bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Anxiety With High-Cost Health Care Use Among Individuals With Type 2 Diabetes
Authors: Iturralde Esti , Chi Felicia W. , Grant Richard W. , Weisner Constance , Van Dyke Lucas , Pruzansky Alix , Bui Sandy , Madvig Philip , Pearl Robert , Sterling Stacy A. 
Published: June 2019

OBJECTIVE
People with type 2 diabetes vary greatly in their use of high-cost health care resources. We examined the association of anxiety with high-cost use after accounting for depression and medical comorbidity.

RESEARCH DESIGN AND METHODS
Using electronic health record data, we assessed past anxiety diagnosis, health care use and costs, demographics, comorbidities, and diabetes control status and complications during 2008–2012 for 143,573 adult members of an integrated health care system with type 2 diabetes. Multivariable regression models estimated associations between anxiety and emergency department (ED) use, total hospitalization costs, and high-cost status (i.e., incurring total health care costs in the top 20% among all system members).

RESULTS
During 2008–2011, 12.9% of participants received a diagnosis of anxiety, of whom 52.9% also had received a depression diagnosis. After adjustment for covariates including depression, anxiety was positively related to the number of ED visits in 2012 (incidence rate ratio 1.27; 95% CI 1.21, 1.34), the likelihood of visiting the ED on a chronic, frequent basis during 2010–2012 (odds ratio 2.55; 95% CI 1.90, 3.44), and high-cost status in 2012 (odds ratio 1.29; 95% CI 1.23, 1.36), but anxiety was not related to total hospitalization costs in 2012 (relative cost ratio 1.06; 95% CI 0.94, 1.21; P = 0.33).

CONCLUSIONS
Anxiety is highly comorbid with depression among individuals with type 2 diabetes and is independently associated with high-cost resource use. Strategies to improve anxiety management among people with diabetes hold the potential to also reduce health care costs.
Age, HLA, and Sex Define a Marked Risk of Organ-Specific Autoimmunity in First-Degree Relatives of Patients With Type 1 Diabetes
Authors: Winkler Christiane , Jolink Manja , Knopff Annette , Kwarteng Nana-Adjoa , Achenbach Peter , Bonifacio Ezio , Ziegler Anette-G. 
Published: June 2019

OBJECTIVE
Autoimmune diseases can be diagnosed early through the detection of autoantibodies. The aim of this study was to determine the risk of organ-specific autoimmunity in individuals with a family history of type 1 diabetes.

RESEARCH DESIGN AND METHODS
The study cohort included 2,441 first-degree relatives of patients with type 1 diabetes who were prospectively followed from birth to a maximum of 29.4 years (median 13.2 years). All were tested regularly for the development of autoantibodies associated with type 1 diabetes (islet), celiac disease (transglutaminase), or thyroid autoimmunity (thyroid peroxidase). The outcome was defined as an autoantibody-positive status on two consecutive samples.

RESULTS
In total, 394 relatives developed one (n = 353) or more (n = 41) of the three disease-associated autoantibodies during follow-up. The risk by age 20 years was 8.0% (95% CI 6.8–9.2%) for islet autoantibodies, 6.3% (5.1–7.5%) for transglutaminase autoantibodies, 10.7% (8.9–12.5%) for thyroid peroxidase autoantibodies, and 21.5% (19.5–23.5%) for any of these autoantibodies. Each of the three disease-associated autoantibodies was defined by distinct HLA, sex, genetic, and age profiles. The risk of developing any of these autoantibodies was 56.5% (40.8–72.2%) in relatives with HLA DR3/DR3 and 44.4% (36.6–52.2%) in relatives with HLA DR3/DR4-DQ8.

CONCLUSIONS
Relatives of patients with type 1 diabetes have a very high risk of organ-specific autoimmunity. Appropriate counseling and genetic and autoantibody testing for multiple autoimmune diseases may be warranted for relatives of patients with type 1 diabetes.
Generación de viajes: ciudadelas privadas de Vía a la Costa y Av. Narcisa de Jesús de la ciudad de Guayaquil, Ecuador
Authors: Von Buchwald Federico , Idrovo Hurel Astrid , Pileggi Alvear José , Gómez Maldonado Carolina 
Published: June 2019

En la actualidad los países y ciudades de Sudamérica no cuentan con estudios de generación de viajes propios, por este motivo la mayoría se encuentra en la obligación de recurrir a estudios elaborados en Estados Unidos o de otros países, para el proyecto presentado se utilizó como referencia el manual realizado por el Institute of Transportation Engineers (ITE). Esta investigación se centró en la fase de generación de viajes, a fin de obtener los volúmenes de viajes generados por conjuntos residenciales, en donde se cuantificó el número de viajes vehiculares producidos por conjuntos residenciales, se realizaron dos análisis diferentes, el primero a seis conjuntos residenciales considerados de condición económica alta y que se encuentran ubicados en Vía a la Costa, y el segundo en cinco conjuntos residenciales ubicados en la Av. Narcisa de Jesús y dos conjuntos residenciales en el sector de Samanes 6 en la ciudad de Guayaquil considerados de condición económica media y finalmente se unieron los conjuntos de ambas condiciones económicas, en los tres casos se las comparó con los resultados del ITE.Para la elaboración del estudio la recopilación de datos fue realizada mediante conteos manuales en las puertas principales de entrada y salida desde las 6:45 horas hasta las 20:00 horas de esta forma se determinó el número de viajes que generan las personas y vehículos que entran y salen de cada conjunto residencial. Se utilizaron variables independientes para establecer una relación con datos reales, la variable considerada para el estudio fue: número de viviendas por conjunto residencial. Una vez determinados estos valores se obtuvieron las ecuaciones de regresión, tasas de generación promedio, coeficientes de correlación y las respectivas graficas de datos, las cuales se compararon con las gráficas propias del ITE. Así pues, en el caso de las ciudadelas de condiciones económicas altas dieron como resultados coeficientes de correlación alrededor del 1% y se demostró que la generación de viajes en EE.UU. de conjuntos residenciales es parecida al de los de clase económica alta en la ciudad de Guayaquil, mientras que en las ciudadelas de condición económica media resultaron relaciones de hasta 3 a 1 siendo mayor las condiciones de EE.UU.
Pengaruh Tekanan Injeksi Gas Terhadap Konsumsi Bahan Bakar dan Efisiensi Termal pada Mesin Diesel Dual Fuel
Authors: Yuvenda Dori , Sudarmanta Bambang , Putra Randi Purnama , Martias Martias , Alwi Erzeddin 
Published: June 2019

Penggunaan compressed natural gas (CNG) sebagai bahan bakar utama pada mesin diesel menyebabkan penurunan performa mesin terutama pada efisiensi termal. Hal ini dikarenakan peningkatan daya mesin yang dikonversi melalui proses pembakaran tidak sebanding dengan penambahan jumlah bahan bakar yang masuk ke dalam ruang bakar seiring dengan penambahan beban mesin. Tujuan dari penelitian ini adalah bagaimana mengoptimalkan tekanan injeksi gas CNG yang diinjeksikan ke dalam ruang bakar melalui port (intake manifold) dapat menurunkan konsumsi bahan bakar dan meningkatkan efisiensi termal pada mesin diesel dual fuel (DDF). Metode penelitian ini dilakukan secara eksperimen pada mesin DDF Diamond DI 800 dengan putaran konstan (1500 rpm). Variasi yang dilakukan adalah mengatur tekanan injeksi gas CNG yang masuk melalui port sebesar 1,5 bar, 2 bar dan 2,5 bar. Hasil yang diperoleh adalah pada tekanan injeksi gas CNG 2,5 bar dapat memberikan persentase subtitusi gas CNG rata rata sebesar 57,59%, sedangkan pada tekanan injeksi gas CNG 1,5 bar dapat menurunkan konsumsi bahan bakar spesifik (SFCdual) hingga sebesar 0,196 kg/HP.jam dan meningkatkan efisiensi termal rata-rata sebesar 3,57% dibandingkan dengan variasi lain, meskipun masih di bawah kondisi operasi mesin single fuel.
Peningkatan Kompetensi Guru Dan Siswa SMK Melalui Pelatihan Kompetensi Kejuruan Teknologi Otomotif
Authors: Sugiarto Toto , Amin Bahrul , Purwanto Wawan , Arif Ahmad , Putra Dwi Sudarno 
Published: June 2019

Sekolah Menengah Kejuruan bertujuan untuk mampu menyiapkan peserta didik yang kreatif, menguasai ilmu pengetahuan dan teknologi, serta memiliki kompetensi yang sesuai dengan tuntutan dunia kerja. Kualitas lulusan SMK tidak hanya ditentukan oleh faktor individu dari siswa itu sendiri, akan tetapi juga sangat ditentukan oleh faktor dari luar, salah satunya komptensi pendidikan yang bisa menyiapkan lulusan sesuai dengan tuntutan dunia kerja. Program Ipteks bagi Masyarakat (IbM) bertujuan untuk memberikan pelatihan Kompetensi Kejuruan Teknologi Otomotif bagi guru dan siswa SMK di kabupaten Solok, kegiatan IbM dengan tema Peningkatan Kompetensi Kejuruan Teknologi Otomotif bagi Guru dan Siswa SMK, dapat meningkatkan pengetahuan dan keterampilan peserta pelatihan sebesar 13,16 % dibidang kompetensi kejuran Teknologi Otomotif.
Sistem Tracking Cahaya Matahari pada Photovoltaic
Authors: Myori Dwiprima Elvanny , Mukhaiyar Riki , Fitri Erna 
Published: June 2019

Umumnya solar cell yang dipasang hanya menghadap satu arah tertentu saja. Gerak semu harian matahari menyebabkan perubahan posisi matahari dari timur ke barat setiap harinya. Perubahan posisi matahari tersebut membuat modul solar cell tidak selalu mendapatkan intensitas cahaya matahari yang maksimal sepanjang hari. Salah satu cara yang dapat dilakukan supaya solar cell mendapatkan intensitas cahaya matahari yang maksimal sepanjang hari adalah dengan menempatkan modul solar cell tegak lurus mengikuti cahaya matahari. Hal tersebut yang melatarbelakangi pembuatan alat tracking cahaya matahari menggunakan komponen Light Dependent Resistor (LDR) sebagai sensor dan motor linear aktuator parabola sebagai penggerak posisi modul solar cell. Cahaya matahari yang mengenai sensor LDR membuat resistansinya berubah sehingga mempengaruhi nilai tegangan yang akan diinformasikan ke analog input mikrokontroller. Mikrokontroller mengolah informasi yang diterima dari sensor LDR dan memberi perintah untuk menggerakkan linear aktuator yang mana akan menggerakkan posisi permukaan modul solar cell dengan dua arah yaitu mengikuti orientasi gerak semu harian matahari dari arah timur ke arah barat. Pada arah timur dan barat masing-masing terdapat sebuah limit switch. Ketika malam hari modul solar cell ini akan kembali bergerak menghadap ke arah Timur dan akan berhenti ketika limit switch Timur aktif. Alat tracking cahaya matahari ini telah dilakukan uji coba. Alat ini telah dapat mengikuti pergerakan matahari dari timur ke barat dengan daya keluaran solar cell dari 8,71 watt mampu ditingkatkan menjadi 12,46 watt dengan konsumsi daya motor sebesar 2,08 watt.
Desenvolvimento de grânulos nanorevestidos contendo trans-resveratrol
Authors: Baron Lana Flávia , Bastos Ana Paula Almeida , Bellaver Franciana Volpato , Fonseca Francisco Noé da 
Published: June 2019

O presente estudo objetivou desenvolver e caracterizar grânulos nanorevestidos contendo trans-resveratrol (RSV). Assim, foram preparadas nanocápsulas poliméricas contendo RSV (NC-RSV, 0,5 mg/mL) e nanocápsulas brancas (NCB) pelo método de deposição interfacial de polímero pré-formado. As formulações foram caracterizadas quanto ao diâmetro, potencial zeta, pH e teor. Também foi avaliada a citotoxicidade das NC-RSV pela técnica de MTT em macrófagos (linhagem RAW) nas concentrações de 0,78 – 100 µg/mL por 24, 48 e 72 h. As NCB, o trans-resveratrol livre e o Tween 80 também foram testados para comparação.A seguir, foram preparados grânulos por via úmida utilizando HPMC ou PVP como aglutinantes, os quais foram caracterizados quanto ao teor, propriedades de fluxo e capacidade de compactação. As NC-RSV apresentaram tamanho médio de 188±3 nm, potencial zeta -26,5±0,2 mV, pH 5,4 e teor médio de 0,4904±0,0056 mg/mL. No teste de MTT, as células expostas às NC-RSV apresentaram viabilidade celular superior a 70% nas concentrações de 0,78 a 6,25 µg/mL. Os grânulos aglutinados com HPMC apresentaram um teor de 37,9±4,5% de RSV e todos os pós apresentaram propriedades de fluxo justo e passável. Desta forma, a utilização da nanotecnologia oferece um meio promissor de liberação de fármacos e a incorporação das nanoformulações em grânulos possibilita o delineamento de formas farmacêuticas de uso oral e com melhor estabilidade, embora outros estudos sejam necessários para ajustar os excipientes e obter preparações mais adequadas.
Palavras-chave: trans-resveratrol. Nanotecnologia. Citotoxicidade. Grânulos.
Partisipasi Masyarakat Lokal Desa Angseri Dalam Pengelolaan Daya Tarik Wisata Air Panas Angseri, Kecamatan Baturiti, Tabanan
Authors: Saputra Gede Mahendra , Nugroho Saptono 
Published: June 2019

Angseri village is located in_Baturiti subdistrict, Tabanan regency, Bali. Angseri village has_Angseri Hot Springs as a tourist attraction. This tourist attraction has a special characteristic than another hot springs tourist attraction._The special characteristic of this hot springs is in the middle of bamboo forest. The management of this hot springs started in 2007 until now and this management still running well with many involved party in it. The research that will be done is_about how is the actual condition of Angseri hot springs reviewed on tourism product component and how is the pattern of participation in management of Angseri hot springs in Angseri village which the_management is managed by the local community itself.
The research method used is qualitative descriptive with in-depth interview, observation, documentation, and literature_study. The data sources are obtained from primary and secondary data. The theory and concept used are concept of attraction, concept of management,_concept of tourism product component, and theory of participation_typology in management.
The actual condition is reviewed from tourism product component located in Angseri hot springs which is an attraction that take benefit from natural potential in the form of hot springs, an adequate access, feasible infrastructures, and the completeness of supporting facilities. In the participation typology of local community in management of Angseri hot springs, there were well organization and management structure and the participation of local community which belongs to pushed participation. In this case, the local community is given socialization by Tourism Department in the beginning of planning Angseri hot springs tourist attraction.

Keywords:Participan, Management,Product Component, Angseri Hot Springs
Penerapan Keselamatan dan Kesehatan Kerja pada Aktivitas Wisata Berenang Bersama Ikan Hiu (Swim with Shark) di Pulau Serangan, Denpasar Selatan
Authors: Simon Julius , Sukana Made 
Published: June 2019

Selection of research is motivated by the increased interest of tourists will kind of attraction travel in Bali. In this kind of travel these attraction are extreme types of tourist activity in Pulau Serangan is, Swim with Sharks. Of course, by choosing the type of extreme travel to swim with the sharks, the great possibility of the risk of accidents caused. Hence the importance of this research study releated to health and safetyof employees and tourist who do this activity in Pulau Serangan.
The data used in this research is qualitative data, while the data source in the form of primary data and secondary data. Data was collected through observation, interviews, and library research. And assisted with the descriptive data analysis techniques.
In applying the safety and health at tourism activities swim with sharks, this report uses occupational safety and health procedures that apply to employees and tourist who do that tourism activity. Besides, the factors triggering the accident, or the result of the impact and the prevention and mitigation to be part of the discussion of this report. The results showed that the application of occupational safety and health on travel activity swim with sharks being the foremost, so most have applied, only need the addition of some other procedure for the safety of travelers.

Keywords: Attraction Tourism, Swim With Shark, Occupational health and safety
Penerapan Keselamatan dan Kesehatan Kerja (K3) pada Atraksi Adventure Tourism di Kawasan Air Terjun Aling-Aling Sambangan
Authors: Wiratami Rut , Bhaskara Gde Indra 
Published: June 2019

Tourist safety is an important aspect in tourism activities and must have serious attention from the manager of a tourism destination. It is also one of tourist satisfaction over the service which further will imposes image of the destination around the world. Sambangan tourism village is one of the tourist destinations in North Bali which is currently popular to domestic and foreign tourists. There are two unique attractions become flagship attractions that are sliding and jumping. Along with the development of an increasing tourist visits since last few years, problems began appear. An accident even cause the loss of life and one of them is a local guide who made a living in that area. Therefore, this research is considered necessary and important in order to find out how the application of safety and health of work have been done so far. Data obtained through library studies, participatory observation and interviews with the determined informants.This research found that the safety and health aspects of work in Sambangan tourism village are still simple due to the limitations of funding and a lack of understanding in the health aspects so that the implementation of health and safety of workis done based on understanding. Therefore, in the future a further research is needed related to the health aspects of a medical, increasing of security aspects in the location of tourists attraction and also the attention and support from the government especially tourism department.

Keywords: Safety and Healthy, Adventure Tourism, Attraction, Waterfall.
Dampak Fenomena Wisata Kuliner Terhadap Kunjungan Wisatawan di Kota Malang, Jawa Timur
Authors: Prayogo Dimas , Suryawan Ida Bagus 
Published: June 2019

This research discusses about the phenomenon impact of culinary tourism in Malang City, East Java. Which is analyze the characteristic of the tourist such as age, job, and where they from. The impact of culinary tourism phenomenon analyze with the aspect of positive and the negative. The point of view for the impact is in 3 (three) point such as economy, social culture, and the environment.
The result of this study is the numbers of tourist departure always raising which is the point of view is still positive. The age of the tourists dominated in 21 – 30 years old. Tourist typology that come to Malang City is incipient mass, the tourist is very considerable about standard of the culinary but they still want the authentic of culinary itself.
The impact of culinary tourism is showing the positive result, the tourist and local people feels that culinary tourism make he economy in Malang city being increased and also tourist can learn about the culture.

Keywords : Phenomenon, Impact, Culinary Tourism, Malang City
Pengelolaan Daya Tarik Wisata Budaya Pura Puseh Pura Desa, Desa Pekraman Batuan, Gianyar
Authors: Suryaningsih Ni Wayan Eka , Nugroho Saptono 
Published: June 2019

“Pura Puseh Pura Desa” keeps safely the inheritance things and its histories in the past. In addition, the existence of unique spiritual rituals of Batuan people as cultural attraction will support the development of “Pura Puseh Pura Desa” become a cultural tourism which is managed by elitist of Batuan village.
This research is located in Batuan village, Gianyar regency. The type of data in this research is qualitative data. The data source obtained from primary and secondarydata. The method of this research is descriptive qualitative data that collected through through interviews, observation, and documentation. The determination of informant used purposive sampling.
The result of this research shows that “Pura Puseh Pura Desa” become an attracttion of cultural tourism which is managed by elite as the representative of Batuan village. The managed “Pura Puseh Pura Desa” by doing function of management such as planning, organization, actuating, controlling.

Keyword: Managementof tourist attraction, elite,Pura Puseh Pura Desa, cultural tourism
Peran Stakeholders dalam Konservasi Penyu Belimbing di Pantai Peneluran Jamursba Medi Kabupaten Tambrauw Provinsi Papua Barat
Authors: Yewen Martha Yulita , Ariwangsa I Made Bayu 
Published: June 2019

The conservation potential of Leatherback Sea Turtle in Jamursba Medi Spawning Beach is for ecotourism attraction. This research was conducted at PeneluranJamursbaMedi Beach. This research was conducted to find out the potential of Leatherback Sea Turtle at JamursbaMediSpawningBeach as ecotourism attraction in Tambrauw Regency and also to find out the form of cooperation of Stakeholders in the area of Jamursba Medi Spawning Beach, Regency of Tambrauw, Province of West Papua. The type of data being used in this research was qualitative and quantitative with primary and secondary data source obtained through data sampling technique of depth interview observation, literature study with informant determination technique of purposive sampling and data analysis technique of descriptive qualitative. The result of research shows that in the area of Spawning Beach, Leatherback Sea Turtles have a potential to support tourism development in the form of natural, cultural and human. These three potencies are the assets to give contribution for tourism development and management of coastal park and has potential for ecotourism sector. So participation and active role of stakeholders namely Government, Population, and non-governmental organizations / WWF (World Wildlife Fund) is required for advancement and development in the area of Jamursba Medi Spawning Beach.

Key words: Potency, Ecotourism Conservation, Stakeholder.
Strategi Promosi Bali Treetop Adventure Park Di Kebun Raya Eka Karya Bali, Bedugul, Kabupaten Tabanan
Authors: Azzahra Aulia , Pujani Luh Putu Kerti 
Published: June 2019

The tourism sector contributes a lot to the economic development in Indonesia, it can be seen from the number of new job opening, increasing the income of the state and increasing the economy of the people around the tourist destination. However, in its development, tourism has also experienced many problems, such as the increasingly tight competition among Southeast Asian countries in controlling the world tourism market target to make its region as the world's main tourist destination in the region. A poorly-organized marketing strategy can be a major problem in market target. It happened at the outbound tourist attraction of Bali Treetop Adventure Park located at Eka Karya Bali Botanical Garden, Bedugul, Tabanan Regency. Many tourists do not know the attraction of this outbound tour. This is due to lack of information for tourists about the tourist attraction, a less precise marketing strategy is suspected to be the main problem.
The purpose of this research is to find out the marketing strategy of Bali Treetop Adventure Park at Eka Karya Bali Botanical Garden, Bedugul, Tabanan Regency. Types of data that is used are qualitative data and quantitative data with approaches through observation, interviews, questionnaires distribution to tourists, literature study and documentation. The data analyzed in the research is the explanation of various explanations of data obtained directly from the managers of Bali Treetop Adventure Park and tourists during this research took place.
The result of this research is Bali Treetop Adventure Park has several marketing strategies that is direct promotion (sales call, exhibition, brochure), promotion of mass media (magazine, baliho, Facebook, YouTube), indirect promotion (travel agent and local guide). The target of the market has been obtained but it is not maximized, this is caused by the market strategies which is not done properly. So it is necessary to improve its performance for human resources in the tourist attraction of Bali Treetop Adventure Park is to achieve the desired number of tourists visit.

Keywords : outbond, tourist attractions, treetop