bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacist-Physician Collaboration at a Family Medicine Residency Program: A Focus Group Study
Authors: Hager Keri , Murphy Courntey , Uden Don , Sick Brian 
Published: February 2018

Background: In response to transforming healthcare and pursuit of the Triple Aim, many health systems have added team members to expand the capabilities and effectiveness of the team to facilitate these aims. The objective of this study was to explore knowledge and perceptions of pharmacist-physician collaboration among family medicine residents (FMR), family medicine faculty (FMF), and pharmacist faculty and residents in a practice where clinical pharmacy services were relatively new. Understanding the nuances of pharmacist-physician interactions will provide insight into how to improve FMR education to prepare learners for patient-centered, team-based practice.
Methods: An exploratory descriptive qualitative study design was used to articulate perceptions of professional roles and team-based care in an interprofessional family medicine community-based clinical practice. Five, 60-minute focus groups were conducted in a clinical training setting that focuses on preparing family medicine physicians for collaborative rural primary care practice.
Results: Twenty-one FMRs, eight FMF, and six clinical pharmacists participated. Three themes emerged from the focus groups and were consistent across the groups: 1) roles of pharmacists recognized by physicians in different settings, 2) benefits to collaboration, and 3) keys to successful pharmacist-physician collaboration which include a) developing the relationship, b) optimizing communication, c) creating beneficial clinical workflow, d) clarifying roles and responsibilities, and e) increasing opportunities for meaningful interactions.
Conclusion: This study demonstrated that by co-locating physicians and pharmacists in the same environment, and providing a basic structure for collaboration, a collaborative working relationship can be initiated. Practices looking to have more effective collaborative working relationships should strive to increase the frequency of interactions of the professions, help the physicians understand the abilities of pharmacists, and help the pharmacists articulate to the physicians the value of what they provide to patients. The five keys identified in this study are building blocks to advance a successful collaborative working relationship that positively benefits patient care and achieves the Quadruple Aim.
Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties
Treatment of Human Subjects: IRB exemption granted

Type: Original Research
La defensa tecnica en los procesos de nulidad y restablecimiento del Derecho contra la DIAN
Authors: Mayorga Lagos Juan Darío , Escobar Perdomo Jonathan Leonardo , Vásquez Gaviria Sonia , Rojas Álvarez Magdalena , Duarte Rivas María Angélica , Ortiz Tovar Diana Marcela 
Published: February 2018

Cuando los contribuyentes de renta, personas naturales, se ven abocados a un proceso sancionatorio, adelantado por la DIAN, éstos por lo general no conocen el procedimiento a seguir, ignorando algunos los derechos que tienen. Este proceso debe garantizarle los derechos del contribuyente establecidos en el artículo 29 Constitución Política que son:La defensa y la asistencia de un abogado escogido por él, o de oficio, durante la investigación y el juzgamiento;Un debido proceso público sin dilaciones injustificadas; Presentar pruebas y controvertir las que se alleguen en su contra; Impugnar la sentencia condenatoria, yNo ser juzgado dos veces por el mismo hecho.Este artículo trae la “presunción de inocencia”, que en esta investigación, en ocasiones no se aplica y por el contrario, invierte la carga de la prueba y obliga al contribuyente a desvirtuar la responsabilidad determinada por la administración de impuestos.La DIAN – Dirección de Impuestos y Aduanas Nacionales-, cuenta no solo con una serie de recursos físicos, sino que además cuenta con el talento humano, calificado e idóneo para adelantar el proceso tributario; situación contraria, es la que en ocasiones acompaña al contribuyente persona natural, quien se haya en desigualdad de condiciones frente al ente sancionador.
Environmental Civil Liability under Comparison: Some notes in soft law
Authors: Areal Ludeña Dr. Santiago , Fierro Abella Jorge Alberto 
Published: February 2018

La responsabilidad civil medioambiental sirve como complemento de políticas públicas de regulación. Desastres naturales de devastadora magnitud, paralelo al incremento desmesurado de la población mundial, han capturado la atención de políticos y legisladores a escala global. Preocupantes informes de naturaleza tanto oficial como independiente, concluyen en la imperiosa necesidad de establecer un término para el cambio. Los vacíos dejados por débiles instrumentos internacionales sólo pueden ser subsanados por el estudio comparativo de aquellas normativas que han probado cierto éxito doméstico. Consecuentemente, soluciones europeas y norteamericanas son referenciadas en la actualidad por países en desarrollo. En el presente estudio centraremos nuestra atención en tales desarrollos jurídicos, especialmente en aquellos brindados por el denominado soft law.Después de abordar las especiales características del daño medioambiental, en relación con el daño tradicional, haremos lo propio con los demás elementos configuratorios de la responsabilidad civil. Posteriormente, estudiaremos los elementos característicos de los modelos europeo y norteamericano. Intentaremos dar respuesta a la marcada influencia que históricamente ha ejercido el sistema norteamericano a nivel mundial, así como si ello resulta retrospectivamente justificable. No pasaremos por alto las directivas europeas que desde 1986 hasta 2004 han incorporado importantes avances respecto de su par Transatlántico. Este será el primero de subsiguientes esfuerzos por incluir un análisis interdisciplinario que involucre tópico tales como la prevención y la autorregulación del daño medioambiental.
ANALISA KOORDINASI SINYAL ANTAR SIMPANG DENGAN MENGGUNAKAN SOFTWARE TRANSYT 14 (Studi Kasus Simpang Empat & Simpang BPD Kota Lhokseumawe)
Authors: Abdullah Zulfhazli 
Published: February 2018

<p>Koordinasi antar simpang secara umum dimaksudkan untuk meningkatkan pelayanan suatu jaringan jalan, mengurangi waktu tunda dan waktu berhenti kendaraan. Setelah melakukan antrian waktu merah pada salah satu persimpangan, kendaraan diharapkan akan memperoleh waktu hijau pada persimpangan berikutnya. Sistem koordinasi demikian belum diterapkan di Jalan Merdeka Kota Lhokseumawe. Sebagai jalan utama pada pada lintasan tersebut ada dua persimpangan bersinyal yaitu, Simpang Empat dan Simpang BPD. Akibat belum adanya koordinasi antar persimpangan tersebut, sering kendaraan yang baru lolos dari Simpang Empat harus berhenti dan menunggu fase hijau lagi pada Simpang BPD dan begitu juga arah sebaliknya. Sehingga antrian, waktu tundaan dan waktu berhenti yang panjang terutama pada jam puncak tidak dapat dihindari. Metode yang digunakan pada penelitian ini yaitu Metode Manual Kapasitas Jalan Indonesia (MKJI 1997), sementara untuk koordinasi lampu antar simpang menggunakan bantuan perangkat lunak <em>Transyt 14</em> berpedoman pada metode <em>Transport and Road Research Laboratory</em> (TRRL) Inggris. <em>Transyt 14</em> digunakan untuk mengevaluasi kinerja persimpangan pada kondisi eksisting serta membuat beberapa alternatif koordinasi dengan <em>performance index</em> (PI) sebagai kriteria utama. Hasil penelitian untuk alternatif terbaik dibandingkan kondisi eksisting diperoleh waktu siklus 100 detik, degree of saturation turun 17,07%, antrian berkurang 14,15%, waktu tunda berkurang 57,38%, jumlah henti turun 20,57%, dan tingkat pelayanan dapat ditingkatkan dari C menjadi B.</p><p> Kata kunci : <em>Koordinasi, Simpang Bersinyal, Transyt 14, level of servise</em></p>
PREDIKSI KEKUATAN STRUKTUR ALAT UJI GETARAN ENGINE LSU SERIES MENGGUNAKAN METODE ELEMEN HINGGA (STRENGTH PREDICTION OF THE ENGINE VIBRATION TEST STAND OF LSU SERIES USING FINITE ELEMENT METHOD)
Authors: Wandono Fajar Ari , Syah Agus Harno Nurdin 
Published: February 2018

In order to know about vibration characteristics of a combination between engine and propeller used in LAPAN Surveillance UAV (LSU) series, it needs a test apparatus called the engine vibration test stand. The engine vibration test stand structure must be strong and stiff to get good result in engine vibration test. In the initial phase, the engine vibration test stand was madeof 1 meter length of ASTM A36 material with H shape and the lower part of it was bolted to the reinforced floor. By using a finite element method software and inputting some parameters from engine DA-170 and mechanical properties of ASTM A36, the engine vibration test stand had safety factor of 26,24. Furthermore, the top five natural frequencies were 61,94Hz, 77,18Hz, 93,79 Hz, 212,23Hz and 286,24Hz. AbstrakUntuk mengetahui karakteristik getaran dari kombinasi engine dan propeller yang digunakan pada LAPAN Surveillance UAV (LSU) series maka diperlukan sebuah alat uji yang disebut alat uji getaran engine (AUGE). Struktur AUGE harus dibuat kuat dan kaku untuk mendapatkan hasil uji getaran engine yang baik. Sebagai langkah awal telah dibuat sebuah AUGE yang terbuat dari material ASTM A36 yang berbentuk H setinggi 1 meter dengan bagian bawahnya dibaut ke sebuah lantai yang sudah diperkuat. Dengan menggunakan software metode elemen hingga dan memasukkan parameter engine DA-170 serta sifat mekanik ASTM A36 didapatkan bahwa struktur AUGE tersebut memiliki nilai faktor keamanan sebesar 26,24. Adapun lima nilai pertama frekuensi pribadi dari struktur tersebut adalah 61,94 Hz, 77,18 Hz, 93,79 Hz, 212,23 Hz dan 286,24 Hz.
METODE PENENTUAN TITIK KOORDINAT ZONA POTENSI PENANGKAPAN IKAN PELAGIS BERDASARKAN HASIL DETEKSI TERMAL FRONT SUHU PERMUKAAN LAUT
Authors: Hamzah Rossi , Marpaung Sartono , Prayogo Teguh 
Published: February 2018

Information points coordinate of potential fishing zones (PFZ) is required by user that to be more effective in conducting fishing operation. The results of thermal front detection using single image edge detection (SIED) asshape contour lines. This research aims to determine points coordinate for potential fishing zone based on detection of thermal fronts sea surface temperatures.To determine point coordinate performed segmentation on detection result according to size fishnet grid. Contour line contained in each grid is a polygon shape.Centroid of each polygon is point coordinate of PFZ. The result of sea surface temperature data processing from Terra/Aqua MODIS and Suomi NPP VIIRS satellitesindicates that method of determination the centroid of polygon is very effective in determining the point coordinate of PFZ. Using that method the processing stages of satellite data to be faster, more efficient and practical due to the information of PFZ is already as points coordinate.Abstrak Informasi titik koordinat zona potensi penangkapan ikan (ZPPI) sangat diperlukan oleh pengguna agar lebih efektif dalam melakukan operasi penangkapan ikan. Hasil deteksi termal front menggunakan metode Single Image Edge Detection (SIED) dalam bentuk garis kontur. Penelitian ini bertujuan untuk menentukan titik koordinat ZPPI berdasarkan hasil deteksi termal front suhu permukaan laut. Untuk menentukan titik koordinat dilakukan segmentasi hasil deteksi sesuai ukuran fishnet grid. Garis kontur yang terdapat dalam setiap grid merupakan bentuk poligon. Pusat geometri dari setiap poligon merupakan titik koordinat ZPPI. Hasil pengolahan data suhu permukaan laut dari satelit Terra/Aqua MODIS dan Suomi NPP VIIRS menunjukkan bahwa metode penentuan pusat geometri poligon sangat efektif dalam menentukan titik koordinat ZPPI. Dengan menggunakan metode tersebut tahap pengolahan data satelit menjadi lebih cepat, efisien dan lebih praktis karena informasi ZPPI sudah dalam bentuk titik koordinat.
Modeling of Creep Behavior of an Argillaceous Rock by Numerical Homogenization Method
Authors: Dahhaoui Hachimi , Belayachi Naïma , Zadjaoui Abdeldjalil 
Published: February 2018

This paper is devoted to modeling the creep behavior of argillaceous rock and a comparison with experimental and numerical results from literature. The proposed time dependent modeling is based on a numerical homogenization method, matrix-inclusion material microstructure and a creep micromechanical model. The nonlinear viscosity of the argillaceous matrix is described by the creep model “Modified Time Hardening”, while classical linear elasticity is applied for the calcite and quartz inclusions. The simulation accuracy was analyzed under single and multistage creep test. A satisfactory agreement between the simulation and the experimental results are obtained by assuming the main mineral phases of the Callovo-Oxfordian argillite. It was found that better agreements could be obtained when the multi-scale modeling is performed on sample with a given mineralogical composition and much more precisely volume fraction. The results show how numerical homogenization method is capable of effectively modelling macroscopic creep deformation.
Characteristics of GPs responding to an educational intervention to minimise inappropriate prescriptions: subgroup analyses of the Rx-PAD study
Authors: Rognstad Sture , Brekke Mette , Mdala Ibrahimu , Fetveit Arne , Gjelstad Svein , Straand Jørund 
Published: February 2018

BackgroundInterventions aimed at improving GPs’ prescribing practice usually apply a 'one size fits all' when analysing intervention effects. Few studies explore intervention effects by variables related to the GPs’ age, sex, specialist status, practice type (single-handed versus group), practice setting (urban versus rural), and baseline performance regarding the target of an intervention.AimTo explore the characteristics of the GPs responding to a comprehensive educational intervention.Design & settingA secondary analysis of a cluster, randomised educational intervention in Norwegian general practice. Pre-intervention data were captured from January 2005 to December 2005, and post-intervention data from June 2006 to June 2007. The intervention was carried out from January to June 2006.MethodEighty continuing medical education (CME) groups, including 449 GPs aged 27–68 years, were randomly allocated to either an education intervention arm (41 groups, 250 GPs) or a control arm (39 groups, 199 GPs). The primary outcome was GPs' change in potentially inappropriate prescriptions (PIPs) per 100 prescriptions issued to patients aged ≥70 years. The interaction between intervention outcome and variables related to the GPs and their practices were tested.ResultsImprovements in prescribing were highest among GPs aged 57–68 years (incidence rate ratio [IRR] = 0.77 [95% confidence interval {CI} = 0.73 to 0.81]), those who were specialists (IRR = 0.80 [95% CI = 0.78 to 0.82]), and those who worked in single-handed practices (IRR = 0.75 [95% CI = 0.68 to 0.83]), among GPs with 2.4 to 2.9 PIPs per 100 prescriptions at baseline (IRR = 0.74 [95% CI = 0.70 to 0.78]), and GPs with ≥15 prescriptions per patient per year at baseline (IRR = 0.77 [95% CI = 0.73 to 0.80]).ConclusionThe GPs with the lowest adherence to recommended practice at baseline improved their practice most.
Molecular epidemiology of Cryptosporidium spp. in North Lebanon
Authors: Osman Marwan , Benamrouz Sadia , Guyot Karine , El Safadi Dima , Mallat Hassan , Dabboussi Fouad , Hamze Monzer , Viscogliosi Eric , Certad Gabriela 
Published: February 2018

Cryptosporidium spp. are enteroparasites with worldwide distribution that infect the gastrointestinal tract of several vertebrates including humans. Human to human, zoonotic, foodborne and waterborne are reported as the main transmission routes of this parasite. Cryptosporidium spp. have been recognized as the predominant cause of waterborne and foodborne outbreaks. However, the epidemiological situation of cryptosporidiosis is not well known in Lebanon, a developing country with a population often affected by intestinal parasitic infections.
This study was devoted to determine the prevalence and the genetic diversity of Cryptosporidium spp. in symptomatic hospitalized patients and in two children populations with different socio-economic level in North-Lebanon, as well as the risk factors associated with cryptosporidiosis.
Fecal samples obtained from these populations were examined microscopically by modified Ziehl-Neelsen staining as well as nested PCR were done for the detection of Cryptosporidium oocysts.
Out of 163 symptomatic hospitalized patients and 249 children, Cryptosporidium was present in 11% and 10.4% respectively according to microscopy examination and/or molecular tests. The genotyping showed the predominance of Cryptosporidium hominis in both populations. Subgenotype analysis of the isolates at the gp60 locus identified three subtypes IdA19, IbA10G2 and IaA18R3 for C. hominis and two subtypes IIaA15G1R1 and IIaA15G2R1 for C. parvum. Moreover, cryptosporidiosis was correlated with having meals outside home and presence of gastrointestinal symptoms especially diarrhea (p <0.05).
This work constitutes the first molecular epidemiology study outlining risk factors associated with cryptosporidiosis in Lebanon. These findings support a need of a control program to prevent the circulation of this parasite.
Hepatitis C in Lebanon: burden of the disease and value of comprehensive screening and treatment
Authors: Abou Rached Antoine , Abou Kheir Selim , Saba Jowana , Assaf Salwa , Kassis Georges , Sanchez Gonzalez Yuri , Ethgen Olivier 
Published: February 2018

Introduction: As few reliable data on the burden of hepatitis C virus (HCV) are available from the Middle East, we analyzed HCV burden in the Lebanese population and the value of comprehensive screening and treatment at different age groups and fibrosis stages.
Methodology: A multi-cohort, health-state-transition model was developed to project the number of HCV patients achieving a sustained virologic response 12 weeks after treatment (SVR12) or progressing to compensated cirrhosis (CC), decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC), and liver-related death (LrD) from 2016 to 2036. Epidemiology and mortality data were extracted from the Ministry of Health bulletin while costs were collected from insurance claims. The proportion of patients screened for HCV was projected to increase to 60%/85%/99% (low/medium/high screening scenarios) in 2036, with a new cohort being diagnosed each year. SVR12 rates were extracted from clinical trials. Separate models were used for 18-39 and 40- 80 age groups to account for different prevalence and screening rates.
Results: Low, medium and high HCV screening scenarios showed that 3,838, 5,665 and 7,669 individuals would be diagnosed with HCV infection from 2016 to 2036, 40% aged 18-39 and 60% aged 40-80. In the absence of treatment, the projected number of patients reaching CC, DCC, HCC and LrD in 2036 was 899, 147, 131 and 147 respectively for the 18-39 age groups. In the 40-80 age groups, these projections were substantially greater: 2,828 CC, 736 DCC, 668 HCC and 958 LrD. The overall economic burden of these complications would reach 150 million €. However, introducing direct-acting antivirals (DAAs) for F0-F4 patients would increase by 43% and 62% the proportion of remaining life-years (LYs) spent in SVR12 compared to DAAs given to F2-F4 or to F3-F4 only, respectively. Although DAAs for F0-F4 increase the cost of HCV treatment, they also provide the greatest health benefit and lowest cost per LY gained in SVR12. Compared to no treatment and screening, adopting the high screening variant and DAAs access to F0-F4 would cost an additional 1,957 € for every LY gained in SVR12 for patients aged 18-39 and -168 € for the 40-80 age group.
Conclusion: An enhanced screening policy coupled with broader access to DAAs will diminish the future burden of HCV in the Lebanese population and provide the greatest health benefits among middle-aged and elder adults with net cost savings.
ESBL-producing Escherichia coli and Klebsiella pneumoniae in two major Lebanese hospitals: molecular epidemiology and correlation with consumption
Authors: Obeid Anas , Maliha Peter , Abdallah Samah , Akl Estelle , Deeb Maria , El Moussawi Hassan , Salem-Sokhn Elie , Matar Ghassan , Daoud Ziad 
Published: February 2018

Introduction: Extended-spectrum – beta lactamases (ESBLs) are increasingly detected globally among Escherichia coli and Klebsiella pneumoniae. The correlation between antibiotics use and resistance, though not fully described, has been addressed and shown in several studies. In this study, the profiles of ESBLs in E. coli and K. pneumoniae isolated from two Lebanese hospitals and their relationship to antibiotic consumption were determined.
Methodology: A total of 205 E. coli and 67 K. pneumoniae isolates resistant to third- or fourth-generation cephalosporins were collected between January 2011 and January 2012. Antibiotic susceptibility and consumption data were also collected from 2010–2012. Double-disk synergy and Etest ESBL assays were performed, followed by PCR for ESBL genes. Pulsed-field gel electrophoresis (PFGE) was performed for representative isolates. Statistical analysis for consumption and susceptibility data over 3 years was performed.
Results: As expected, CTX-M-15 was predominant. In both hospitals, strains of E. coli and K. pneumoniae harbored at least one ESBL, and in some cases (23%) harboured four different ESBLs. A significant correlation was detected between total use of antimicrobial agents and resistance to various antibiotics. This was obvious for the use of penicillins and resistance to aztreonam, ceftazidime and ciprofloxacin, and use of third- and fourth-generation cephalosporins and resistance to ceftazidime, cefuroxime, cefoxitin and ciprofloxacin in both bacteria.
Conclusions: This study shows the predominance of CTX-M-15 among cephalosporin-resistant E. coli and K. pneumoniae in Lebanese hospitals and highlights the direct relationship between the use of antibiotics and the emergence of resistance in bacteria.