bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Advance Care Planning in a Resident Primary Care Clinic
Authors: Nassikas Nicholas J. , Baird Grayson L. , Duffy Christine M. 
Published: September 2019

Introduction:Two-thirds of chronically ill patients do not have an advance directive. The primary aim of this study was to develop an intervention to increase the documentation of advance directives in elderly adults in an internal medicine resident primary care clinic. The secondary aims were to improve resident confidence in discussing advance care planning and increase the number of discussions.Methods:The study was a pre- and postintervention study. The study intervention was a 30-minute educational session on advance care planning. Study participants were patients aged 65 years and older who were seen in an internal medicine residency primary care clinic over a 6-month period and internal medicine residents. Clinic encounters were reviewed for the presence of advance care planning discussions before and after the intervention. Resident confidence was measured on a Likert scale.Results:Two hundred ninety-five eligible patients were seen in the clinic from January 1, 2017, to June 30, 2017, and included in the analysis performed between 2017 and 2018. The mean number of documented advance care planning discussions increased from 2.24 (95% confidence interval [CI]: 1.0-4.9) during the preintervention period to 8.94 (95% CI: 5.94-13.24]) during the postintervention period ( P = .0011). Following the intervention, residents overall reported increased confidence in discussing advance care planning.Conclusion:A relatively modest intervention to increase advance care planning discussions is feasible in an internal medicine primary care clinic and can improve the confidence of residents with end-of-life discussion.
Variability in Baseball Throwing Metrics During a Structured Long-Toss Program: Does One Size Fit All or Should Programs Be Individualized?
Authors: Leafblad Nels D. , Larson Dirk R. , Fleisig Glenn S. , Conte Stan , Fealy Stephen A. , Dines Joshua S. , D’Angelo John , Camp Christopher L. 
Published: September 2019

Background: The variability of throwing metrics, particularly elbow torque and ball velocity, during structured long-toss programs is unknown. Hypotheses: (1) Elbow torque and ball velocity would increase as throwers progressed through a structured long-toss program and (2) intrathrower reliability would be high while interthrower reliability would be variable. Study Design: Descriptive laboratory study. Level of Evidence: Level 3. Methods: Sixty healthy high school and collegiate pitchers participated in a structured long-toss program while wearing a validated inertial measurement unit, which measured arm slot, arm velocity, shoulder rotation, and elbow varus torque. Ball velocity was assessed by radar gun. These metrics were compared within and between all pitchers at 90, 120, 150, and 180 ft and maximum effort mound pitching. Intra- and interthrower reliabilities were calculated for each metric at every stage of the program. Results: Ball velocity significantly changed at each progressive throwing distance, but elbow torque did not. Pitching from the mound did not place more torque on the elbow than long-toss throwing from 120 ft and beyond. Intrathrower reliability was excellent (intraclass correlation coefficient >0.75) throughout the progressive long-toss program, especially on the mound. Ninety-one percent of throwers had acceptable interthrower reliability (coefficient of variation <5%) for ball velocity, whereas only 79% of throwers had acceptable interthrower reliability for elbow torque. Conclusion: Based on trends in elbow torque, it may be practical to incorporate pitching from the mound earlier in the program (once a player is comfortable throwing from 120 ft). Ball velocity and elbow torque do not necessarily correlate with one another, so a degree of caution should be exercised when using radar guns to estimate elbow torque. Given the variability in elbow torque between throwers, some athletes would likely benefit from an individualized throwing program. Clinical Relevance: Increased ball velocity does not necessarily equate to increased elbow torque in long-toss. Some individuals would likely benefit from individualized long-toss programs for rehabilitation.
Assessing concussion knowledge and awareness in faculty and staff in a collegiate setting
Authors: Mokris Rebecca L , Kessler Andrea , Williams Kathleen , Ranney John , Webster Jeffrey , Stauffer Kory 
Published: September 2019

Purpose To examine faculty and academic support staff members’ awareness and knowledge regarding concussions. Design Cross-sectional, web-based questionnaire. Setting Division II collegiate setting. Subjects A total of 123 collegiate faculty, administrative and academic support staff participated in the study. Measure(s): Participants completed the Faculty and Staff Concussion Awareness and Knowledge Survey. Analysis: Descriptive statistics were compiled for demographic information within the survey. Analysis of variance was performed on concussion awareness and concussion knowledge survey questions. Results The majority of the sample had teaching responsibilities in the University (75%). There was a significant effect of college departments within the university on individuals’ level of awareness (F (5, 117) = 9.74, p < .001). The Athletics department scored the highest in awareness of concussion symptomology, while the Business department scored the lowest. Females demonstrated significantly more awareness of concussion symptoms than males (F (1, 121) = 10.488, p = .002). University department significantly impacted knowledge of concussion treatments (F (5, 117) = 3.67, p < .004). The Health Sciences department scored the highest in knowledge of concussion treatments, while the Business department scored the lowest. Past experience with academic accommodations was associated with respondents’ knowledge of concussion treatment (F (1, 121) = 4.046, p = .047). Conclusions Concussion management in a collegiate setting should include the faculty and academic support staff. Colleges and Universities should consider educational programming regarding etiology and recovery from concussions for effective management when student experience a concussion.
Sitagliptin does not reduce the risk of cardiovascular death or hospitalization for heart failure following myocardial infarction in patients with diabetes: observations from TECOS
Authors: Nauck Michael A. , McGuire Darren K. , Pieper Karen S. , Lokhnygina Yuliya , Strandberg Timo E. , Riefflin Axel , Delibasi Tuncay , Peterson Eric D. , White Harvey D. , Scott Russell , Holman Rury R. 
Published: September 2019

Abstract
Background
To examine the effects of the DPP-4i sitagliptin on CV outcomes during and after incident MI in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS).

Methods
TECOS randomized 14,671 participants with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD) to sitagliptin or placebo, in addition to usual care. For those who had a within-trial MI, we analyzed case fatality, and for those with a nonfatal MI, we examined a composite cardiovascular (CV) outcome (CV death or hospitalization for heart failure [hHF]) by treatment group, using Cox proportional hazards models left-censored at the time of the first within-trial MI, without and with adjustment for potential confounders, in intention-to-treat analyses.

Results
During TECOS, 616 participants had ≥ 1 MI (sitagliptin group 300, placebo group 316, HR 0.95, 95% CI 0.81–1.11, P = 0.49), of which 25 were fatal [11 and 14, respectively]). Of the 591 patients with a nonfatal MI, 87 (15%) died subsequently, with 66 (11%) being CV deaths, and 57 (10%) experiencing hHF. The composite outcome occurred in 58 (20.1%; 13.9 per 100 person-years) sitagliptin group participants and 50 (16.6%; 11.7 per 100 person-years) placebo group participants (HR 1.21, 95% CI 0.83–1.77, P = 0.32, adjusted HR 1.23, 95% CI 0.83–1.82, P = 0.31). On-treatment sensitivity analyses also showed no significant between-group differences in post-MI outcomes.

Conclusions
In patients with type 2 diabetes and ASCVD experiencing an MI, sitagliptin did not reduce subsequent risk of CV death or hHF, contrary to expectations derived from preclinical animal models.
Trial registration clinicaltrials.gov no. NCT00790205
Survival of Critically Ill Oncologic Patients Requiring Invasive Ventilatory Support: A Prospective Comparative Cohort Study With Nononcologic Patients
Authors: López Rene , Samtani Suraj Rajesh , Montes Jose Miguel , Perez Rodrigo , Martin Maria Jose , Salazar Alvaro , Graf Jeronimo 
Published: September 2019

PURPOSE Cancer is in the process of changing to become a chronic disease; therefore, an increasing number of oncologic patients (OPs) are being admitted to intensive care units (ICUs) for supportive care of disease or therapy-related complications. We compare the short- and long-term outcomes of critically ill mechanically ventilated OPs with those of their nononcologic counterparts. PATIENTS AND METHODS We performed a prospective study of patients admitted to our ICU between October 2017 and February 2019. Demographic, physiologic, laboratory, clinical, and treatment data were obtained. The primary outcome was survival at 28 days and at the end of the follow-up period. Secondary outcomes were survival according to acute severity scoring (Acute Physiology and Chronic Health Evaluation II score), Eastern Cooperative Oncology Group (ECOG) performance status, and Charlson comorbidity index. RESULTS A total of 1,490 patients were admitted during the study period; 358 patients (24%) were OPs, and 100 of these OPs were supported with mechanical ventilation. Seventy-three percent of OPs had an ECOG performances status of 0 or 1, and 90% had solid tumors. Reason for admission to the ICU was postoperative admission in 44 patients and neutropenic infection in 10 patients. The follow-up period was 148 days (range, 42 to 363 days). Survival at 28 days was similar between OPs and nononcologic patients and associated with the Acute Physiology and Chronic Health Evaluation II score. However, long-term survival was lower in OPs compared with nononcologic patients (52% v 76%, respectively; P < .001) and associated with poor ECOG performance status. CONCLUSION Short-term survival of critically ill, mechanically ventilated OPs is similar to that of their nononcologic counterparts and is determined by the severity of the critical illness.
Sodium nitroprusside prevents the detrimental effects of glucose on the neurovascular unit and behaviour in zebrafish
Authors: Chhabria Karishma , Vouros Avgoustinos , Gray Caroline , MacDonald Ryan B. , Jiang Zhen , Wilkinson Robert Neil , Plant Karen , Vasilaki Eleni , Howarth Clare , Chico Timothy J. A. 
Published: September 2019

ABSTRACT
Diabetes is associated with dysfunction of the neurovascular unit, although the mechanisms of this are incompletely understood and currently no treatment exists to prevent these negative effects. We previously found that the nitric oxide (NO) donor sodium nitroprusside (SNP) prevents the detrimental effect of glucose on neurovascular coupling in zebrafish. We therefore sought to establish the wider effects of glucose exposure on both the neurovascular unit and on behaviour in zebrafish, and the ability of SNP to prevent these. We incubated 4-days post-fertilisation (dpf) zebrafish embryos in 20 mM glucose or mannitol for 5 days until 9 dpf, with or without 0.1 mM SNP co-treatment for 24 h (8-9 dpf), and quantified vascular NO reactivity, vascular mural cell number, expression of a klf2a reporter, glial fibrillary acidic protein (GFAP) and transient receptor potential cation channel subfamily V member 4 (TRPV4), as well as spontaneous neuronal activation at 9 dpf, all in the optic tectum. We also assessed the effect on light/dark preference and locomotory characteristics during free-swimming studies. We find that glucose exposure significantly reduced NO reactivity, klf2a reporter expression, vascular mural cell number and TRPV4 expression, while significantly increasing spontaneous neuronal activation and GFAP expression (all in the optic tectum). Furthermore, when we examined larval behaviour, we found that glucose exposure significantly altered light/dark preference and high and low speed locomotion while in light. Co-treatment with SNP reversed all these molecular and behavioural effects of glucose exposure. Our findings comprehensively describe the negative effects of glucose exposure on the vascular anatomy, molecular phenotype and function of the optic tectum, and on whole-organism behaviour. We also show that SNP or other NO donors may represent a therapeutic strategy to ameliorate the complications of diabetes on the neurovascular unit.
This article has an associated First Person interview with the first author of the paper.
Pequeno glossário sobre o mau pintor. Busca, impossibilidade e fracasso — a pintura como linguagem imperfeita.
Authors: Houayek Hugo 
Published: September 2019

O artigo abarca conceitos que se relacionam com a posição do artista contemporâneo no mundo e de como este pode atuar criticamente. PALAVRAS-CHAVE:Arte contemporânea, linguagem, pintura, mau pintor ABSTRACT:The entry covers concepts that relate to the position of the contemporary artist in the world and how it can act critically. KEYWORDS:Contemporary art, language, painting, bad painter
Sobre o perecível
Authors: Arbex Julia 
Published: September 2019

Uma diferente leitura para o conceito de perecível é proposta traçando-se uma aproximação ao que o filósofo francês Gilbert Simondon chamaria por sistema metaestável e como esse perecível poderia se materializar num trabalho de arte. A different reading for the concept of perishable is proposed by drawing an approximation to what the French philosopher Gilbert Simondon would call a metastable system and how this perishable could materialize in a work of art.Palavras-chave: perecível, metaestável, equilíbrio, materialidadeKey words: perishable, metastable, equilibrium, materiality
Arquitetura da Paisagem
Authors: Penna Júnia 
Published: September 2019

O homem ao vivenciar a paisagem é por ela ativado. Em “Arquitetura da Paisagem” investigo o modo como essa temática se manifesta na minha produção artística. Na construção do pensamento busco estabelecer conexões com concepções desenvolvidas por Anne Cauquelin, Jean-Marc Besse e Augustim Berque que refletem sobre a noção da paisagem na atualidade.Palavras Chaves: arte contemporânea, percepção, paisagem, natureza. ABSTRACTWhen people experience the landscape, they are activated by it. In “Landscape Architecture” I investigate the way this theme manifests itself in my artístic production. In the thought construction, I try to establish connections with conceptions developed by Anne Cauquelin, Jean-Marc Besse and Augustin Berque, who reflect about the notion of landscape nowadays.Key words: contemporary art, perception, landscape, nature.
CINTA SEBAGAI RELIGIOUS PEACE BUILDING (Perspektif Muhammad Fethullah Gülen)
Authors: Kholil Ahmad 
Published: September 2019

Sociologically, religion has a double function. On the one hand, religion can be a factor of social cohesion and harmony creation, but on the other hand it can also be a factor religious disharmony between people of different religions. This paper examines the views of Fethullah Gülen on the social function of religion that is based on love and peace. Differences of religion, according to him, is a consequence of the choice of each human being in order to establish the absolute truth based on how they believe. Therefore, differences in religion is not something scar y or even harmful for social life, as long as people are able to live in the light of love and peace.
PERAN INTEGRATIF AGAMA-AGAMA DALAM MENGATASI MASALAH KEMISKINAN DI BANJARASRI KALIBAWANG KULONPROGO DAERAH ISTIMEWA YOGYAKARTA DENGAN PENDEKATAN SOSIOLOGI DAN PSIKOLOGI
Authors: Anna Dian Nur 
Published: September 2019

This study aims to determine the poverty problems of Banjarasri society in Kalibawang, Kulonprogro, the Special Territory of Yogyakarta in sociolog y and psychological perspective. The study tries to map out the main problems of the poverty and to look for alternatives solution of the problem. Implementing grounded research and integrative review on the role of religions in society, the study proves that religions are even able to help in solving the problem of poverty. The study then concluded that religious institutions have important roles in overcoming poverty problem through various economic, social and educational programs.
COSMOTHEANDRIC: HUBUNGAN ANTAR AGAMA MENURUT RAIMON PANIKKAR DAN RELEVANSINYA TERHADAP HUBUNGAN ANTAR AGAMA DI INDONESIA
Authors: S. Azis Pajri 
Published: September 2019

Indonesia serves as a countr y with variety of cultures, traditions and religions. Religion, as one of the assets, becomes the problem in interfaith encounter when it faces the truth claim and ag gressive mission. As the consequence, the unexpected conflict happens that resulted in abundant victim and material loss. Two queries include Raimon Panikkar’s cosmotheandric concept in interfaith relation and its relevance on inter-religious relation in Indonesia. This article uses library research applying Peter L. Ber ger’s social construction theor y to analyze the construction of Panikkar’s concept and its relevance on inter-religious relation in Indonesia. Cosmotheandric, in this context, is a reality connected theos, anthropic and cosmos dimension. Panikkar’s Cosmotheandric has been constructed from Christian Trinity, Hinduism Advaita Vedanta and Buddhism Pratityasamut. Religion, in cosmotheandric structure, is situated in the antropical dimension. As the result, Panikar views religions as a part of reality that constructed Cosmotheandric reality. In this regard, religions bore the interconnected entity that constructed Cosmotheandric reality. The application of idea in Indonesian context is done by altering the Cosmotheandric language into local expressions that has sound meaning with theos, antropos and cosmos.
SHAMBHALA; MITOS ABADI SPIRITUALITAS BUDDHA MAHAYANA DI TIBET
Authors: Almujaddidy Ali Ilham 
Published: September 2019

Dewasa ini, agama sebagai sebuah konstitusi mulai ditinggalkan, sedangkan spiritualitas sudah mulai maju karena lebih meyakinkan. Di Barat, Buddha tumbuh dan berkembang layaknya tanaman. Ajaran-ajaran spiritualitas Bud-dha sudah mulai dipakai oleh berbagai kalangan dari berbagai latar belakang agama. Hingga akhirnya semangat beragama tidak lagi terbatas oleh dogma komunitas dan lebih pada penjelajahan spiritual individu. Barat dikenal dengan rasionalitasnya, sedangkan Timur dikenal dengan kearifan spiritualnya. Jauh sebelum Buddha berkembang di Barat, Timur telah menunjukkan pesonanya terhadap dunia. Pesona kearifan itu muncul dari arah Gunung Himalaya di sebuah negeri yang tersembunyi di balik bayang-bayang China. Tibet adalah sebuah negara dengan karakter spiritual yang unik. Magnet spiritualnya bahkan menarik simpati orang-orang yang memiliki pengaruh besar, dari masa GenghisKhan sampai Adolf Hitler. Mereka merasa terpanggil untuk mencari sebuah surga dunia yang terlanjur menjadi utopia spiritual, surga itu disebut dengan Shambhala.Shambhala sebagai spiritualitas tertinggi umat Buddha Mahyana di Tibetmemiliki visi spiritual berupa keinginan untuk mempertahankan etika-etika manusia, sekaligus mencari kebebasan sepenuhnya kepada setiap orang. Pada dasarnya, konsep ajaran spiritual Shambhala sepenuhnya terdapat dalam teks Kalachakra Tantra, sebuah kitab yang memiliki ajaran paling tinggi, esoteris dan sulit dimengerti. Oleh karena itu, Shambhala akan bisa dicapai hanya dengan laku meditasi Kalachakra secara intensif. Shambhala sebagai ajaran spiritualitas terting gi memiliki pengaruh yang signifikan terhadap umat Buddha Mahayana di Tibet. Adapun Kalachakra Tantra memainkan peranan penting dalam pembentukan ajaran spiritualitas yang terdapat dalam Shambhala. Uraiannya menyebutkan bahwa Shambhala merupakan ajaran yang paling penting yang harus dipraktekkan oleh umat Buddha Tibet khususnya. Hal ini bukan karena Shambhala lebih unik daripada yang lain, melainkan karena ajaran spiritualitas Shambhala sangat vital dan diberikan untuk titisan keduniaan yang bisa diaplikasikan di bawah semua kondisi manusia. Oleh karena itu, filsafat perenial sebagai cermin spiritual Shambhala dibutuhkan untuk membangun kesadaran esoteris dalam setiap dimensi kehidupan manusia, yang bangunan pemikirannya mencerminkan pengetahuan yang mensucikan dan mencerahkan bagi peningkatan spiritualitas, sehingga dapat dengan mudah menghayati makna substansi agama yang sebenarnya.
Représentation et valeur politique du conflit ethnique en ex-Yougoslavie dans Tactics Ogre : de Sarajevo à Baramus
Authors: Wit Sébastien 
Published: September 2019

Avec Tactics Ogre: Let Us Cling Together sorti en 1995 sur la Super Famicom de Nintendo, Quest propose un jeu vidéo ambitieux sur le plan narratif, et directement inspiré des guerres ethniques faisant rage en ex-Yougoslavie. L’horreur d’une tuerie potentiellement instrumentalisée comme celle de Sarajevo en février 1994 devrait rendre sa transposition dans le médium ludique particulièrement délicate. Comment transformer un crime de guerre en dispositif narratif ? Dans ces conditions, quel rôle la vérité historique joue-t-elle ? Quel rapport se tisse entre l’actualité et la fiction vidéoludique ? Partant de ces interrogations, il s’agira de voir dans cet article le type de discours que le jeu vidéo est en mesure de tenir sur la question de l’ethnicité, prise à la fois dans sa dimension politique et sociale. Cela nous amènera à interroger la contribution de l'industrie vidéoludique à cet imaginaire du pouvoir socialement partagé sans lequel il n'est pas possible de faire société.
Usurpation d’identité clinique : Carcinome spinocellulaire de la paupière diagnostiqué antérieurement comme une bosse oculaire
Authors: Virk Sanjeet Kaur , Stursma April J. , Fisher Brian D. , Rodriguez Alexis 
Published: September 2019

Les tumeurs malignes de la paupière sont souvent difficiles à diagnostiquer à un stade précoce et peuvent poser un défi sur le plan clinique. En raison de la prévalence élevée des cancers de la peau périoculaire, les cliniciens doivent être très attentifs dans leur évaluation des lésions cutanées. Un homme de 83 ans sans aucun antécédent de tumeur maligne présentait une lésion non cicatrisante et en croissance rapide de la paupière inférieure gauche. Après une référence en oculoplastique, on a diagnostiqué chez le patient un carcinome spinocellulaire sans métastase ni invasion des tissus de la couche profonde. La prise en charge a nécessité une exentération orbitaire gauche, suivie d’une radiothérapie.
Ce cas illustre l’évolution clinique et la nature invasive du carcinome spinocellulaire périoculaire. Bien que ce carcinome puisse se présenter sous diverses formes, la plupart sont des lésions hyperkératosiques indolores qui évoluent et deviennent progressivement ulcéreuses. Il est essentiel d’avoir des antécédents détaillés et de procéder à un examen clinique minutieux pour détecter la malignité en temps opportun.