bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electronic Health Record Use in Swiss Nursing Homes and Its Association With Implicit Rationing of Nursing Care Documentation: Multicenter Cross-sectional Survey Study
Authors: Ausserhofer Dietmar , Favez Lauriane , Simon Michael , Zúñiga Franziska 
Published: March 2021

Background
Nursing homes (NHs) are increasingly implementing electronic health records (EHRs); however, little information is available on EHR use in NH settings. It remains unclear how care workers perceive its safety, quality, and efficiency, and whether EHR use might ease the burden of documentation, thereby reducing its implicit rationing.

Objective
This study aims to describe nurses’ perceptions regarding the usefulness of the EHR system and whether sufficient numbers of computers are available in Swiss NHs, and to explore the system’s association with implicit rationing of nursing care documentation.

Methods
This was a multicenter cross-sectional study using survey data from the Swiss Nursing Homes Human Resources Project 2018. It includes a convenience sample of 107 NHs, 302 care units, and 1975 care workers (ie, registered nurses and licensed practical nurses) from Switzerland’s German- and French-speaking regions. Care workers completed questionnaires assessing the level of implicit rationing of nursing care documentation, their perceptions of the EHR system’s usefulness and of how sufficient the number of available computers was, staffing and resource adequacy, leadership ability, and teamwork and safety climate. For analysis, we applied generalized linear mixed models, including individual-level nurse survey data and data on unit and facility characteristics.

Results
Overall, the care workers perceived the EHR systems as useful; ratings ranged from 69.42% (1362/1962; guarantees safe care and treatment) to 78.32% (1535/1960; allows quick access to relevant information on the residents). However, less than half (914/1961, 46.61%) of the care workers reported sufficient computers on their unit to allow timely documentation. Half of the care workers responded that they sometimes or often had to ration the documentation of care. After adjusting for work environment factors and safety and teamwork climate, both higher care worker ratings of the EHR system’s usefulness (β=−.12; 95% CI −0.17 to −0.06) and sufficient numbers of computers (β=−.09; 95% CI −0.12 to −0.06) were consistently associated with lower implicit rationing of nursing care documentation.

Conclusions
Both the usefulness of the EHR system and the number of computers available were important explanatory factors for care workers leaving care activities (eg, developing or updating nursing care plans) unfinished. NH managers should carefully select and implement their information technology infrastructure with greater involvement and attention to the needs of their care workers and residents. Further research is needed to develop and implement user-friendly information technology infrastructure in NHs and to evaluate their impact on care processes as well as resident and care worker outcomes.
THE FRAMEWORK MODEL OF DIGITAL COOPERATIVE TO EXPLORE ECONOMIC POTENTIAL IN HIGHER EDUCATION
Authors: Hasbullah Hasbullah , Bareduan Salleh Ahmad 
Published: March 2021

In February 2020, the Indonesian Ministry of Cooperatives and SMEs noted that in the last four years, 81,686 cooperatives were dissolved, leaving 123,048 active cooperatives. This case is a huge challenge for the government to overcome. Indonesian Internet Service Providers Association (APJII) stated that the number of internet users in Indonesia reached 196.7 million in the middle of 2020. Meanwhile, data from Google & Temasek showed purchasing products via e-Commerce in Indonesia reached US$ 10.9 billion in 2017 and continuously increased in 2020. Most cooperatives in Indonesia run business conventionally with manual transactions, limited time, traditional logistics, and conventional membership administration. Nowadays, the institution with tens of thousands of members no longer effectively runs cooperative conventionally in a disruptive era. A conventional cooperative at a private university in Jakarta was observed in the study. There are tens of thousands of students and staff at the university. Three research questions arise, such as what can not be adequately solved in a traditional cooperative, what tools are used in digital cooperatives, and what shape can be used in the digital cooperative system model to solve issues. This study proposes a framework model in developing a digital cooperative to accommodate a huge amount of membership and enhance business scope. The research identified technology needed to overcome matters cannot be dealt with in a conventional cooperative. It provided a digital cooperative frameworks model that impacts value creation, value capture, and value delivery, especially in higher education.
Línguas sem posse - em direção a um inconsciente menor institucional
Authors: Ribas Cristina Thorstenberg , Cobo-Guevara Paula 
Published: March 2021

Como podemos pensar um insconsciente institucional, hoje?; e o que ele nos diz das práticas menores que uma instituição pode abarcar? Pensamos, com esse artigo, que o movimento de instituição e destituição a partir de um inconsciente menor institucional tem mais a ver com um procedimento de passagens, que modifica e arrasta a instituição em direção a um fora. A subjetividade é matéria, é agenciada nesse arrasto, e com os pés no chão, é possível produzir singularidades por contágio e vizinhança. Apontamos como uma saúde menor pode dar passagem a movimentos instituintes, como ela também elabora uma processualidade estética (reconceitualizando afetos na e da arte), e como se pode cartografar seus circuitos, que sempre escapam a intentos de representação. AbstractHow can we think about an institutional unconscious today? And what does it tell us about the minor practices that an institution can embrace? The movement of institution and destitution from a institutional minor unconscious has more to do with a procedure of making-passage, which in itself modifies and drags the institution towards an outside. Subjectivity is matter, it is rearranged in this dragging out, and with your feet on the ground, it is possible to produce singularities through contagion and neighbouring. We point out how a minor health can give way to instituting movements, how it also elaborates a processual aesthetics (reconceptualizing affections in and of art), and how one can map out its circuits, which always escape the intent of representation
Glycemic Outcome Associated With Insulin Pump and Glucose Sensor Use in Children and Adolescents With Type 1 Diabetes. Data From the International Pediatric Registry SWEET
Authors: Cardona-Hernandez Roque , Schwandt Anke , Alkandari Hessa , Bratke Heiko , Chobot Agata , Coles Nicole , Corathers Sarah , Goksen Damla , Goss Peter , Imane Zineb , Nagl Katrin , O’Riordan Stephen M.P. , Jefferies Craig 
Published: March 2021

OBJECTIVE
Insulin delivery methods, glucose-monitoring modalities, and related outcomes were examined in a large, international, diverse cohort of children and adolescents with type 1 diabetes from the Better Control in Pediatric and Adolescent Diabetes: Working to Create Centers of Reference (SWEET) -Registry.

RESEARCH DESIGN AND METHODS
Participants with type 1 diabetes of ≥1 year, aged ≤18 years, and who had documented pump or sensor usage during the period August 2017–July 2019 were stratified into four categories: injections–no sensor (referent); injections + sensor; pump–no sensor; and pump + sensor. HbA1c and proportion of patients with diabetic ketoacidosis (DKA) or severe hypoglycemia (SH) were analyzed; linear and logistic regression models adjusted for demographics, region, and gross domestic product per capita were applied.

RESULTS
Data of 25,654 participants were analyzed. The proportions of participants (adjusted HbA1c data) by study group were as follows: injections–no sensor group, 37.44% (8.72; 95% CI 8.68–8.75); injections + sensor group, 14.98% (8.30; 95% CI 8.25–8.35); pump–no sensor group, 17.22% (8.07; 95% CI 8.03–8.12); and pump + sensor group, 30.35% (7.81; 95% CI 7.77–7.84). HbA1c was lower in all categories of participants who used a pump and/or sensor compared with the injections–no sensor treatment method (P &lt; 0.001). The proportion of DKA episodes was lower in participants in the pump + sensor (1.98%; 95% CI 1.64–2.48; P &lt; 0.001) and the pump–no sensor (2.02%; 95% CI 1.64–2.48; P &lt; 0.05) groups when compared with those in the injections–no sensor group (2.91%; 95% CI 2.59–3.31). The proportion of participants experiencing SH was lower in pump–no sensor group (1.10%; 95% CI 0.85–1.43; P &lt; 0.001) but higher in the injections + sensor group (4.25%; 95% CI 3.65–4.95; P &lt; 0.001) compared with the injections–no sensor group (2.35%; 95% CI 2.04–2.71).

CONCLUSIONS
Lower HbA1c and fewer DKA episodes were observed in participants using either a pump or continuous glucose monitoring (CGM) or both. Pump use was associated with a lower rate of SH. Across SWEET centers, use of pumps and CGM is increasing. The concomitant use of pump and CGM was associated with an additive benefit.
Cardiovascular, Renal, and Metabolic Outcomes of Dapagliflozin Versus Placebo in a Primary Cardiovascular Prevention Cohort: Analyses From DECLARE-TIMI 58
Authors: Cahn Avivit , Raz Itamar , Leiter Lawrence A. , Mosenzon Ofri , Murphy Sabina A. , Goodrich Erica L. , Yanuv Ilan , Rozenberg Aliza , Bhatt Deepak L. , McGuire Darren K. , Wilding John P.H. , Gause-Nilsson Ingrid A.M. , Langkilde Anna Maria , Sabatine Marc S. , Wiviott Stephen D. 
Published: March 2021

OBJECTIVE
International guidelines propose prescribing sodium–glucose cotransporter 2 (SGLT2) inhibitors to patients with type 2 diabetes (T2D) as secondary prevention in patients with established atherosclerotic cardiovascular disease (ASCVD) or for primary prevention of cardiovascular events in high-risk patients with multiple risk factors (MRF) for ASCVD. The current analyses expand on the cardiovascular renal and metabolic effects of SGLT2 inhibitors in MRF patients.

RESEARCH DESIGN AND METHODS
In DECLARE-TIMI 58, 17,160 patients with T2D and MRF (59.4%) or established ASCVD (40.6%) were randomized to dapagliflozin versus placebo; patients were followed for a median of 4.2 years. The cardiovascular and renal outcomes in the MRF cohort were studied across clinically relevant subgroups for treatment effect and subgroup-based treatment interaction.

RESULTS
Among patients with MRF, the reduction with dapagliflozin in risk of cardiovascular death or hospitalization for heart failure (CVD/HHF) (hazard ratio [HR] 0.84, 95% CI 0.67–1.04) and the renal-specific outcome (HR 0.51, 95% CI 0.37–0.69) did not differ from that for patients with ASCVD (Pinteraction 0.99 and 0.72, respectively). The effect on CVD/HHF was entirely driven by a reduction in HHF (HR 0.64, 95% CI 0.46–0.88). The benefits of dapagliflozin on HHF and on the renal-specific outcome, among the subset with MRF, were directionally consistent across clinically relevant subgroups. At 48 months, HbA1c, weight, systolic blood pressure, and urinary albumin–to–creatinine ratio were lower with dapagliflozin versus placebo and estimated glomerular filtration rate was higher (P &lt; 0.001).

CONCLUSIONS
In patients with T2D and MRF, dapagliflozin reduced the risk of HHF and adverse renal outcomes regardless of baseline characteristics. These analyses support the benefit of dapagliflozin for important outcomes in a broad primary prevention population.
Cardiovascular and Renal Disease Burden in Type 1 Compared With Type 2 Diabetes: A Two-Country Nationwide Observational Study
Authors: Kristófi Robin , Bodegard Johan , Norhammar Anna , Thuresson Marcus , Nathanson David , Nyström Thomas , Birkeland Kåre I. , Eriksson Jan W. 
Published: March 2021

OBJECTIVE
Type 1 diabetes (T1D) and type 2 diabetes (T2D) increase risks of cardiovascular (CV) and renal disease (CVRD) compared with diabetes-free populations. Direct comparisons between T1D and T2D are scarce. We examined this by pooling full-population cohorts in Sweden and Norway.

RESEARCH DESIGN AND METHODS
A total of 59,331 patients with T1D and 484,241 patients with T2D, aged 18–84 years, were followed over a mean period of 2.6 years from 31 December 2013. Patients were identified in nationwide prescribed drug and hospital registries in Norway and Sweden. Prevalence and event rates of myocardial infarction (MI), heart failure (HF), stroke, chronic kidney disease (CKD), all-cause death, and CV death were assessed following age stratification in 5-year intervals. Cox regression analyses were used to estimate risk.

RESULTS
The prevalence of CV disease was similar in T1D and T2D across age strata, whereas CKD was more common in T1D. Age-adjusted event rates comparing T1D versus T2D showed that HF risk was increased between ages 65 and 79 years, MI between 55 and 79 years, and stroke between 40 and 54 years (1.3–1.4-fold, 1.3–1.8-fold, and 1.4–1.7-fold, respectively). CKD risk was 1.4–3.0-fold higher in T1D at all ages. The all-cause death risk was 1.2–1.5-fold higher in T1D at age &gt;50 years, with a similar trend for CV death.

CONCLUSIONS
Adult patients with T1D compared with those with T2D had an overall greater risk of cardiorenal disease (HF and CKD) across ages, MI and all-cause death at middle-older ages, and stroke at younger ages. The total age-adjusted CVRD burden and risks were greater among patients with T1D compared with those with T2D, highlighting their need for improved prevention strategies.
A retrospective comparative study of outcome with surgical excision and repair versus nonsurgical and ablative treatments for basal cell carcinoma
Authors: Mahajan Soniya , Kalaivani Mani , Sethuraman Gomathy , Khaitan Binod Kumar , Verma Kaushal Kumar , Gupta Somesh 
Published: March 2021

Background:
There are few studies on basal cell carcinoma (BCC) from India. Long-term follow-up is available in only one study and the aesthetic outcome of treatment has not been evaluated in Indian patients.

Aims:
In this retrospective study on BCC, we compared treatment failure, recurrence rates and aesthetic outcomes on long-term follow-up between surgical excision and repair, and nonsurgical and ablative treatments.

Methods:
Records of patients with BCC treated in the dermatologic surgery clinic over the past 10 years were analyzed. Patients with histopathologically confirmed BCC who could be contacted were evaluated for recurrence, treatment failure, overall satisfaction and aesthetic outcomes by global aesthetic improvement scale.

Results:
Out of 98 patients, 72 were contactable. Four patients received both nonsurgical and ablative treatments and surgical excision and repair sequentially and were excluded. The mean age of patients was 57.9 ± 15.8 years (24–90 years) and the male: female ratio was 1.6:1. The most common site involved was the face (72.1%) followed by trunk and scalp, and the most common type of BCC was the pigmented superficial type (33.8%), followed by the pigmented noduloulcerative type (16.2%). There was no significant difference between the groups in the number of high-risk cases. The mean follow-up period was 37.1 ± 31.4 (range, 4–120) months. Fifty one patients were treated with surgical excision and repair, and 17 with nonsurgical and ablative treatments (9-imiquimod, 5-cryotherapy, 4-radiotherapy). Treatment failure was seen in 5 (7.4%) patients, all in the nonsurgical and ablative treatments group (P = 0.0006). Recurrence was seen in 2 (2.9%) patients, both in the surgical excision and repair group (P > 0.05). Mean patient satisfaction was significantly higher with surgical excision and repair, though there was no significant difference in the Global Aesthetic Improvement Scale between the groups.

Limitations:
The sample size was low. Only telephonic and pictorial assessments were done where the patient could not come for follow-up.

Conclusions:
Surgical excision and repair was associated with better outcomes than nonsurgical and ablative treatments. Treatment failures and adverse events were high with nonsurgical and ablative treatments. The recurrence rate was low.
Karakteristik penderita infeksi HIV/AIDS di klinik voluntary counseling and testing Lazarus RS St. Antonius Pontianak tahun 2017
Authors: Prawira Yuda , Uwan Willy Brodus , Ilmiawan Muhammad In’am 
Published: March 2021

Latar Belakang: Human Immunodeficiency Virus (HIV) merupakan jenis retrovirus dari genus lentivirus, yang menginfeksi sel-sel kekebalan tubuh dan menyebabkan turunnya kekebalan tubuh manusia sehingga pada akhirnya dapat menyebabkan sekumpulan gejala penyakit yang disebut dengan Acquired Immune Deficiency Syndrome (AIDS). HIV merupakan salah satu penyakit infeksi utama penyebab kematian bagi seluruh dunia yang terus mengalami peningkatan secara signifikan. Metode: Penelitian ini menggunakan desain deskriptif observasional.Variabel penelitian ini adalah karakteristik sosiodemografi dan klinis penderita HIV/AIDS yang terdaftar di Klinik Voluntary Counseling and Testing (VCT) Lazarus Rumah Sakit Santo Antonius Pontianak sepanjang tahun 2017. Hasil: Terdapat 29 pasien yang memenuhi kriteria inklusi. Karakteristik penderita HIV/AIDS ditemukan kelompok usia terbanyak 25-49 tahun (82.76%), jenis kelamin laki-laki (62.07%), tingkat pendidikan sedang (37.93%), orientasi heteroseksual (96.55%), pekerjaan karyawan swasta (31.03%), status menikah (58.62%), asal daerah Kota Pontianak (55.17%), faktor risiko terbanyak heteroseksual (96.55%), infeksi oportunistik terbanyak kandidiasis (55.10%), kadarsel CD4+ terbanyak pada nilai <200 sel/mm3 (68.97%), stadium II (79.31%), lama terapi ARV selama 6-18 bulan (41.39%), dengan jenis ARV lini 1 (100%), efektoksisitas (-) sebesar 72.41% sedangkan sisanya efek toksisitas ARV terbanyak berupa mual (50%). Kesimpulan. Karakteristik penderita infeksi HIV/AIDS di Klinik VCT Lazarus Rumah Sakit Umum Santo Antonius berdasarkan karakteristik sosiodemografi terbanyak pada usia 25-49 tahun, jenis kelamin terbanyak pada laki-laki, tingkat pendidikan sedang, orientasi heterokseksual, pekerjaan karyawan swasta, berstatus menikah, dan berasal dari Kota Pontianak. Pada karakteristik klinis terbanyak memiliki faktor risiko heteroseksual, infeksi oportunistik kandidiasis, penderita terbanyak dengan kadar sel CD4+ <200 sel/mm3, dengan stadium II, lama terapi ARV selama 6-18 bulan dengan jenis ARV lini 1, lebih banyak penderita tidak mengalami efek toksisitas ARV, dan gejala mual yang lebih sering dialami penderita.
Aktivitas Ekstrak Metanol Daun Sukun (Artocarpus altilis F.) sebagai Larvasida Aedes aegypti
Authors: Alfarizy Jefry , Ilmiawan Muhammad I , Andriani Andriani 
Published: March 2021

Latar Belakang. Demam Berdarah Dengue (DBD) merupakan penyakit infeksi yang disebabkan oleh virus dengue melalui gigitan nyamuk betina Aedes aegypti. Penggunaan larvasida sintetik jangka panjang telah banyak menimbulkan resistensi. Daun sukun (Artocarpus altilis F.) memiliki kandungan metabolit sekunder berupa alkaloid, flavonoid, tanin dan saponin yang berpotensi sebagai biolarvasida. Metode. Penelitian ini merupakan penelitian eksperimental dengan post test only control group design. Digunakan 725 ekor larva Aedes aegypti instar III/IV, yang terdiri dari 125 ekor uji pendahuluan dan 600 ekor uji aktivitas larvasida. Uji aktivitas larvasida dibagi dalam 6 kelompok yang terdiri dari kelompok kontrol positif (temefos), kontrol negatif (akuades), serta 4 kelompok perlakuan dengan konsentrasi ekstrak metanol daun sukun 1,5%, 2,5%, 5%, dan 7,5%. Dilakukan 4 kali replikasi. Pengamatan dilakukan setelah 24 jam pasca perlakuan. Hasil. Persentase kematian larva yang dihasilkan oleh ekstrak metanol daun sukun konsentrasi 1,5%, 2,5%, 5% dan 7,5% secara berturut-turut adalah 50%, 52%, 65% dan 69%. Persentase kematian larva pada kontrol negatif sebesar 0%, sedangkan pada kontrol positif sebesar 100%. Terdapat perbedaan bermakna antara kematian larva yang ditimbulkan oleh berbagai kelompok konsentrasi ekstrak metanol daun sukun dengan kontrol positif. Kesimpulan. Ekstrak metanol daun sukun pada konsentrasi 1,5% hingga 7,5% memiliki aktivitas sebagai larvasida Aedes aegypti, namun lebih lemah jika dibandingkan dengan temefos.
Implementasi Kebijakan Program Indonesia Pintar (PIP)
Authors: Rakista Putri Mutiara 
Published: March 2021

Implementasi kebijakan publik merupakan merupakan suatu kegiatan yang dimaksudkan oleh seorang pelaksana atau implementor dengan tujuan untuk merealisasikan suatu program pemerintah sehingga menunjukkan hasil atau mencapai tujuan yang ingin dicapai. Program Indonesia Pintar adalah pemberian bantuan tunai dari pemerintah kepada anak usia sekolah dari keluarga kurang mampu. Tujuan dari Program Indonesia Pintar adalah meningkatkan akses bagi anak usia 6 sampai dengan 21 tahun untuk mendapatkan layanan pendidikan, Mencegah peserta didik dari kemungkinan putus sekolah dan menarik siswa putus sekolah atau tidak melanjutkan agar kembali mendapatkan layanan pendidikan. Penelitian ini terfokus pada dampak program indonesia pintar pada tingkat sekolah dasar. Metode penelitian yang digunakan dalam penelitian ini adalah metode kualitatif. Penelitian ini dilakukan pada tingkat sekolah dasar di Kabupaten Banyumas. Metode analisis data yang digunakan adalah metode analisis interaktif. Hasil Penelitian menunjukan bahwa Implementasi Program Indonesia Pintar pada tingkat Sekolah Dasar di Kabupaten Banyumas sudah berjalan dengan baik hal ini ditandai dengan proses pelaksanaan program yang dilakukan sesuai dengan tujuan dan SOP yang berlaku.
Implementasi kebijakan publik merupakan merupakan suatu kegiatan yang dimaksudkan oleh seorang pelaksana atau implementor dengan tujuan untuk merealisasikan suatu program pemerintah sehingga menunjukkan hasil atau mencapai tujuan yang ingin dicapai. Program Indonesia Pintar adalah pemberian bantuan tunai dari pemerintah kepada anak usia sekolah dari keluarga kurang mampu. Tujuan dari Program Indonesia Pintar adalah meningkatkan akses bagi anak usia 6 sampai dengan 21 tahun untuk mendapatkan layanan pendidikan, Mencegah peserta didik dari kemungkinan putus sekolah dan menarik siswa putus sekolah atau tidak melanjutkan agar kembali mendapatkan layanan pendidikan. Penelitian ini terfokus pada dampak program indonesia pintar pada tingkat sekolah dasar. Metode penelitian yang digunakan dalam penelitian ini adalah metode kualitatif. Penelitian ini dilakukan pada tingkat sekolah dasar di Kabupaten Banyumas. Metode analisis data yang digunakan adalah metode analisis interaktif. Hasil Penelitian menunjukan bahwa Implementasi Program Indonesia Pintar pada tingkat Sekolah Dasar di Kabupaten Banyumas sudah berjalan dengan baik hal ini ditandai dengan proses pelaksanaan program yang dilakukan sesuai dengan tujuan dan SOP yang berlaku.
Identification of focal epileptic regions from electroencephalographic data: Feigenbaum graphs
Authors: Guarneros G. , Pérez C. , Montiel A. , Rojas J. F. 
Published: March 2021

In the study of problems related to epilepsy analyzing electroencephalograms data is of much importance to help, one hand, to its diagnosis, and, another hand in the possibility of diminishing errors in surgery. We do this analysis making the Feigenbaum graphs for real electroencephalographic signals data sets and calculating characteristic networks (graph) quantities, such as average clustering, degree distribution, and average shortest path length. We manage to characterize two different data sets from each other, from data sets corresponding to focal and non-focal neuronal activity both time out of an epileptic seizure. This method enables us to identify sets of data from epileptic focal zones and suggest our approach could be used to aid physicians with diagnosing epilepsy from electroencephalographic data and/or in an exact establishment of the epileptic focal region for surgery.