bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awareness and practice of medical waste management among healthcare providers in National Referral Hospital
Authors: Letho Zimba , Yangdon Tshering , Lhamo Chhimi , Limbu Chandra Bdr , Yoezer Sonam , Jamtsho Thinley , Chhetri Puja , Tshering Dawa 
Published: January 2021

Introduction
The management and treatment of Medical Waste (MW) are of great concern owing to its potential hazard to human health and the environment, particularly in developing countries. In Bhutan, although guidelines exist on the prevention and management of wastes, the implementation is still hampered by technological, economic, social difficulties and inadequate training of staff responsible for handling these waste. The study aimed at assessing the awareness and practice of medical waste management among health care providers and support staff at the National Referral Hospital and its compliance with the existing National guidelines and policies.

Materials and methods
An observational cross-sectional study was conducted from March to April 2019. Three research instruments were developed and used; (i) Demographic questionnaire, (ii) Awareness questions, and (iii) the Observational checklist. The data was coded and double entered into Epi data version 3.1 and SPSS version 18 was used for analysis. Descriptive statistics were used to present the findings of the study.

Results
The majority of the respondents were female (54.1%) with a mean age of 32.2 (±7.67) years, most of whom have not received any waste management related training/education (56.8%). About 74.4% are aware of medical waste management and 98.2% are aware on the importance of using proper personal protective equipment. Only 37.6% knew about the maximum time limit for medical waste to be kept in hospital premises is 48 hours. About 61.3% of the observed units/wards/departments correctly segregated the waste in accordance to the national guidelines. However, half of the Hospital wastes are not being correctly transported based on correct segregation process with 58% of waste not segregated into infectious and general wastes.

Conclusion
The awareness and practice of medical waste management among healthcare workers is often limited with inadequate sensitization and lack of proper implementation of the existing National guidelines at the study site. Therefore, timely and effective monitoring is required with regular training for healthcare workers and support staff. Furthermore, strengthening the waste management system at National Referral Hospital would provide beneficial impact in enhancing safety measures of patients.
Evaluating survival in subjects with astrocytic brain tumors by dynamic susceptibility-weighted perfusion MR imaging
Authors: White Matthew L. , Zhang Yan , Kazmi Syed A. Jaffar , Aizenberg Michele , Shonka Nicole , Yu Fang , Appiah Adams Kusi 
Published: January 2021

Purpose
Studies have evaluated the application of perfusion MR for predicting survival in patients with astrocytic brain tumors, but few of them statistically adjust their results to reflect the impact of the variability of treatment administered in the patients. Our aim was to analyze the association between the perfusion values and overall survival time, with adjustment for various clinical factors, including initial treatments and follow-up treatments.

Materials and methods
This study consisted of 51 patients with astrocytic brain tumors who underwent perfusion-weighted MRI with MultiHance® at a dose of 0.1 mmol/kg prior to initial surgery. We measured the mean rCBV, the 5% & 10% maximum rCBV, and the variation of rCBV in the tumors. Comparisons were made between patients with and without 2-year survival using two-sample t-test or Wilcoxon rank-sum test for the continuous data, or chi-square and Fisher exact tests for categorical data. The multivariate cox-proportional hazard regression was fit to evaluate the association between rCBV and overall survival time, with adjustment for clinical factors.

Results
Patients who survived less than 2 years after diagnosis had a higher mean and maximum rCBV and a larger variation of rCBV. After adjusting for clinical factors including therapeutic measures, we found no significant association of overall survival time within 2 years with any of these rCBV values.

Conclusions
Although patients who survived less than 2 years had a higher mean and maximum rCBV and a larger variation of rCBV, rCBV itself may not be used independently for predicting 2-year survival of patients with astrocytic brain tumors.
Development and evaluation of a multiplex loop-mediated isothermal amplification (LAMP) assay for differentiation of Mycobacterium tuberculosis and non-tuberculosis mycobacterium in clinical samples
Authors: Kim Jeeyong , Park Borae G. , Lim Da Hye , Jang Woong Sik , Nam Jeonghun , Mihn Do-CiC , Lim Chae Seung 
Published: January 2021

Introduction
The rapid and accurate diagnosis of tuberculosis (TB) is important to reduce morbidity and mortality rates and risk of transmission. Therefore, molecular detection methods such as a real-time PCR–based assay for Mycobacterium tuberculosis (MTB) have been commonly used for diagnosis of TB. Loop-mediated isothermal amplification (LAMP) assay was believed to be a simple, quick, and cost-effective isothermal nucleic acid amplification diagnostic test for infectious diseases. In this study, we designed an in-house multiplex LAMP assay for the differential detection of MTB and non-tuberculosis mycobacterium (NTM), and evaluated the assay using clinical samples.

Material and methods
For the multiplex LAMP assay, two sets of specific primers were designed: the first one was specific for IS6110 genes of MTB, and the second one was universal for rpoB genes of mycobacterium species including NTM. MTB was confirmed with a positive reaction with both primer sets, and NTM was identified with a positive reaction by only the second primer set without a MTB-specific reaction. Total 333 clinical samples were analyzed to evaluate the multiplex LAMP assay. Clinical samples were composed of 195 positive samples (72 MTB and 123NTM) and 138 negative samples. All samples were confirmed positivity or negativity by real-time PCR for MTB and NTM. Analytical sensitivity and specificity were evaluated for the multiplex LAMP assay in comparison with acid fast bacilli staining and the culture method.

Results
Of 123 NTM samples, 121 were identified as NTM and 72/72 MTB were identified as MTB by the multiplex LAMP assay. False negative reactions were seen only in two NTM positive samples with co-infection of Candida spp. All 138 negative samples were identified as negative for MTB and NTM. Analytical sensitivity of the multiplex LAMP assay was 100% (72/72) for MTB, and 98.4% (121/123) for NTM. And the specificity of assay was 100% (138/138) for all.

Conclusions
Our newly designed multiplex LAMP assay for MTB and NTM showed relatively good sensitivity in comparison with previously published data to detect isolated MTB. This multiplex LAMP assay is expected to become a useful tool for detecting and differentiating MTB from NTM rapidly at an acceptable sensitivity.
Screening accuracy of a 14-day smartphone ambulatory assessment of depression symptoms and mood dynamics in a general population sample: Comparison with the PHQ-9 depression screening
Authors: Burchert Sebastian , Kerber André , Zimmermann Johannes , Knaevelsrud Christine 
Published: January 2021

IntroductionMajor depression affects over 300 million people worldwide, but cases are often detected late or remain undetected. This increases the risk of symptom deterioration and chronification. Consequently, there is a high demand for low threshold but clinically sound approaches to depression detection. Recent studies show a great willingness among users of mobile health apps to assess daily depression symptoms. In this pilot study, we present a provisional validation of the depression screening app Moodpath. The app offers a 14-day ambulatory assessment (AA) of depression symptoms based on the ICD-10 criteria as well as ecologically momentary mood ratings that allow the study of short-term mood dynamics.Materials and methodsN = 113 Moodpath users were selected through consecutive sampling and filled out the Patient Health Questionnaire (PHQ-9) after completing 14 days of AA with 3 question blocks (morning, midday, and evening) per day. The psychometric properties (sensitivity, specificity, accuracy) of the ambulatory Moodpath screening were assessed based on the retrospective PHQ-9 screening result. In addition, several indicators of mood dynamics (e.g. average, inertia, instability), were calculated and investigated for their individual and incremental predictive value using regression models.ResultsWe found a strong linear relationship between the PHQ-9 score and the AA Moodpath depression score (r = .76, p < .001). The app-based screening demonstrated a high sensitivity (.879) and acceptable specificity (.745). Different indicators of mood dynamics covered substantial amounts of PHQ-9 variance, depending on the number of days with mood data that were included in the analyses.DiscussionAA and PHQ-9 shared a large proportion of variance but may not measure exactly the same construct. This may be due to the differences in the underlying diagnostic systems or due to differences in momentary and retrospective assessments. Further validation through structured clinical interviews is indicated. The results suggest that ambulatory assessed mood indicators are a promising addition to multimodal depression screening tools. Improving app-based AA screenings requires adapted screening algorithms and corresponding methods for the analysis of dynamic processes over time.
Социология за пределами реальности: постгуманизм и биополитика в сериале «Мир Дикого Запада»
Authors: Сычев Андрей Анатольевич , Коваль Екатерина Александровна , Ушкин Сергей Геннадьевич 
Published: January 2021

В последние годы значительно увеличилось количество сериалов, изображающих искусственный интеллект и его влияние на реальность («Почти человек», «Люди», «Черное зеркало», «Лучше, чем люди», «Проект Анна Николаевна»). В центре интеллектуальных споров оказался «Мир Дикого Запада», спровоцировавший новые дискуссии о постгуманизме и биополитике. Подобные сериалы играют все более существенную роль как в репрезентации реальности, так и в конструировании нарративов о будущем. Наша задача — в том, чтобы использовать сериальный продукт как один из ключей к пониманию основных трендов в формировании новой социальности. Для их интерпретации требуется погружение в мысленный эксперимент, использование герменевтического подхода. Расширительным элементом служит содержательный анализ пользовательских рецензий о «Мире Дикого Запада», размещенных на сайте «КиноПоиск» (всего 147 рецензий). В расчет берутся те, которые отражают отношение зрителей к внутреннему устройству сериала. Художественные образы искусственной социальности могут использоваться как своеобразный тренажер, необходимый в период, когда люди конструируют нормативное пространство сосуществования человека и робота. Разработка этических правил взаимодействия человека с искусственным интеллектом — важное условие этого процесса. Если субъекты искусственного интеллекта обрели сознание (как антропоморфные роботы из «Мира Дикого Запада»), мы вынуждены признать автономию их воли. Если это интеллектуальные автономные системы, лишенные воли, но имеющие определенные способности (например, к самообучению), вопрос о нормативном признании искусственного интеллекта не ставится. Однако не снимается необходимость выработки адекватного отношения к таким субъектам: патологическая жестокость «настоящего человека» в «Мире Дикого Запада» прекрасно иллюстрирует вред, наносимый индивидом окружающим (в том числе тем, кто считается бессознательным субъектом), а в итоге — и себе самому. Подобная проблема нередко рассматривается в контексте взаимоотношений человека и животных или экосистем. Наконец, если искусственный интеллект воспринимается строго инструментально, то потребности в выработке особых этических правил не появится. В разрешении моральных дилемм, связанных с искусственным интеллектом, пригодился бы навык «думать наперед», значимым фактором формирования которого сегодня становится сериальная культура.
Благодарность. Статья подготовлена при финансовой поддержке РФФИ (проект № 19-011-00082).
Implementation of a Standardized Approach to Improve the Pediatric Discharge Medication Process
Authors: Philips Kaitlyn , Zhou Roy , Lee Diana S. , Marrese Christine , Nazif Joanne , Browne Constance , Sinnett Mark , Tuckman Steven , Modi Anjali , Rinke Michael L. 
Published: January 2021

BACKGROUND AND OBJECTIVES:The pediatric inpatient discharge medication process is complicated, and caregivers have difficulty managing instructions. Authors of few studies evaluate systematic processes for ensuring quality in these care transitions. We aimed to improve caregiver medication management and understanding of discharge medications by standardizing the discharge medication process.METHODS:An interprofessional team at an urban, tertiary care children’s hospital trialed interventions to improve caregiver medication management and understanding. These included mnemonics to aid in complete medication counseling, electronic medical record enhancements to standardize medication documentation and simplify dose rounding, and housestaff education. The primary outcome measure was the proportion of discharge medication–related failures in each 4-week period. Failure was defined as an incorrect response on ≥1 survey questions. Statistical process control was used to analyze improvement over time. Process measures related to medication documentation and dose rounding were compared by using the χ2 test and process control.RESULTS:Special cause variation occurred in the mean discharge medication–related failure rate, which decreased from 70.1% to 36.1% and was sustained. There were significantly more complete after-visit summaries (21.0% vs 85.1%; P &lt; .001) and more patients with simplified dosing (75.2% vs 95.6%; P &lt; .001) in the intervention period. Special cause variation also occurred for these measures.CONCLUSIONS:A systematic approach to standardizing the discharge medication process led to improved caregiver medication management and understanding after pediatric inpatient discharge. These changes could be adapted by other hospitals to enhance the quality of this care transition.
A Batalha do Livramento: exposição e silenciamento entre os Tembé-Tenetehara
Authors: Jordy Filho Nassif Ricci , Neves Ivânia Dos Santos 
Published: January 2021

Em 1996, um grupo de 77 Tembé-Tenetehara da Terra Indígena Alto Rio Guamá foi aprisionado por fazendeiros invasores de suas terras no estado do Pará. Durante três dias foram submetidos à tortura e à falta de condições mínimas para sobreviver e o grau de violência explícita deste caso produziu repercussão na mídia local e nacional. Depois de liberados, no entanto, houve um silenciamento sobre este acontecimento que só se interrompeu em 2014, com a realização da pesquisa Patrimônio Cultural Tembé-Tenetahara. Neste artigo, analisamos discursivamente as emergências históricas deste acontecimento, a partir das narrativas políticas dos Tembé-Tenetehara e das fotografias publicadas na cobertura dos jornais impressos. Tomamos como referência teórica as formulações de acontecimento, intericonicidade, redes de memória e memória subterrânea. Palavras-Chaves: Dispositivo Colonial, Resistência, Conflitos De Terra.
Contribución de colombianos a la generación de conocimiento y desarrollo tecnológico internacional a partir de solicitudes de patentes PCT
Authors: Romero Betancur David , Parra Villamil Blanca Janneth 
Published: January 2021

Uno de los indicadores que permiten medir el desarrollo tecnológico y la innovación de un país es el número de solicitudes de patentes, estas además de brindar protección a los inventores en un territorio específico, potencian el desarrollo económico y fomentan la innovación científica y tecnológica. El estudio que se presenta a continuación está basado en el análisis de los registros de solicitudes de patentes en el marco del Tratado de Cooperación de Patentes (PCT por sus siglas en inglés), en las que han participado como titulares colombianos, y que han sido presentadas durante los últimos 20 años en jurisdicciones diferentes a Colombia. La información fue obtenida de la base de datos de patentes de la Organización Mundial de la Propiedad Intelectual (OMPI). Dentro de los factores analizados se encuentra la dinámica en la que se dio la cooperación entre los titulares y los sectores tecnológicos de mayor tendencia de protección, para esto se empleó un abordaje de tipo cuantitativo con enfoque descriptivo.
Los resultados evidencian que los países de mayor interés para tramitar solicitudes de patentes son Europa, Norteamérica y Asia, con una participación mínima en la región centro y suramericana, de igual forma se destaca el trabajo colaborativo que es notorio por el alto número de solicitudes presentadas en co-titularidad, bien sea empresa, universidad, organismo gubernamental o persona natural, tan solo una tercera parte de las solicitudes corresponde a aquellas en cabeza de un solo titular, de las que cerca de la mitad corresponde a personas naturales; este panorama refleja el alto grado de cooperación en torno al cual se generan los desarrollos tecnológicos que relacionan a colombianos.
Distribution de cash-flows aux actionnaires : moyens, dÃ©terminants, effets et modÃ¨les
Authors: Ahmed Nabaoui , Mohamed Benhrimida 
Published: January 2021

La problÃ©matique de la politique de distribution des cash-flows a suscitÃ© lâ€™intÃ©rÃªt de plusieurs Ã©conomistes au fil du temps. Dans les derniÃ¨res dÃ©cennies, plusieurs Ã©tudes thÃ©oriques mais aussi empiriques, se sont concentrÃ©es sur lâ€™objectif dâ€™augurer le mystÃ¨re de ce Â« puzzle Â» tel que le qualifie Black en 1976. Le dÃ©veloppement de la finance dâ€™entreprise et de marchÃ© a enrichi le terrain thÃ©orique et empirique en la matiÃ¨re. Cet article a pour objectif dâ€™examiner les effets de la structure de propriÃ©tÃ© du capital et la nature dâ€™actionnariat sur le dividende au travers la mise en exergue des diffÃ©rents conflits qui peuvent surgir entre les diffÃ©rentes parties prenantes de la firme, tout en faisant appel Ã la thÃ©orie dâ€™agence, dâ€™asymÃ©trie dâ€™information ou des signaux, de clientÃ¨le fiscale, de oiseau en main, dâ€™enracinement, et ce aprÃ¨s mise en Ã©vidence, des diffÃ©rents moyens de distribution, et de modÃ¨les retraÃ§ant les effets du montant du dividende sur la valeur de la firme.Ce travail rÃ©vÃ¨le quâ€™un consensus sur la problÃ©matique du dividende est encore loin dâ€™avoir le jour et les chercheurs sont toujours sur la locomotive dâ€™expliquer le dividende chacun au moins Ã partir de ses constats contextuels.
The issue of the cash flows distribution policy has aroused the interest of several economists over time. In recent decades, several theoretical but also empirical studies have focused on the objective of predicting the mystery of this "puzzle" as Black describes it in 1976. The development of corporate and market finance has enriched the theoretical and empirical ground in the matter. The objective of this paper is to examine the effects that the structure of the ownership of capital and the nature of shareholding can have on the dividend by highlighting the various conflicts that can arise between the various stakeholders of the firm, while appealing to the theory of agency, asymmetry of information or signals, fiscal clientele, bird in hand, rooting, and this after highlighting the different means of distribution, and models tracing the effects of the amount of the dividend on the value of the firm. This work reveals that a consensus on the issue of the dividend is still far from having the day and researchers are still on the locomotive to explain the dividend each at least based on its contextual findings.
Operational Challenges of Engaging Development Partners in District Health Planning in Tanzania
Authors: Charles James , Ukio Kusirye , Hoffman Axel , Kalolo Albino 
Published: January 2021

Abstract
BackgroundDevelopment assistance for health represents an important source of health financing in many low and middle-income countries. However, there are few accounts on how priorities funded through Development assistance for health are integrated with district health priorities. This study aimed at understanding the operational challenges of engaging development partners in district health planning in Tanzania MethodsThis explanatory mixed methods study was conducted in Kinondoni and Bahi districts. A structured checklist to 35 participants collected quantitative data whereas a semi-structured guide collected qualitative from 20 key informants (the council health planning team members and the development partners) to obtain information related to engagement of development partners in the planning processes and subsequent implementation of the district plan. We used descriptive analysis for quantitative data and thematic analysis for qualitative data ResultsMajority (86%) of the development partners delivering aid in the studied districts were Non Governmental Organizations. We found high engagement of Development partners (DPs) (87.5%) in Bahi district and very low in Kinondoni district (37.5%). Guidance on district priorities to be included in Development partner’s plans as part of the Comprehensive Council Health Plan (CCHP) was given to 36% of the Development partners. Submission of written plans to be integrated in the District plans was done by only 56% of Development partners, with majority (77.7%) from Kinondoni district not submitting their plans. Only 8% of the submitted plans appeared in the final District plan document. Qualitative findings reported operational challenges to engagements such as differences in planning cycles between the government and donors, uncertainties in funding from the prime donors, lack of transparency, limited skills of district planning teams, technical practicalities on planning tools and processes, inadequate knowledge on planning guidelines among DPs and poor donor coordination at the district level. ConclusionsWe found low engagement of Development partners in planning. To be resolved are operational challenges related to differences in planning cycles, articulations and communication of local priorities, donor coordination, and technical skills on planning and stakeholder engagement.