bluuebunny/crossref_metadata_2025_split huggingface dataset:
Création numérique et propriété industrielle, vers la réconciliation ?
Authors: Iteanu Olivier 
Published: May 2021

Depuis cinquante ans, le droit d’auteur et le droit des brevets se livrent bataille pour s’accaparer un bien, source de nombreuses richesses : les créations numériques, auxquelles appartiennent notamment les logiciels. Longtemps, le droit d’auteur l’a emporté. Pourtant, les créations numériques sont des « œuvres » nécessitant souvent la mobilisation de nombreux ingénieurs et techniciens, mais aussi de lourds investissements ; nous sommes bien loin de l’image de l’auteur seul devant sa machine à écrire. Et, de fait, le rattachement des créations numériques au régime de la propriété littéraire et artistique a obligé le législateur et, par voie de conséquence, le juge à bien des contorsions et dérobades. Pendant ce temps, les récentes réformes apportées au droit des brevets donnent à ce dernier plus de souplesse et lui permet ainsi de retrouver une certaine attractivité. Retour sur une épopée juridique dont on attend encore le dénouement.
Structural Validity of the Hospital Anxiety and Depression Scale Among Family Members of Critically Ill Patients
Authors: Pignatiello Grant A. , Townsend Aloen L. , Hickman Ronald L. 
Published: May 2021

Background
The Hospital Anxiety and Depression Scale (HADS) is commonly used clinically and scientifically among surrogate decision makers for critically ill patients. The validity of the HADS has been scrutinized, but its use among surrogate decision makers has not been examined.

Objective
To examine the structural validity of the HADS.

Methods
This study was a secondary analysis of data obtained from a 3-arm randomized controlled trial of a decision support intervention. Participants were recruited from 6 intensive care units at a tertiary medical center in Northeast Ohio. Participants were adult surrogate decision makers for critically ill, cognitively impaired adults who were not expected to be discharged from the intensive care unit within the subsequent 48 hours. The fit of 2-factor, 3-factor, and bifactor structures of the HADS was tested with confirmatory factor analysis.

Results
The bifactor structure, possessing a general psychological distress factor and anxiety and depression group factors, showed a superior fit and met a priori thresholds for acceptable model fit. The general psychological distress factor accounted for more than 75% of the common variance in the HADS items.

Conclusion
Confirmatory factor analysis provided evidence supporting a bifactor structure of the HADS. In this sample, the instrument validly measures psychological distress rather than distinct symptoms of anxiety and depression. Replication of these results is encouraged, and use of alternative measures is recommended when measuring distinct symptoms of anxiety and depression among surrogate decision makers for critically ill patients.
Bridging the Gap Between the Intensive Care Unit and the Acute Medical Care Unit
Authors: Kim Eileen , Kast Charles , Afroz-Hossain Anika , Qiu Michael , Pappas Karalyn , Sinvani Liron 
Published: May 2021

Background
Despite a growing cohort of intensive care unit (ICU) survivors, little is known about the early ICU aftercare period.

Objective
To identify gaps in early ICU aftercare and factors associated with poor hospital outcomes.

Methods
A multisite, retrospective study (January 1 to December 31, 2017) was conducted among randomly selected patients admitted to the medical ICU and subsequently transferred to acute medical care units. Records were reviewed for patient characteristics, ICU course, and early ICU aftercare practices and syndromes. Associations between practices and hospital outcomes were calculated with χ2 and Wilcoxon rank sum tests, followed by logistic regression.

Results
One hundred fifty-one patients met inclusion criteria (mean [SD] age, 64.2 [19.1] years; 51.7% male; 44.4% White). The most frequent diagnoses were sepsis (35.8%) and respiratory failure (33.8%). During early ICU aftercare, 46.4% had dietary restrictions, 25.8% had bed rest orders, 25.0% had a bladder catheter, 26.5% had advance directive documentation, 33.8% had dysphagia, 34.3% had functional decline, and 23.2% had delirium. Higher Charlson Comorbidity Index (odds ratio, 1.6) and midodrine use on medical units (odds ratio, 7.5) were associated with in-hospital mortality; mechanical ventilation in the ICU was associated with rapid response on medical unit (odds ratio, 12.9); and bladder catheters were associated with ICU readmission (odds ratio, 5.2).

Conclusions
Delirium, debility, and dysphagia are frequently encountered in early ICU aftercare, yet bed rest, dietary restriction, and lack of advance directive documentation are common. Future studies are urgently needed to characterize and address early ICU aftercare.
Implementing the Pediatric Family Satisfaction in the Intensive Care Unit (ICU) Survey in a Pediatric Cardiac ICU
Authors: Manna John 
Published: May 2021

Background
Few responses to the Child Hospital Consumer Assessment of Healthcare Providers and Systems and no use of family satisfaction scores indicated the need to implement a program to collect and use family satisfaction data at a pediatric cardiac intensive care unit (ICU) at a southeastern academic medical center.

Objectives
To improve response rates for family satisfaction surveys, to identify future quality improvement initiatives, to receive qualitative feedback from key stakeholders, and to better understand nursing staff’s satisfaction with the project implementation process.

Methods
A quality improvement program using the Pediatric Family Satisfaction in the Intensive Care Unit (pFS-ICU) survey was implemented to evaluate family satisfaction data from a pediatric cardiac ICU. Data were collected for 6 months to identify quality improvement initiatives for continuing excellence. An interprofessional focus group of key stakeholders assessed feedback and perceptions.

Results
A 61% response rate (n = 81 responses) was achieved on the pFS-ICU survey. Respondents ranked the pediatric cardiac ICU higher than 90% excellence in all categories in every month but 1 (in 1 category). The focus group revealed the survey’s ease of use and indicated that the data allow more focus on patient-centered care. A staff survey showed that 100% of staff understood the new process and 87% agreed that the survey is an effective tool.

Conclusion
Researchers should study the pFS-ICU survey in other inpatient pediatric step-down units and ICUs because it fosters a high response rate that provides real-time data, leading to quality improvement initiatives that can increase quality of care and improve outcomes.
Patients’ Adaptations After Acute Respiratory Distress Syndrome: A Qualitative Study
Authors: Hauschildt Katrina E. , Seigworth Claire , Kamphuis Lee A. , Hough Catherine L. , Moss Marc , McPeake Joanne M. , Harrod Molly , Iwashyna Theodore J. 
Published: May 2021

BackgroundMany patients confront physical, cognitive, and emotional problems after acute respiratory distress syndrome (ARDS). No proven therapies for these problems exist, and many patients manage new disability and recovery with little formal support. Eliciting patients’ adaptations to these problems after hospitalization may identify opportunities to improve recovery.ObjectivesTo explore how patients adapt to physical, cognitive, and emotional changes related to hospitalization for ARDS.MethodsSemistructured interviews were conducted after hospitalization in patients with ARDS who had received mechanical ventilation. This was an ancillary study to a multicenter randomized controlled trial. Consecutive surviving patients who spoke English, consented to follow-up, and had been randomized between November 12, 2017, and April 5, 2018 were interviewed 9 to 16 months after that.ResultsForty-six of 79 eligible patients (58%) participated (mean [range] age, 55 [20-84] years). All patients reported using strategies to address physical, emotional, or cognitive problems after hospitalization. For physical and cognitive problems, patients reported accommodative strategies for adapting to new disabilities and recuperative strategies for recovering previous ability. For emotional issues, no clear distinction between accommodative and recuperative strategies emerged. Social support and previous familiarity with the health care system helped patients generate and use many strategies. Thirty-one of 46 patients reported at least 1 persistent problem for which they had no acceptable adaptation.ConclusionsPatients employed various strategies to manage problems after ARDS. More work is needed to identify and disseminate effective strategies to patients and their families.
Laparoscopic radical hysterectomy with enclosed colpotomy without the use of uterine manipulator for early-stage cervical cancer
Authors: Ding Bo , Guan Xiaoming , Duan Kristina , Shen Yang 
Published: May 2021

Background:
We report the application of transuterine suspension sutures (TUSSs) for manipulation and vaginal closure before colpotomy in laparoscopic radical hysterectomy for early-stage cervical cancer.

Methodology:
Eight patients with clinical stage IB1 cervical squamous cell cancer were treated with laparoscopic radical hysterectomy between October 2019 and May 2020. The procedure was performed without a traditional uterine manipulator, and the vaginal cuff was closed with a stapler before colpotomy to prevent tumour spillage.

Results:
All patients successfully underwent the surgery, with a median hospitalisation of 8 days (range 6–14). All drains and urethral catheters were removed after a median of 7 days (range 5–11) and 16 days (range 12–21), respectively. A median of 26 (range 20–32) pelvic lymph nodes were resected and no lymph-related complications were encountered post-operatively. With an enclosed colpotomy, no visible tumour tissues were exposed to the pelvic cavity, and all vaginal stumps healed well without complications. All pathological examinations of the vaginal margin were negative, and there were no residual lesions. At a median follow-up of 6 months, all patients were alive with no recurrence of disease.

Conclusion:
We found that laparoscopic radical hysterectomy with TUSS and vaginal closure before colpotomy is a useful and effective procedure to prevent tumour spillage for the treatment of cervical cancer.
Endoscopic ultrasound-guided drainage of intra-abdominal diverticular abscess. A case series
Authors: Donatelli Gianfranco , Cereatti Fabrizio , Fazi Maurizio , Ceci Vincenzo , Dhumane Parag 
Published: May 2021

Aim:
Diverticular disease is widespread worldwide. Mainstay approach is non-operative treatment with bowel rest and broad-spectrum intravenous antibiotics. However, extra-colic abscess larger than 4 cm may require percutaneous trans-abdominal drainage. We report a single centre case series of patients underwent to trans-luminal endoscopic ultrasound (EUS)-guided drainage of pelvic abscess in diverticular disease with temporary placement of lumen apposing metal stent (LAMS).

Methods:
All patients referred to our tertiary centre from January 2019 to July 2020 were enrolled in a prospective data base that was retrospectively analysed. Procedural steps were as follows: pre-operative computed tomography scan, broad-spectrum antibiotic therapy, EUS-guided deployment of LAMS for 15 days, LAMS removal and deployment of pigtail stent in case of pseudo-cavity persistence.

Results:
Ten patients (6F) with an average of 59.6 years were enrolled with deployment of 10 LAMS. One patient was excluded after EUS evaluation and 1 patient had 2 LAMS for 2 separate abscesses. Technical and clinical success was achieved in 88.8% (8/9).

Conclusions:
Management of diverticulitis has shifted from primary surgical intervention towards a non-operative approach of bowel rest and broad-spectrum intravenous antibiotics in conjunction with interventional procedures to drain abscesses whenever necessary. EUS-guided drainage with LAMS for the management of diverticular abscesses seems an efficient treatment modality for encapsulated abscesses more than 4 cm in size and close to colonic wall. In expert centres, it may avoid radiologic intervention and/or surgery in a relevant percentage of cases.
Optimising working space for laparoscopic pyeloplasty in infants
Authors: Mandelia Ankur , Haldar Rudrashish , Siddiqui Yousuf , Mishra Ashwani 
Published: May 2021

Aims:
This study aimed to test the efficacy of SGPGI protocol to minimise bowel distension and optimise working space for laparoscopic pyeloplasty in infants.

Methodology:
All infants who underwent laparoscopic pyeloplasty for unilateral pelvi-ureteric junction obstruction (PUJO) between January 2017 and March 2020 were included in the study. The patient cohort was divided into two groups: Group A and B. Group A included patients who underwent routine pre-operative preparation. Group B included patients wherein the SGPGI protocol was used. The key features of the protocol were fasting for 8 h, enemas, inserting a nasogastric tube in the pre-operative period and decompressing the colon on the operation table. Demographic features, pre-operative, intraoperative and post-operative parameters were compared between the two groups.

Results:
A total of 26 infants with unilateral PUJO underwent laparoscopic pyeloplasty during the study period. Group A included 12 patients and Group B included 14 patients. Both the groups were similar in age, weight and sex distribution. The median surgeon's rating score for suturing conditions was 2 for Group A and 5 for Group B patients (P > 0.05). The operating time was significantly longer in Group A (196 ± 21 min) as compared to Group B (114 ± 18 min) (P < 0.05). In Group A, intra-abdominal pressure (IAP) varied between 9 and 14 mmHg (median 12 mmHg), while in Group B, IAP varied between 6 and 9 mmHg (median 8 mmHg) (P < 0.05). In Group A, in 2/12 cases (16.7%), conversion to an open procedure was necessary because of inadequate working space owing to gross intestinal distension. Two patients in Group A also had intraoperative injuries to adjacent structures due to poor working space.

Conclusions:
Optimal working space is critical to the performance of advanced laparoscopic surgery like pyeloplasty in infants. SGPGI protocol significantly improves working space, which permits a faster and safer surgery with a lower intra-abdominal working pressure. This protocol is simple, safe and easy to replicate at most centres in our country.
Predicción de la diabetes mellitus tipo 2 en pacientes adultos mediante regresión logística binaria.
Authors: Sánchez Martínez Belkis , Vega Falcón Vladimir , Gómez Martínez Nairovys 
Published: May 2021

La Diabetes Mellitus tipo 2 (DM2) es una enfermedad asociada a factores de riesgo, caracterizada por gran morbilidad y mortalidad. El objetivo fue predecir la probabilidad de que la población de un Consultorio Médico en Cuba se enferme de DM2. Fue un estudio de tipo observacional, transversal, retrospectivo y analítico, correspondiente al nivel predictivo, desarrollado en 628 pacientes. Se utilizó la regresión logística binaria, con el apoyo del SPSS 25. Como resultado, se logró predecir la probabilidad de que la población se enferme de DM2. Como conclusión se evidenció que quienes tuvieron la predisposición genética e Hipertensión Arterial presentaron más riesgo de enfermar de DM2, no ocurriendo lo mismo con la edad y el sexo, cuyas relaciones no fueron significativas.
Perceived Readiness of Educated Youth towards Ethnic Integration in Sri Lanka
Authors: Kumari M.S. Dimuthu 
Published: May 2021

Sri Lanka is a multi-ethnic society hence the ethnic integration has been a hot topic for decades. By 2021, it has been 73 years after the independence from British empires, however, natives still struggle for the reconciliation among themselves. Often occurred ethnic clashes usually account for a huge social and economic cost. Various scholars have highlighted that youth is highly active in initiating ethnic clashes. And, it is quoted specifically for the ‘Educated youth’ in Sri Lankan context. Therefore, this study explores the perceptions of ‘multi-ethnic, educated youth’ in heightening ethnic integration in Sri Lanka. This study utilized quantitative research approach and survey method. Primary data was mainly used for the study and collected through an online questionnaire. 100 multi-ethnic youth who are studying in higher education institutions in Sri Lanka selected as the sample using random sampling technique. The readiness of respondents was basically measured through their perceptions with respect to the social integration model proposed by Awang et al (2019). Descriptive statistics were used in analyzing data. The results showed that the overall readiness of educated youth in promoting ethnic integration is high in Sri Lankan context. The respondents are almost ready for the social acceptance and cultural appreciation levels of the model. However, they have showed, relatively a slight attraction towards compromisation and adaptation levels for which a high degree of ethnic tolerance is required. Therefore, it can be concluded that the majority of educated youth are social extroverts and are aware the importance of integration. However, since they showed a little attraction towards the upper layers of integration pyramid, there is a need of re-evaluating existing social integration policies. So that, some policy recommendations are suggested to enhance more operational activities in reconciliation process to reach the upper levels of ethnic integration (compromization and adaptation) in Sri Lankan context.
ESTUDIO SOBRE EL CRECIMIENTO DEL PAUTAJE PUBLICITARIO EN LOS CINES DE GUAYAQUIL ECUADOR
Authors: Salas Luzuriaga Edgar 
Published: May 2021

El presente trabajo de investigación se enfoca en analizar el mercado del cine ecuatoriano, con mayor énfasis en las ciudades de Guayaquil, y Samborondón, su crecimiento y las preferencias del consumidor. El cine como tal tiene una historia a través de los años que ha logrado un gran impacto hacia la atracción del público en masas en un solo establecimiento, es así como en cuestión de años grandes marcas han encontrado efectos positivos en canales de publicidad como las pantallas del cine. A lo largo de la investigación se van a exponer los beneficios, empresas que publicitan, antecedentes relacionados con el cine en un ambiente tanto internacional como nacional. Para poder evaluar las variables se realizaron 200 encuestas dirigidas a los consumidores. Fue así como se determinó que dentro de las 2 cadenas de cine existentes en Ecuador, Supercines supera las preferencias del consumidor y es reconocido por su disponibilidad de horarios. De esta manera, se demostró que existen un sin número de preferencias del consumidor y su perspectiva en cuanto a la publicidad minutos antes de sus películas. Finalmente, la publicidad dentro de los cines alcanza un nivel importante de recordación de marca y sigue siendo un buen elemento para grandes empresas.
LA LOGÍSTICA INVERSA, UNA ALTERNATIVA ESTRATÉGICA DE EMPRESAS LATINOAMERICANAS PARA COMPETIR EN LOS MERCADOS INTERNACIONALES
Authors: Silva Álvarez Karoline , Hurtado Sangurima Mildred Pamela , González Illescas Mayiya 
Published: May 2021

El propósito de este artículo es analizar las prácticas de logística inversa que adoptan las empresas latinoamericanas exportadoras para ser competitivas y sostenibles. Los resultados se obtuvieron a través de un enfoque cualitativo y una investigación de carácter descriptivo, a partir de artículos científicos que han explorado la experiencia de empresas en la aplicación de logística inversa. Se emplearon métodos teóricos histórico-lógico, inductivo-deductivo y analítico-sintético. Los principales hallazgos indican que las empresas exportadoras a nivel de Latinoamérica están tomando impulso y abriéndose a innovaciones medioambientales con el fin de incursionar en mercados altamente competitivos como el europeo. No obstante, se destaca la complejidad que implica el manejo de la cadena completa en el ámbito de logística inversa, que demanda de grandes recursos económicos, y un alto nivel de cooperación organizacional.
CASO - LA NUEVA ERA TECNOLOGICA
Authors: Gómez Rosalyn , Medina José , Véliz José 
Published: May 2021

Este caso de negocios es sobre la aplicación online de una nueva herramienta creada principios del año 2010 con la misión obtener el mejor contenido de excelente calidad para los clientes; y a futuros inversores las perspectivas de un crecimiento rentable, con una visión en convertirse en la mejor aplicación de entretenimiento en su categoría. En un inicio la manera de generar rentabilidad era con los anuncios, para ello se necesita un buen número de tráfico de clientes y por consiguiente ganancias. Para poder hacer esto, es necesario que te unas a redes de anuncios como el caso de Admob de Google. Se buscará analizar otras forma de generar ingresos que estén relacionadas con el servicio de calidad y pueda contribuir a la toma de decisiones en relación a nuestros futuros inversores.
A Study of the Socioeconomic Impact of Mobile Phones on SMEs in the Waterloo Community, the Western Rural District of Sierra Leone
Authors: Mansaray Hassan Elsan 
Published: May 2021

To assess the impact of mobile phones on small and medium enterprises (SMEs) in the Waterloo Community, the researcher used qualitative research methods to do the study. It is selected with the intention of evaluating the socioeconomic impact on the use of mobile phones in the transport, Sand and stone mining as well as general merchandize/petty trading activities in the Waterloo community. Hence, simple random sampling technique was applied in selecting the number of participants that were involved in the study. The study discovered that the SMEs have contributed to socioeconomic development at certain level through the use of mobile phones. The impact of mobile phones in the Waterloo community involved: precise accounting and bookkeeping, making payments and collections, selling of products, and services to customers, connecting people, and increase business network opportunities and jobs creation.
The study further revealed the challenges faced by SMEs in their daily operations in the Waterloo community for example, increased competition from large firms, and multinational corporations, the ability to adjust to fast changing market demand, technological capacity, and change limitations linking knowledge, innovation, and creativity. Other challenges include lack of previous experience to run the SMEs, poor planning, no proper markets assessment, uncommercialized products, scanty marketing skills and lack of good corporate governance.
PENGARUH KOMUNIKASI TERHADAP PRODUKTIVITAS KERJA KARYAWAN PADA KOPERASI KARYA BERSAMA SMK PGRI 2 BELITANG OGAN KOMERING ULU TIMUR
Authors: Mardani Mardani , Kurniawan Deni , Zaidun Zaidun , Khoiriah Siti 
Published: May 2021

Penelitian ini bertujuan untuk mengetahui besarnya pengaruh komunikasi terhadap produktivitas kerja karyawan pada koperasi Karya Bersama SMK PGRI 2 Belitang OKU Timur. kesimpulan yang didapat adalah r = 0,80 yang telah dikonsultasikan dengan standard yang konservatif maka terletak diantara 0,800- 1,000 yang artinya tergolong pada korelasi atau pengaruh yang sangat kuat antara komunikasi dengan produktivitas kerja karyawan pada koperasi Karya Bersama SMK PGRI 2 Belitang OKU Timur dan setelah diadakan uji hipotesis diketahui t hitung = 3,77 dan t tabel diperoleh 1,860 . Adapun saran yang dapat diberikan adalah pihak koperasi harus memberikan arahan kepada para karyawannya bahwa pentingnya komunikasi untuk meningkatkan produktivitas kerja. Komunikasi mempunyai pengaruh yang sangat kuat terhadap produktivitas kerja karyawan pada koperasi Karya Bersama SMK PGRI 2 Belitang OKU Timur, dapat dilihat dari hasil analisa kuantitatif melalui koefisien korelasi diperoleh r = 0,80 setelah dihubungkan dengan standar yang konservatif ternyata r = 0,80 terletak diantara 0,800 – 1,000 termasuk pada korelasi yang sangat kuat.