bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colocating Teleophthalmology Within Primary Care Settings to Improve Access to Diabetic Retinopathy Screening: Retrospective Descriptive Evaluation
Authors: Wandy Tiffany , Rayaz Shuja , Brager Jenna Ashly Levenson , Kiritsy Michael , Offermann Elizabeth , Durand Daniel 
Published: June 2021

Background
Annual retinal exams for patients with diabetes are critical as diabetic retinopathy is the number one cause of preventable blindness in working-age adults in the United States. Currently, most patients with diabetes in the United States receive a referral from their primary care provider to see an ophthalmologist for their annual dilated eye exam, which can be an added inconvenience and expense. As such, there is a need for alternative screening strategies within an outpatient network. The use of a telemedicine platform in a primary care setting serves as a novel strategy to increase diabetic retinopathy screening rates. In order to provide better access to diabetic retinopathy screening for our patients, cameras were placed in 3 primary care practices in October 2017 as part of an 8-month pilot program. Specialized cameras from Intelligent Retinal Imaging Systems (IRIS) were used to acquire images that could be interpreted remotely by ophthalmologists within the LifeBridge Health network for the diagnosis of diabetic retinopathy and the detection of other types of pathology (eg, macular edema).

Objective
The aim of this retrospective descriptive study was to examine whether a telemedicine platform can be used as a cost-effective way to increase diabetic retinopathy screening rates in the primary care setting.

Methods
Aggregate screening volume and diagnostic data were collected for each of the 3 practice locations for the 8-month pilot period (October 30, 2017, through June 30, 2018). Additionally, payor reimbursement data and equipment cost data were used to determine the payback period for each of the 3 practice locations.

Results
The pilot program proved the business case that implementation of the IRIS camera in 3 practice locations could result in enough patients being screened to pay for the cost of the camera within a maximum of 2 years. The 3 practices showed increased diabetic retinopathy screening rates of 1%, 6%, and 24%, respectively, and were all able to screen enough patients to be on track to pay off the cost of the camera within 2 years of implementation. Aggregate data from the pilot period showed that of the 1213 patients who were screened, approximately 17.1% (n=207) were diagnosed with diabetic retinopathy and an additional 17.7% (n=215) were suspected of having some other form of pathology. Of note, 10.1% (n=123) were also identified as being “IRIS saves,” defined as having pathology identified that was severe enough to be considered an imminent threat to their vision.

Conclusions
This retrospective descriptive study suggests that a telemedicine platform can be used to improve diabetic retinopathy screening rates in the primary care setting within a large health care system in a cost-effective way that allows for the cost of the equipment to be recouped through billing within a maximum of 2 years.
Trends in First-Line Glucose-Lowering Drug Use in Adults With Type 2 Diabetes in Light of Emerging Evidence for SGLT-2i and GLP-1RA
Authors: Shin HoJin , Schneeweiss Sebastian , Glynn Robert J. , Patorno Elisabetta 
Published: June 2021

OBJECTIVE
We evaluated recent use trends and predictors of first-line antidiabetes treatment in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS
Using two large U.S. health insurance databases (Clinformatics and Medicare), we identified adult patients with type 2 diabetes who initiated antidiabetes treatment from 2013 through 2019. Quarterly trends in use of first-line antidiabetes treatment were plotted overall and stratified by cardiovascular disease (CVD). Multinomial logistic regressions were fit to estimate predictors of first-line antidiabetes treatment, using metformin, the recommended first-line treatment for type 2 diabetes, as the common referent.

RESULTS
Metformin was the most frequently initiated medication, used by 80.6% of Medicare beneficiaries and 83.1% of commercially insured patients. Sulfonylureas were used by 8.7% (Medicare) and 4.7% (commercial). Both populations had low use of sodium–glucose cotransporter 2 inhibitors (SGLT-2i, 0.8% [Medicare] and 1.7% [commercial]) and glucagon-like peptide 1 receptor agonists (GLP-1Ra; 1.0% [Medicare] and 3.5% [commercial]), with increasing trends over time (P &lt; 0.01). Initiators of antidiabetes drugs with established cardiovascular benefits (SGLT-2i and GLP-1RA) were more likely to be younger and had prevalent CVD or higher socioeconomic status compared with initiators of metformin.

CONCLUSIONS
Among adult patients with type 2 diabetes, metformin was by far the most frequent first-line treatment. While the use of SGLT-2i and GLP-1RA was low from 2013 through 2019, it increased among patients with CVD.
Comparison of the Effect of Agitation on Whitening and Tooth Sensitivity of In-Office Bleaching: A Randomized Clinical Trial
Authors: Kiyuna RC , Martins LM , Hanzen TA , Reis A , Loguercio AD , Silva LM 
Published: June 2021

SUMMARY

Objective:
This single-blind, split-mouth, randomized trial was aimed at evaluating the bleaching efficacy (BE) and tooth sensitivity (TS) of a 20% hydrogen peroxide (HP) bleaching agent used under active or passive application.

Methods and Materials:
Twenty-two patients with canines darker than C2 were selected. Teeth were bleached in two sessions, with a one-week interval between treatments. The bleaching agent was applied using active (HPactive) or passive (HPpassive) application. Each tooth in the HPactive-allocated hemiarch received bleaching gel with sonic activation after 10 and 30 minutes from the start of treatment, with rounded movements all over the buccal surface. The color changes were evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (VITA Easyshade Spectrophotometer) methods at baseline and 30 days after the second session. TS was recorded up to 48 hours after treatment using a 0-10 visual analog scale. Color change in shade guide units (SGUs) and ΔE was analyzed using a Wilcoxon test (α=0.05). The absolute risk and intensity of TS were evaluated using McNemar test and a Wilcoxon test, respectively (α=0.05).

Results:
Significant whitening was observed in both groups after 30 days of clinical evaluation. The activation did not significantly influence BE (ΔSGU HPpassive=5.6 and HPActive=5.8; p=0.98; and ΔE HPpassive=10.6 and HPactive=10.3; p=0.83). Absolute risk of TS (HPactive=36.4% and HPpassive=31.8%; p=0.94) was similar for both groups (Fisher exact test). TS intensity (visual analogue scale) was higher during the bleaching sessions and up to 24 hours thereafter for both groups, with no differences between groups (two-way analysis of variance and Tukey).

Conclusion:
The active application of a 20% HP gel did not improve BE and TS.
PENGEMBANGAN MULTIMEDIA PEMBELAJARAN INTERAKTIF BERBASIS LECTORA INSPIRE PADA PELAJARAN INSTALASI PENERANGAN LISTRIK DI SMK SWASTA DWIWARNA MEDAN
Authors: Saleh Anwar , Siagian Sahat 
Published: June 2021

Abstract The purpose of this research is to develop interactive learning multimedia in the form of an interactive CD, using several software including Lectora Inspire, Adobe Photoshop CS6, Bandycam, and AMR to MP3 Converter. This development research used the Borg and Gall research model adapted from Sugiyono. The target of this research is the Expert Lecturer at the State University of Medan. The eligibility test of interactive learning multimedia was carried out by media validators, material validators, and acceptance validators. Based on the data analysis conducted, it shows that the resulting learning multimedia is good with a score of 4.4 for material validation, a score of 4.5 for media validation, and a score of 4.2 for validation of acceptances. So the results of the validation show that the learning multimedia developed is eligible for use. Key Words: Interactive Multimedia, Lectora Inspire Software, Electrical Lighting Installation AbstrakTujuan dari penelitian ini adalah mengembangkan multimedia pembelajaran interaktif dalam bentuk CD interaktif, menggunakan beberapa software diantaranya Lectora Inspire, Adobe Photoshop CS6, Bandycam, dan AMR to MP3 Converter. Penelitian pengembangan ini menggunakan model penelitian Borg and Gall yang diadaptasi dari Sugiyono. Sasaran penelitian ini adalah Dosen Ahli Universitas Negeri Medan. Uji kelayakan multimedia pembelajaran interaktif dilakukan oleh validator media, validator materi, dan validator penerimaan. Berdasarkan analisis data yang dilakukan menunjukkan bahwa multimedia pembelajaran yang dihasilkan baik dengan skor validasi materi 4,4, validasi media skor 4,5, dan validasi penerimaan skor 4,2. Sehingga hasil validasi menunjukkan bahwa multimedia pembelajaran yang dikembangkan layak untuk digunakan.Kata Kunci: Multimedia Interaktif, Software Lectora Inspire, Instalasi Penerangan Listrik
Global existence and blow-up of generalized self-similar solutions for a space-fractional diffusion equation with mixed conditions
Authors: Nouioua Farid , Basti Bilal 
Published: June 2021

Abstract
This paper investigates the problem of the existence and uniqueness of solutions under the generalized self-similar forms to the space-fractional diffusion equation. Therefore, through applying the properties of Schauder’s and Banach’s fixed point theorems; we establish several results on the global existence and blow-up of generalized self-similar solutions to this equation.
Research on Increasing the Degree of Individual Protection against Bullets through the use of Ceramic Materials
Authors: Ilie Florin 
Published: June 2021

Abstract
The protection of forces in the new world conflicts has become a particularly important issue for all the world’s armies. Therefore, ensuring an optimal level of protection, combined with maintaining freedom of movement in the tactical field has become a very important topic for research teams. This goal can be achieved by using materials in the protection of forces with a relatively low mass, but to ensure a substantial reduction in the kinetic energy of ballistic penetrators. In this paper are presented some considerations on how the ballistic penetration process is affected by the presence of ceramic materials.
Market Structure analysis with Herfindahl-Hirchman Index and Lauraéus-Kaivo-Oja Indices in the Global Cobotics Markets
Authors: Lauraéus Theresa , Kaivo-oja Jari , Knudsen Mikkel S. , Kuokkanen Kimmo 
Published: June 2021

Abstract

Research purpose. The study is focused on the expected market dynamics of global cobotics markets. This study investigates the current market structure of the global cobotics market. The scientific aim of the research is to report the first data-based market structure analysis of the global cobotics market with the HHI index and with the LKI index analysis. With analysis we are able to show the diversification rate of the global cobotics market.

Design / Methodology / Approach. The methodology is based on conventional statistical index theory and statistics. The methodology is the calculation of the Herfindahl-Hirchman Index and the Lauraéus-Kaivo-oja Index. The authors compare the results of these two methodologies.

Findings. The Herfindahl-Hirschman Index (HHI) and the Lauraéus-Kaivo-oja Index are statistical measures of market concentration, and they can be used to determine market competitiveness. This paper demonstrates novel data analytics possibilities of new market data collected by the Statzon, Ltd with various comparative analytical results and findings. By our analyses we can help multiple industrial stakeholders make faster decisions and better strategic plans with the easiest and fastest access to accurate, reliable, and up-to-date cobotics industry statistics, forecasts, and insights. The finding is that this study reveals the current market structure of global cobotics. It is a novel finding and result.

Originality / Value / Practical implications. This paper demonstrates the novel and exciting possibilities of transparent index calculation tools. The authors provide original results. Authors underline that extra value added to stakeholders and customers will be provided by joint data pooling strategy of various data sources, which is a key approach of this paper. Real-time market structure analyses create reliable and knowledge-based information for decision-makers and stakeholders of the global cobotics industry.
A New Sustainability Model – A Four Essential Quadrants Framework
Authors: Fioravante Philip L. 
Published: June 2021

Abstract

Research purpose. This paper will present contemporary ideas on how, when, and where the four quadrants are vital to the sustainability of an organization and central to the future of the entity. There have long been suppositions and actual operational level models featuring three primary rudiments. Much of the prior research and modeling has centered on Economic, Social, and Environmental as the basis for sustainability within business models. This particular research brought new perspectives and addressed some deficiencies in the existing sustainability models.

Design / Methodology / Approach. A qualitative methodology aligned with an axiological philosophical assumption is evidenced throughout the explanatory review, and new open-ended interviews focused on values while discussing the nuances of sustainability. The methodology applied is a review of relevant literature on sustainability, critical thinking, CSR, and financial acumen that was utilized to augment the interviews.

Findings. This new and distinct perspective develops and puts forth four quadrants that are corollary to these three core elements. However, this version purports a more comprehensive and holistic framing with a focus on Financial Acumen, Critical Thinking, Creativity & Innovation, and Corporate Social Responsibility (CSR). Each of these “new model” fundamentals provides a broader application for sustainability within a business strategy as companies look to distinguish themselves in the markets served. There is no doubt that executives are faced with a myriad of complex and, in some sense, extraordinary demands on the business.

Originality / Value / Practical implications. This sustainability model captures four imperatives for sustaining and improving business performance and, in the end, a sophisticated and authentic approach providing engagement by and with all stakeholders. Financial acumen must be comprehensive and create value; Critical Thinking must be pervasive throughout the organization; Creativity & Innovation must drive systematic improvements throughout, and Corporate Social Responsibility should be a core business strategy for both employee engagement and creating external social influences. Though this last supposition can be argued such as Friedman put forth, there remains the awareness and recognition of the importance of CSR in a business model. This particular research will broaden the view of those involved with sustainability to now include critical thinking, creativity, and innovation.
Online interaction descriptors: A tool for the development of tasks for language competences and language use
Authors: Bérešová Jana , Micallef Alice 
Published: June 2021

Abstract
The study focuses on a new scale of the framework introduced by the CEFR Companion Volume. Slovak and Maltese teachers were invited to participate in the training sessions in which they were exposed to lists of descriptors related to online interaction. The goal of familiarisation activities related to indicating reference levels was to prepare teachers for constructing tasks designed for practicing online communication in language classes, relevant to the proficiency levels of their students. The data on teachers’ judgements are clearly displayed and analysed in order to find out similarities and differences between teachers’ perceptions of language proficiency in two countries. Workshop sessions stimulated in-depth discussions the conclusions of which are reflected in the recommendations for language educators and teachers.
Antimicrobial resistance and virulence factor gene profiles of Enterococcus spp. isolated from giant panda oral cavities
Authors: Zhong Rui , Zhou Ziyao , Liu Haifeng , Zhong Zhijun , Peng Guangneng 
Published: June 2021

Abstract

Introduction
The objective of this study was to determine the prevalence and characteristics of antimicrobial-resistant Enterococcus faecalis and E. faecium isolated from the oral cavities of captive giant pandas in China.

Material and Methods
The virulence-associated determinant and antimicrobial resistance genes were detected and antimicrobial susceptibility tests were performed on 54 strains of each bacterium.

Results
All isolates showed 100% multidrug resistance. E. faecalis isolates showed a higher percentage of strains resistant to gentamicin (48.1%), vancomycin (55.6%), linezolid (100%), and streptomycin (33.3%) than E. faecium isolates. The resistance genes of Enterococcus spp. were present to highly varying extents according to antibiotic type, their presence breaking down for E. faecalis and E. faecium respectively as aac(6')/aph(2″) 5.56% and 5.56%; aph(3')-Ⅲ 0% and 14.81%; ant(6)-I 0% and 3.7%; ant(4')-Ia 0% and 64.81%; tetL 20.37% and 100%; vanA 92.59% and 46.3%; vanB 0% and 0%; cfr 0% and 90.74%; optrA 96.3% and 3.7%; blaZ 0% and 1.85%; blaTEM 0% and 0%; tetA 20.37% and 0%; tetC 24.07% and 100%; tetM 0% and 0%; ermA 12.96% and 100%; ermB 5.56% and 3.7%; and ermC 0% and 1.85%.Virulence-associated determinants were detected in this research, which typically include efaA, gelE, asa1, ace, cylA, esp and hyl; however, the latter three were not detected. High proportions of the isolates carried the efaA, gelE, asa1, and ace genes. Respectively for E. faecalis and E. faecium their detection was efaA 98.1% and 85.2%; gelE 98.1% and 87%; asa1 92.6% and 87%; and ace 87% and 85.2%.

Conclusion
This is the first study on the potential disease risk and antimicrobial-resistant characteristics of E. faecalis and E. faecium isolates in giant panda oral cavities. The results of this study show that the antimicrobial resistance rate of Enterococcus spp. isolated from the oral cavity of captive pandas is very high, and thus needs to be monitored.
Effects of vitamin C and magnesium L-threonate treatment on learning and memory in lead-poisoned mice
Authors: Bislimi Kemajl , Mazreku Ilir , Halili Jeton , Aliko Valbona , Sinani Kushtrim , Hoxha Liridon 
Published: June 2021

Abstract

Introduction
The aim of this study was to investigate the effects of vitamin C (vit C) and magnesium L-threonate (MgT) on the learning ability and memory of mice intoxicated with lead acetate.

Material and Methods
The experimental male Swiss albinos were divided into five groups of 10 during a 40-day treatment period. One group were untreated controls, one received lead acetate at 90 mg/kg b.w., one additionally vit C at 40 mg/kg b.w., another additionally MgT at 100 mg/kg b.w., and the last was administered MgT without lead acetate. After a 20-day washout period, the animals were trained in the Morris water maze test for 6 days and after a 24-hour interval, were assessed for memory in the same test. At test end the mice were sacrificed and their organs sampled.

Results
The results of total time and number of entries into the platform zone showed that significantly poorer performances were recorded for the group poisoned with lead acetate alone and significantly lower scores for learning and memory were recorded for the intoxicated and supplemented groups compared to the control group. Catalase activity was significantly reduced in the liver, pancreas and kidney but significantly potentiated in brain tissue by these two supplements compared to the control group. Lead concentration in brain tissue was significantly higher in the presence of vit C than in the control or lead acetate-only groups.

Conclusion
Lead acetate had adverse effects on learning and memory of mice and also increased catalase activity.
Could ferritin, vitamin B12, and vitamin D play a role in the etiopathogenesis of fibromyalgia syndrome?
Authors: Kucuk Adem , Baykara Rabia Aydogan , Tuzcu Ayca , Omma Ahmet , Cure Medine Cumhur , Cure Erkan , Acet Gunseli Karaca , Dogan Erdal 
Published: June 2021

Abstract

Introduction. Fibromyalgia syndrome (FS) comprises general body pain, sleep disturbances, and fatigue. Vitamin B12 (VB), vitamin D (VD), and iron deficiencies lead to similar complaints. First, this study aimed to evaluate the VB, VD, and ferritin levels of patients with FS. Second, it aimed to investigate whether there was a relationship between these parameters and FS severity.

Material and methods. The study included 58 female patients with FS and 58 healthy females as a control group. The patients completed the Fibromyalgia Impact Questionnaire (FIQ), Visual Analog Scale (VAS), fatigue questionnaire, Pittsburgh sleep quality scale, and the Short Form-36 (SF-36). This study examined the VD, VB, and ferritin levels of the patient and control groups.

Results. The VB (240.0 [110.0–394.0] vs 291.0 [210.0–609.0] pg/ml, p<0.001), VD (12.5 [3.0–45.0] vs 20.0 [5.0–54.0] ng/ml, p=0.013), and ferritin levels (21.2 [4.0–86.0] vs 32.0 [7.1–120.0], ng/ml, p=0.009) of the FS patients were determined to be significantly lower than those of the control group. A negative correlation was determined between the number of tender points and VB, VD, and ferritin levels. In the regression analysis, we found low ferritin levels (odds ratio [OR] 1.036, 95% confidence interval [CI] 1.015–1.058, p<0.001) and VB (OR 1.010, CI 1.002–1.018, p=0.010) to be an independent risk factor for FS.

Conclusions. There may be a relationship between VB, VD, and ferritin levels and the number of tender points in patients with FS. Levels of iron and VB may play a vital role in FS etiopathogenesis. However, VD levels may not be a risk factor for FS etiopathogenesis.