bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing Prediction Models for 30-Day Unplanned Readmission Among Children With Medical Complexity
Authors: Leary Jana C. , Price Lori Lyn , Scott Cassandra E.R. , Kent David , Wong John B. , Freund Karen M. 
Published: March 2019

OBJECTIVES:
To target interventions to prevent readmission, we sought to develop clinical prediction models for 30-day readmission among children with complex chronic conditions (CCCs).

METHODS:
After extracting sociodemographic and clinical characteristics from electronic health records for children with CCCs admitted to an academic medical center, we constructed a multivariable logistic regression model to predict readmission from characteristics obtainable at admission and then a second model adding hospitalization and discharge variables to the first model. We assessed model performance using c-statistic and calibration curves and internal validation using bootstrapping. We then created readmission risk scoring systems from final model β-coefficients.

RESULTS:
Of the 2296 index admissions involving children with CCCs, 188 (8.2%) had unplanned 30-day readmissions. The model with admission characteristics included previous admissions, previous emergency department visits, number of CCC categories, and medical versus surgical admission (c-statistic 0.65). The model with hospitalization and discharge factors added discharge disposition, length of stay, and weekday discharge to the admission variables (c-statistic 0.67). Bootstrap samples had similar c-statistics, and slopes did not suggest significant overfitting for either model. Readmission risk was 3.6% to 4.9% in the lowest risk quartile versus 15.9% to 17.6% in the highest risk quartile (or 3.6–4.5 times higher) for both models.

CONCLUSIONS:
Clinical variables related to the degree of medical complexity and illness severity can stratify children with CCCs into groups with clinically meaningful differences in the risk of readmission. Future research will explore whether these models can be used to target interventions and resources aimed at decreasing readmissions.
A Clinical Pathway for the Care of Critically Ill Patients With Asthma in the Community Hospital Setting
Authors: Smith Alla , Banville Debra , Gruver E. James , Lenox Jesslyn , Melvin Patrice , Waltzman Mark 
Published: March 2019

OBJECTIVES:
The management of severe pediatric asthma exacerbations is variable. The use of clinical pathways has been shown to decrease time to clinical recovery and length of stay (LOS) for critically ill patients with asthma in freestanding children’s hospitals. We sought to determine if implementing a clinical pathway for pediatric patients who are on continuous albuterol in a community hospital would decrease time to clinical recovery and LOS.

METHODS:
A clinical pathway for guiding the initiation, escalation, and weaning of critical asthma therapies was adapted to a community hospital without a PICU. There were 2 years of baseline data collection (from September 2014 to August 2016) and 16 months of intervention data collection. Segmented regression analysis of interrupted time series was used to evaluate the pathway’s impact on LOS and time to clinical recovery.

RESULTS:
There were 129 patients in the study, including 69 in the baseline group and 60 in the intervention group. After pathway implementation, there was an absolute reduction of 10.2 hours (SD 2.0 hours) in time to clinical recovery (P ≤ .001). There was no significant effect on LOS. There was a significant reduction in the transfer rate (27.5% of patients in the baseline period versus 11.7% of patients in the intervention period; P = .025). There was no increase in key adverse events, which included the percentage of patients who required ICU-specific therapies while awaiting transfer (7.3% of patients in the baseline period versus 1.7% of patients in the intervention period; P = .215).

CONCLUSIONS:
The implementation of a clinical pathway for the management of critically ill children with asthma and on continuous albuterol in a community hospital was associated with a significant reduction in time to clinical recovery without an increase in key adverse events.
Predicting Postoperative Physiologic Decline After Surgery
Authors: Berry Jay G. , Johnson Connor , Crofton Charis , Staffa Steven J. , DiTillio Maura , Leahy Izabela , Salem Joseph , Rangel Shawn J. , Singer Sara J. , Ferrari Lynne 
Published: March 2019

BACKGROUND:
Projecting postoperative recovery in pediatric surgical patients is challenging. We assessed how the patients’ number of complex chronic conditions (CCCs) and chronic medications interacted with active health issues to influence the likelihood of postoperative physiologic decline (PoPD).

METHODS:
A prospective study of 3295 patients undergoing elective surgery at a freestanding children’s hospital. During preoperative clinical evaluation, active health problems, CCCs, and medications were documented. PoPD (compromise of cardiovascular, respiratory, and/or neurologic systems) was measured prospectively every 4 hours by inpatient nurses. PoPD odds were estimated with multivariable logistic regression. Classification and regression tree analysis distinguished children with the highest and lowest likelihood of PoPD.

RESULTS:
Median age at surgery was 8 years (interquartile range: 2–15); 2336 (70.9%) patients had a CCC; and 241 (7.3%) used ≥11 home medications. During preoperative evaluation, 1556 (47.2%) patients had ≥1 active health problem. After surgery, 882 (26.8%) experienced PoPD. The adjusted odds of PoPD were 1.2 (95% confidence interval [CI]: 1.0–1.4) for presence versus absence of an active health problem; 1.4 (95% CI: 1.0–1.9) for ≥11 vs 0 home medications; and 2.2 (95% CI: 1.7–2.9) for ≥3 vs 0 CCCs. In classification and regression tree analysis, the lowest rate of PoPD (8.6%) occurred in children without an active health problem at the preoperative evaluation; the highest rate (57.2%) occurred in children with a CCC who used ≥11 home medications.

CONCLUSIONS:
Greater than 1 in 4 pediatric patients undergoing elective surgery experienced PoPD. Combinations of active health problems at preoperative evaluation, polypharmacy, and multimorbidity distinguished patients with a low versus high risk of PoPD.
Penerapan Ekstrak Putri Malu (Mimosa pudica L.) sebagai Penghambat Melanosis pada Udang selama Penyimpanan Dingin
Authors: Jannah Nabila Tsarwatul , Agustini Tri Winarni , Anggo Apri Dwi 
Published: March 2019

Salah satu masalah pada mutu udang selama penanganan adalah munculnya melanosis. Melanosis merupakan bercak hitam yang timbul akibat aktivitas enzim PPO (polifenoloksidase). Tanaman putri malu (Mimosa pudica L.) memiliki senyawa bioaktif yang dapat berfungsi sebagai antioksidan seperti flavonoid, fenol dan tanin. Penelitian ini bertujuan untuk mengetahui efektivitas dan konsentrasi terbaik ekstrak tanaman putri malu (Mimosa pudica L.) dalam proses enzimatis (melanosis) pada udang selama penyimpanan dingin. Konsentrasi yang digunakan adalah 0%, 3%, 5% dan 7% dengan penyimpanan selama 10 hari dan pengujian dilakukan setiap 2 hari (hari ke 0, 2, 4, 6, 8 dan 10). Paramater pengujian yang diamati adalah uji melanosis secara visual, TBA, TVBN, sensori dan pH. Rancangan percobaan yang digunakan adalah RAL. Hasil penelitian menunjukkan ekstrak tanaman putri malu memberikan pengaruh nyata dalam mempertahankan mutu udang dari terjadinya reaksi melanosis hingga hari ke-6. Konsentrasi terbaik adalah konsentrasi 7% yang dapat mempertahankan mutu udang hingga hari ke-6 karena konsentrasi 7% memiliki nilai hasil uji melanosis, TBA, TVBN, dan pH yang terendah serta nilai sensori tertinggi.
Performance of a novel built-up column composed of four cold-formed tubes
Authors: Chen Xiaomiao , Xia Junwu , Xu Bo , Ma Renwei 
Published: March 2019

A novel built-up column (BUC) under axial compression was experimentally investigated. The BUC consisted of four cold-formed thin-walled rectangular tubes assembled with several V-type or I-type connectors by self-tapping screws. Based on the axial loading tests of ten novel BUCs, the compressive stability of BUCs was studied, including the ultimate bearing capacity and failure mode. The relationships between load and axial shortening, lateral displacement and strain of the tubes were measured in tests. The test results were compared with predictions of codes (AISI S100-07 and GB 50018-2002) and a modified design method was developed. The results showed that the BUCs composed of four rectangular tubes assembled with V-type connectors and I-type connectors are different from classic latticed columns and battened columns in the calculation model of the transverse displacement produced by shear force. The predicted values calculated according to the suggested design method were found to be in good agreement with the experimental values of the novel BUC.
La política ambiental internacional y el discurso del papa Francisco: ¿hacia una ecología del pueblo?/ International Environmental Politics and the Discourse of Pope Francis: Towards an Ecology of the People?
Authors: Foa Torres Jorge Gabriel , Tuninetti Luis 
Published: March 2019

Resumen
Numerosas reacciones y polémicas ha generado el discurso del papa Francisco en el campo de la política ambiental, en especial desde la aparición en 2015 de la encíclica “Alabado Seas: sobre el Cuidado de la Casa Común” (Laudato Si´). En ese marco, el presente artículo, en primer lugar, identifica las principales lógicas o gramáticas que han intervenido en las discusiones político-ideológicas en torno a la causa ambiental en las últimas décadas, a escala latinoamericana y mundial. En segundo lugar, ubica y caracteriza al discurso del papa Francisco en tal contexto. El enfoque utilizado es el del análisis político del discurso. Fundado en el reconocimiento del carácter constitutivamente antagónico de las sociedades, este se orienta a la comprensión crítica de las prácticas sociodiscursivas, enfatizando en sus instancias políticas o momentos fundacionales. El argumento central del artículo es que el posicionamiento de Francisco, mientras se distingue de la lógica desarrollista, es antagónico respecto de las posturas neomalthusiana y neoliberal. Al mismo tiempo, se aproxima a la ecología crítica, modulándola tanto en relación con el rol de las corporaciones transnacionales como con la crítica al paradigma tecnocrático y la incorporación de la noción de pueblo.
Abstract
Pope Francis’ discourse in the field of environmental policy has recently generated numerous reactions and controversies, especially since the appearance in 2015 of the Encyclical “(Praise be to you - On Care for Our Common Home” (Laudato Si '). In that framework, this article firstly identifies the main logics or grammars that have intervened in the political-ideological discussions around the environmental cause in recent decades, on a Latin American and world scale. In the second place, the discourse of Pope Francis is located and characterized in that context. The approach in which this work is inscribed is the analysis of political discourse. Based in the recognition of the constitutively antagonistic character of societies, it is oriented to the critical understanding of socio-discursive practices, emphasizing in their political instances or foundational moments. The central argument of the article is that Francisco's positioning, while differing from the developmentalist logic, is antagonistic to neo-Malthusian and neoliberal positions. At the same time, it approaches critical ecology, modulating it both in relation to the role of transnational corporations and in criticizing the technocratic paradigm and incorporating the notion of the people.
Internalización del principio de las responsabilidades comunes, pero diferenciadas: interpretaciones desde la sociedad civil brasileña/Internalization of the Principle of Common but Differentiated Responsibilities: Interpretations from the Brazilian Civil
Authors: Kiessling Christopher Kurt 
Published: March 2019

El principio de las responsabilidades comunes, pero diferenciadas, ha sido una norma constitutiva de la política climática global. Su interpretación tradicional sostiene que diferentes niveles de protección ambiental deben esperarse entre los países desarrollados y los países emergentes y/o en vías de desarrollo. Sin embargo, dicho sentido comenzó a ser cuestionado y contestado por actores de la sociedad civil, tanto a escala global como en contextos domésticos particulares. En este artículo se describe el proceso de localización del principio de las responsabilidades comunes, pero diferenciadas, en el discurso doméstico brasilero de la sociedad civil organizada sobre cambio climático entre los años 2005 y 2015, desde una perspectiva constructivista de las Relaciones Internacionales. Para alcanzar este objetivo, se plantean las diversas interpretaciones y reinterpretaciones del principio por parte de actores no estatales en Brasil.

Abstract
The principle of common but differentiated responsibilities has been a constitutive norm since the origins of the global climate policy. The traditional interpretation of this norm maintains that different levels of environmental protection should be expected between developed countries and emerging and/or developing countries. However, this interpretation began to be questioned and challenged by civil society actors, both globally and in particular domestic contexts. This article describes the process of localization of the principle of common but differentiated responsibilities in the Brazilian domestic discourse of organized civil society on climate change between the years 2005 and 2015, from a constructivist perspective of International Relations. To achieve this objective, the different interpretations and reinterpretations of the principle by non-state actors in Brazil are presented.
Decoding Academic Fair Use: Transformative Use and the Fair Use Doctrine in Scholarship
Authors: Bunker Matthew D. 
Published: March 2019

Fair use in copyright law is an enormously complex legal doctrine. Although much scholarly attention has been paid to fair use in the context of teaching -- particularly in on-line education -- relatively little research exists on the problem of fair use in scholarship. This article analyzes reported federal cases on fair use in scholarly contexts, with a particular emphasis on the transformative use doctrine that has become enormously influential in fair use determinations. The article explores insights from this body of case law that may assist future scholars wishing to fairly use copyrighted expression in their scholarship.
Sistemas Silvopastoriles y Cambio climático: Estimación y predicción de Biomasa Arbórea
Authors: Jiménez Ruiz Edwin Rolando , Fonseca González William , Pazmiño Pesantez Leticia 
Published: March 2019

En este trabajo se cuantificó la biomasa y el carbono almacenado en la cobertura vegetal de un sistema silvopastoril compuesto por pasto (Hyparrhenia rufa) y guasmo (Guazuma ulmifolia) establecido en forma natural en el cantón Balzar de la provincia del Guayas en Ecuador. A través del método destructivo y con un muestreo aleatorio por medio de parcelas anidadas, se evaluó la cantidad de biomasa arbórea y subterránea de árboles de diámetro promedio, la necromasa y la vegetación herbácea. Se desarrollaron modelos para estimar la biomasa del árbol completo y sus componentes (tronco, raíz, ramas y hojas) y el volumen. La biomasa arbórea es de 16.45 Mgha-1 (8.23 MgC ha-1) y el aporte de la vegetación herbácea y la necromasa de 1.4 y 1.9 Mg ha-1 (0.7 y 0.95 Mg C ha-1), respectivamente. Los modelos predicen la biomasa y el volumen en función del diámetro con errores de estimación o sesgos menores al 3% y mostraron ajustes (R2) mayores a 96%. Adicionalmente, se generó información sobre factores de expansión de biomasa.
Palabras claves: Biomasa, carbono, Guazuma ulmifolia, mitigación, modelos alométricos, servicios ambientales.
Edad al primer parto e indicadores de eﬁciencia en vacas lecheras con diferente potencialidad productividad en sistemas a pastoreo
Authors: Marini Pablo Roberto , Di Masso Ricardo José 
Published: March 2019

El objetivo del presente trabajo fue analizar la relación entre la edad al primer parto con la producción láctea e indicadores reproductivos en vacas lecheras, con diferente potencial productivo. Se utilizaron datos retrospectivos de 260 vacas de raza Holstein biotipo Americano-Canadiense con información desde su nacimiento hasta finalizar la lactancia, recolectados entre los años 1992-2012 en el tambo cabaña perteneciente a la Escuela Agrotécnica Gral. San Martín dependiente de la Universidad Nacional de Rosario. El mismo se encuentra ubicado en la localidad de Casilda, Departamento Caseros, provincia de Santa Fe, Argentina. Los animales se dividieron en dos categorías: vacas puras (n=103) y vacas con registro de cría (n=157). Cada una de las vacas pertenecientes a cada uno de los grupos mencionados se caracterizó en función de los valores de dos indicadores reproductivos: edad al primer parto en días e intervalo parto concepción en días y dos indicadores productivos: producción de leche ajustada a 305 días de lactancia en litros y número de partos. No hubo diferencias significativas entre grupos en su precocidad. Las vacas puras presentaron mayor producción (t = 4,493; P< 0,0001) mientras que las vacas con registro de cría fueron más fértiles (t= 2,039; P= 0,043). Los grupos no difirieron en el número de partos. Las diferencias en el comportamiento de las vacas puras y las vacas con registro de cría, con diferente potencialidad productiva, pone en discusión el objetivo de ejercer presión para lograr un primer parto a los 24 meses como propuesta generalizada en los sistemas a pastoreo.
L’interculturel dans l’enseignement/apprentissage du FLE au Maroc
Authors: BOURRAY Mounir 
Published: March 2019

RÉSUMÉ. Dans le cadre de la didactique des langues étrangères, cet article ayant tracé pour objectif d’étudier la place et le rôle de l’interculturel dans l’enseignement / apprentissage du FLE, présente, dans un premier temps, les résultats d’une enquête menée auprès des enseignants de FLE et des apprenants du cycle secondaire qualifiant au Maroc, et qui se résument comme suit : l’enseignement / apprentissage du FLE implique impérativement l’enseignement / apprentissage de sa culture. Ce rapport langue / culturelle exige de la part des enseignants et leurs apprenants l’adoption en classe de nouvelles approches pédagogiques qui doivent prendre en charge, en plus des dimensions linguistiques et communicatives, celles culturelles et interculturelles du FLE. Dans un second temps, il leur propose quelques pistes pédagogiques possibles pour profiter au maximum de leur contexte plurilingue et multiculturel dans l’enseignement / apprentissage de la dite langue. Mots-clés : apprentissage - enseignement – FLE - interculturel ABSTRACT. In the process of foreign languages didactic, the objective of this article is to investigate the place and role of the intercultural in teaching/ learning process of FLE, to present, in the first phase, the results of a survey on FLE teachers and high school Moroccan learners as follows: The teaching/learning operation of FLE dictates the teaching and learning of its culture. The language/culture rapport urges teachers and learners to adopt the pedagogical approaches and methods to account for the linguistic and communicative dimensions, be them cultural and intercultural of FLE. In the second phase, it recommends some pedagogical implications to be implemented in their multi-lingual and multi-cultural contexts in the process of teaching/learning of the same language. Keywords : FFL - learning – intercultural - teaching
Numerical Simulation of Natural Convection in the Air Gap of a Vertical Flat Plat Thermal Solar Collector with Partitions Attached to Its Glazing
Authors: Laaraba Adel , Khechekhouche Abderrahmane 
Published: March 2019

Heat transfer in the air gap of a vertical flat plat thermal solar collector containing partitions attached to its glazing has been studied numerically. The absorber and the glazing are kept at constant and different temperatures, while the vertical walls (insulation) were kept adiabatically. A conjugate formulation was used for mathematical formulation of the problem and a computer program based on the control volume approach and the simpler algorithm was used. The main aim of the current paper is to study numerically the effects of number of fins and their length on the air pattern and heat transfer. Experimental results showed that interesting phenomena happened, especially in the heat transfer process. It was observed that the heat transfer rate through the air gap is affected greatly and can be controlled by the number of attached fins to the glazing of the solar collector as well as the fin lengths, and the addition of partitions reduces the heat losses by convection by 60%. This study will brings good advantages for further uses, especially related to the heat transfer phenomena in the solar applications.
LAICIZAÇÃO E FINANCIAMENTO DA EDUCAÇÃO NO DEBATE PRÉ-LDB 4.024/1961: ARGUMENTOS (E PROJETOS) EM DISPUTA
Authors: Esquinsani Rosimar Serena Siqueira 
Published: March 2019

O texto incide sobre a descrição e problematização do debate ideológico acerca do público e privado em educação, desencadeado nos últimos anos da década de 1950, voltando o foco para um dos argumentos produzidos na disputa: a possível laicização da sociedade através da escola pública. Através de uma metodologia analítico-reconstrutiva pautada em uma revisão bibliográfica e documental, são reproduzidos argumentos dos dois principais debatedores: o então Arcebispo de Porto Alegre Dom Vicente Scherer e o educador baiano Anísio Spínola Teixeira. Enquanto para Dom Vicente a laicização promovida pelo mundo moderno vilipendiava o direito das famílias em relação a educação dos filhos, Anísio Teixeira pautava seus argumentos no adequado foco de disputa: o financiamento público da educação, no debate da futura Lei 4.024/1961. O texto conclui que, sob uma falsa disputa acerca da possível laicização da educação - defendida a partir da liberdade de escolha da família sobre que ensino oferecer a seus filhos -, restavam questões de ordem econômica. Assim, o foco do debate verdadeiramente não era a laicização da educação, mas o subsidio estatal à escola privada.
A INTERDISCIPLINARIDADE NA/COM A FORMAÇÃO DE PROFESSORES E ACOMUNIDADE ESCOLAR: POTENCIA DOS AFETOS E EXPERIENCIAS COMO SABER
Authors: Silva Marli Da , Severo Bianka , Oliveira Valeska Fortes de 
Published: March 2019

O presente artigo tem o intuito de apresentar a experiência do IV Encontro Ouvindo Coisas, III Encontro de Educação Musical e Pesquisa (Auto)Biográfica e II Festival Nacional de Cinema Estudantil (CINEST), tendo como pressuposto que ele se articulou na intenção de um dispositivo para se pensar o imaginário, formação do professor na perspectiva interdisciplinar com distintas e variadas formas de expressar o conhecimento na relação com o mundo vivido. Assim, pretende-se dar visibilidade desse encontro que busca consolidar redes de investigação constituída a partir dos temas do imaginário, memória, cinema, formação docente e pesquisa (auto)biográfica.Palavras-chave: Educação. Formação de Professores. Imaginário. Interdisciplinaridade. Narrativa.