cross-sectional and retrospective study with analysis of patient simulation recordings and data collection using an assessment instrument with scores ranging from 0 to 10 points to assess pharmacist's behavior, skills, and technical knowledge.
Results: Participants presented poor-to-regular performance, with median scores equal to or lower than six. The median time of the drug dispensing simulation was five minutes and the patient counseling was eight minutes. Pharmacists had better scores in the simulation of asthma cases. In drug dispensing, 99.5% of pharmacists had difficulty checking the patient's time availability, 98.5% did not know how to use the devices, and 94.7% did not advise the patient on what to do if they forgot to take a dose. In patient counseling simulation, 1.18% of pharmacists remembered to advise on what do with medication leftovers, and 50.6% asked questions that induced the patient's responses.
Conclusions: The low-to-regular performance showed that pharmacists had difficulties at improving their skills in the performance of complete and effective drug dispensing and patient counseling.