bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telehealth Finance Variables and Successful Business Models
Authors: Arkwright Bryan T. , Leslie Monica , Light Morgan 
Published: June 2019

Successful telehealth business models are a topic of regular discussion in the healthcare industry, and the financial details of telehealth programs, initiatives, and companies are central to program viability and sustainability. Claims and total payments toward telehealth services are rapidly increasing each year; therefore, it is becoming imperative that organizations carefully navigate the regulatory, financial, operational, and technical aspects impacting, and many times determining, the financial health of telehealth programs. The objective of this article is to define and articulate the financial variables and business models that are the lifeblood of today’s successful telehealth programs, and also to provide insights and information to assist organizations in navigating the nuances of telehealth financial modeling, monitoring, and management.
The financial and business models surrounding telehealth are unique for a number of reasons, mainly because the calculations and architecture of such models often contain many continuous variables, such as people (clinical providers and patients), geography (rural or metropolitan areas), telehealth governance structure, the service provided, the reimbursement or coverage eligibility, the technology used, the quality of care rendered, and the outcome of the care rendered. In addition, a clear need for a departure from traditional ways of projecting return on investment (ROI) becomes apparent with the layering of additional complexities of restrictive payer requirements, various business models, and the transition from volume to value.
A Comparative Study of Clinical Profile, Metabolic Parameters and Outcome of Patient Among Subtypes of Alcohol Dependence Syndrome in Tertiary Level Hospital of Kathmandu Valley
Authors: Pokhrel Prabhakar , Rai Neena , Pathak Rajan , Thapa Aajma , Regmi Nishchal , Sharma Pushpa Prasad 
Published: June 2019

Introduction: Alcohol is a legally allowed substance used for recreation associated with harmful health consequences both on using it and trying to quit (withdrawal phase). Many patients of alcohol dependence are brought to hospital or emergency in the withdrawal phase and require intensive treatment. It’s associated with life threatening conditions and associated with occurrences of seizures and confusion. Based on severity, it can be subtyped and managed differently. The study tries to compare and contrast the subtypes of withdrawal phases of alcohol in terms of clinical, outcome and metabolic parametersMaterials and Methods: This is a cross-sectional study of all patients diagnosed as alcohol dependence syndrome admitted over a period of two years (June 2016 to June 2018) in the psychiatric ward of KIST medical college and teaching hospital. It’s divided into two phases namely complicated and uncomplicated phase and clinical, outcome and metabolic parameters are compared and contrasted.Results: Out of 166 patients studied, 54% of the patients were diagnosed with complicated withdrawal features. Significant changes were noticed in increase duration of stay, low level of platelets and potassium and SGPT levels in a complicated group compare to the uncomplicated group. Mortality was not seen in any of the groupConclusions: Patients can be treated in-ward setting successfully and if the diagnosis is of complicated withdrawal then metabolic parameters like potassium, platelet level has to be taken into consideration. Complicated withdrawal features increase the chance of morbidity and increase the duration of stay.
Bronchoscopic Voriconazole Instillation in Pulmonary Aspergilloma: A Single Center Experience
Authors: Shrestha Prajowl , Dhungana Ashesh 
Published: June 2019

Introduction: Saprophytic growth of Aspergillus species in preexisting lung cavities commonly presents with hemoptysis. Surgical resection is the preferred treatment for hemoptysis control in pulmonary aspergilloma. In patients, who are not candidates for surgical resection bronchoscopic Voriconazole instillation, is an effective option.Materials and Methods: In this retrospective study, data of patients presenting with active hemoptysis, radiological evidence of aspergilloma and those undergoing bronchoscopic Voriconazole instillation at National Academy of Medical Sciences from January 2018 to December 2018 were retrieved. Clinical details including the severity of hemoptysis, number, size and location of aspergilloma, number of Voriconazole instillation sessions and symptom control were assessed. Follow up CT scan after four to six sessions were also evaluated to compare the size of aspergilloma.Results: A total of 11 patients presented with aspergilloma and hemoptysis. Of these, five (45.4%) patients underwent at least four sessions of bronchoscopic Voriconazole instillation. Two patients required six sessions whereas one required nine sessions for hemoptysis control. The procedure was successful in all patients; however, one had a recurrence after 3 months and required bronchial artery embolisation. In four patients there was a reduction in the size of aspergilloma on follow up CT scan. The procedure was well tolerated by all the patients, except for a mild increase in cough in the immediate post-procedure period.Conclusions: Intrabronchial Voriconazole instillation is a safe and effective option for hemoptysis control in patients with pulmonary aspergilloma. However, the optimal dose, frequency, and duration of Voriconazole instillation need to be further evaluated.
Tubercular Lymphadenitis Mimicking Findings of Metastatic Signet Cell Carcinoma in FNAC: A Case Report
Authors: Mainali Nirajan , Nepal Niraj , Choudhary Prabesh Kumar , Uprety Agraj 
Published: June 2019

Tubercular lymphadenitis is one of the most common extrapulmonary tubercular lesions presented in the Outpatient Department which is commonly diagnosed by Fine needle aspiration cytology. Cytological diagnosis of tuberculosis requires the presence of epithelioid cell granulomas demonstration with or without Langhan’s giant cells and necrosis. Sometimes, there can a proliferation of signet like cells without granulomas, which in a cervical lymph node can be given a false interpretation of metastatic signet cell carcinoma.
A 35 year female patient with a complaint of cervical lymphadenopathy came to the medical OPD. FNAC was done which showed numerous scattered signet ring cells. However, epithelioid cell granulomas weren’t observed in the smears. Zeihl Neelsen stain for Acid fast bacilli was done but the organism wasn’t appreciated. A biopsy was done and a histopathological slide showed epithelioid cell granulomas and Langhan’s giant cell. Zeihl Neelsen Stain for Acid fast bacilli, which was positive.
Sistem Pengaturan Bendungan Dengan Dua Keluaran Sebagai Pengendali Banjir
Authors: Bahri Zulkifli 
Published: June 2019

Perancangan suatu sistem pemantauan level ketinggian permukaan air dengan menggunakan sensor air sebagai sensornya dan menggunakan AT89S52 sebagai pengolah datanya. Sistem ini dapat bekerja secara baik berdasarkan program yang telah dirancang .perangkat ini dapat digunakan untuk berbagai keperluan antara lain monitoring ketinggian permukaan air suatu sungai , bendungan, sistem peringatan dini banjir dan lain-lain. Perancangan ini terdiri atas dua tahap, yaitu tahap perancangan <em>hardware </em>dan <em>software. Hadware yang digunakan dalam perancangan ini adalah </em>meliputi sensor air berfungsi sebagai pedeteksi adanya air mikrokontroler sebagai pusat pengendali dari seluruh sistem , pompa sebagai penguras air serta motor DC sebagai penggerak benteng bendungan sedangkan software pada alat ini menggunakan bahasa Assembler. Prinsip kerja sistem ini adalah sebagai sistem pemantau level ketinggian permukaan air yang ditampilkan melalui tampilan LCD dan mempunyai dua fungsi sebagai pengendali banjir, dengan adanya alat sistem pengaturan bendungan ini maka potensi banjir bisa dikurangi kususnya didaerah yang rawan banjir dan penduduk setempat dapat mengetahui status ketinggian air melalui tampilan LCD.
GZFT ANALİZİ, İŞLETMENİN STRATEJİSİNİN BELİRLENMESİ VE DENGELİ ÖLÇÜM KARTININ OLUŞTURULMASI: ANTALYA’DAKİ BİR ALKOLLÜ İÇECEK İŞLETMESİNDE UYGULAMA
Authors: TETİK Merih 
Published: June 2019

﻿﻿﻿﻿﻿Strateji, işletmelerin çevredeki değişikliklere
karşı hazırlıklı olmasını sağlamaktadır. Bu nedenle işletmeler çevredeki
değişiklikleri belirleyip değerlendirmeli ve doğru stratejiyi seçmelidir. Bu
amaçla çalışmada bir alkollü içecek işletmesine GZFT analizi uygulanmıştır.
Analize göre, sektörde otomasyonun gelişmesi en büyük fırsat iken; ithal
alkollü içecek tüketiminin artması, reklam yasakları ve sektöre teşvik
verilmemesi en büyük tehditler arasındadır. İşletmenin en güçlü yanlarından
bazıları; az sayıda tedarikçiyle çalışmak, tam otomasyonla üretim ve pazara
yakınlıktır. Ancak işletme; dağıtım ağı, markalarının bilinirliliği ve müşteri
ilişkileri gibi bazı konularda esas rakibine kıyasla zayıftır. Analizin
sonucunda işletmenin maliyet liderliği stratejisi uyguladığı ortaya çıkmıştır.
İşletme bu stratejiyi uygulamaya devam edecektir. Anahtar Kelimeler:
GZFT analizi, rekabet analizi, strateji, alkollü içecek sektörü, alkollü içecek
sektöründeki problemler. JEL Sınıflandırması: M41, M10, M14, L10, L11, L21, D40.
CAPACITY BUILDING PENGURUS REHABILITASI BERBASIS MASYARAKAT DALAM PELAYANAN TERHADAP PENYANDANG DISABILITAS DI KELURAHAN BABAKAN CIPARAY KECAMATAN BABAKAN CIPARAY KOTA BANDUNG
Authors: Setiadi Arif 
Published: June 2019

Capacity Building adalah proses peningkatan kemampuan pengurus Rehabilitasi Berbasis Masyarakat (RBM) dalam memberikan pelayanan kepada penyandang disabilitas, sehingga penyandang disabilitas dapat mengakses pelayanan yang dibutuhkan. Tujuan penelitian ini adalah untuk mengkaji tentang Capacity Building Pengurus Rehabilitasi Berbasis Masyarakat dalam Pelayanan terhadap Penyandang Disabilitas di Kelurahan Babakan Ciparay Kecamatan Babakan Ciparay Kota Bandung. Metode penelitian yang digunakan adalah kualitatif dengan design action research. Sumber yang digunakan adalah sumber data primer dan sumber data sekunder. Adapun teknik pengumpulan data yang digunakan adalah wawancara mendalam, observasi partisipatif, studi dokumentasi, dan Penilaian Kapasitas. Teknik pemeriksaan data yang digunakan yaitu uji kepercayaan, uji keteralihan, uji ketergantungan dan uji kepastian. Selanjutnya hasil penelitian ini di analisis menggunakan teknik analisis kualitatif. Hasil penelitian ini menunjukkan bahwa capacity building terhadap pengurus RBM Kelurahan Babakan Ciparay membawa perubahan dalam memberikan pelayanan kepada penyandang disabilitas. Capacity Building pengurus RBM tersebut berdampak pada pelayanan terhadap penyandang disabilitas menjadi lebih komprehensif dan berbasis metode serta teknik pekerjaan sosial. Keywords: Capacity Building, Community-Based Rehabilitation, Persons With Disabilities
PENGUATAN KAPASITAS PENGURUS REHABILITASI BERBASIS MASYARAKAT DI KELURAHAN BABAKAN KECAMATAN BABAKAN CIPARAY KOTA BANDUNG
Authors: Bahagiati Dedeh 
Published: June 2019

Penguatan kapasitas merupakan kegiatan-kegiatan yang dilakukan untuk meningkatkan keterampilan pekerjaan sosial pengurus Rehabilitasi Berbasis Masyarakat (RBM) dalam memberikan pelayanan bagi penyandang disabilitas. Tujuan penelitian ini adalah untuk mengkaji tentang karakteristik pengurus RBM, gambaran pelayanan RBM sebelum penguatan kapasitas, pelaksanaan penguatan kapasitas pengurus RBM dan gambaran pelayanan RBM setelah penguatan kapasitas. Metode yang digunakan dalam penelitian ini yaitu metode kualitatif dengan desain penelitian action research. Adapun teknik pengumpulan data yang digunakan adalah wawancara mendalam, studi dokumentasi, observasi partisipatif, dan Diskusi Kelompok Terfokus. Teknik pemeriksaan keabsahan data yang digunakan adalah uji kepercayaan, uji keteralihan, uji ketergantungan dan uji kepastian. Selanjutnya hasil penelitian dianalisis dengan menggunakan teknik analisis data kualitatif yang dilakukan dengan tahapan reduksi data, displai data dan verifikasi. Hasil penelitian menunjukkan bahwa penguatan kapasitas memberikan perubahan terhadap keterampilan pengurus RBM Kelurahan Babakan dalam memberikan pelayanan untuk penanganan masalah penyandang disabilitas yaitu keterampilan identifikasi, asesmen, perencanaan pelayanan, recording, jejaring kerja dan pembuatan proposal. Kata kunci: penguatan kapasitas, Rehabilitasi Berbasis Masyarakat, penyandang disabilitas, pelayanan sosial.
Model Penanganan Perilaku Maladaptif dengan Cognitive behavior Group Therapy pada Remaja Berisiko di Kelurahan Cimahi Kecamatan Cimahi Tengah Kota Cimahi
Authors: Anggreni Hana 
Published: June 2019

Penelitian ini bertujuan untuk melihat bagaimana Cognitive behaviour group therapy dapat menurunkan perilaku maladaptif dari dua subjek penelitian yaitu SNS (Lk/14) dan MV (Lk/14). Kedua subjek penelitian merupakan remaja berisiko terhadap perilaku berisiko seperti terlibat geng, kenakalan remaja ataupun penggunaan obat terlarang. Adapun perilaku maladaptif yang dilakukan adalah perilaku merokok dan perilaku memberontak kepada orangtua yang ditandai dengan tidak mematuhi perintah ataupun berbicara kasar kepada orangtua. Peneliti menggunakan pendekatan kuantitatif dengan metode single subject design dengan model A-B-A. Pada setiap fase dilakukan pengamatan melalui pedoman observasi terhadap frekuensi terjadinya target perilaku. serta dilakukan pengukuran melalui kuisioner untuk melihat aspek kognitif, perasaan dan perilaku.Teknik analisa data dilakukan dengan statistik deskriptif melalui analisa visual dalam kondisi. Hasil Penelitian menunjukkan bahwa level perubahan pada masing-masing variabel yang diukur menunjukkan tanda (+) yang artinya intervensi menunjukkan perubahan yang positif yaitu menurun/ berkurangnya perilaku maladaptif. Kata kunci : remaja berisiko, perilaku maladaptif, cognitive behavior group therapy
Development and validation of risk stratification models for adult spinal deformity surgery
Authors: Pellisé Ferran , Serra-Burriel Miquel , Smith Justin S. , Haddad Sleiman , Kelly Michael P. , Vila-Casademunt Alba , Sánchez Pérez-Grueso Francisco Javier , Bess Shay , Gum Jeffrey L. , Burton Douglas C. , Acaroğlu Emre , Kleinstück Frank , Lafage Virginie , Obeid Ibrahim , Schwab Frank , Shaffrey Christopher I. , Alanay Ahmet , Ames Christopher , _ _ , _ _ 
Published: June 2019

OBJECTIVEAdult spinal deformity (ASD) surgery has a high rate of major complications (MCs). Public information about adverse outcomes is currently limited to registry average estimates. The object of this study was to assess the incidence of adverse events after ASD surgery, and to develop and validate a prognostic tool for the time-to-event risk of MC, hospital readmission (RA), and unplanned reoperation (RO).METHODSTwo models per outcome, created with a random survival forest algorithm, were trained in an 80% random split and tested in the remaining 20%. Two independent prospective multicenter ASD databases, originating from the European continent and the United States, were queried, merged, and analyzed. ASD patients surgically treated by 57 surgeons at 23 sites in 5 countries in the period from 2008 to 2016 were included in the analysis.RESULTSThe final sample consisted of 1612 ASD patients: mean (standard deviation) age 56.7 (17.4) years, 76.6% women, 10.4 (4.3) fused vertebral levels, 55.1% of patients with pelvic fixation, 2047.9 observation-years. Kaplan-Meier estimates showed that 12.1% of patients had at least one MC at 10 days after surgery; 21.5%, at 90 days; and 36%, at 2 years. Discrimination, measured as the concordance statistic, was up to 71.7% (95% CI 68%–75%) in the development sample for the postoperative complications model. Surgical invasiveness, age, magnitude of deformity, and frailty were the strongest predictors of MCs. Individual cumulative risk estimates at 2 years ranged from 3.9% to 74.1% for MCs, from 3.17% to 44.2% for RAs, and from 2.67% to 51.9% for ROs.CONCLUSIONSThe creation of accurate prognostic models for the occurrence and timing of MCs, RAs, and ROs following ASD surgery is possible. The presented variability in patient risk profiles alongside the discrimination and calibration of the models highlights the potential benefits of obtaining time-to-event risk estimates for patients and clinicians.
Advocacy in pediatric neurosurgery: results from a 2017 survey of the American Society of Pediatric Neurosurgeons
Authors: LoPresti Melissa , Lam Sandi , Orrico Katie , Browd Samuel R. , Ellenbogen Richard G. , Martin Jonathan 
Published: June 2019

OBJECTIVEPediatric neurosurgeons are unswerving advocates for public health–related issues in children, with most providers participating in local, regional, national, or international efforts. Collective advocacy efforts by organized pediatric neurosurgeons have not been undertaken to date.METHODSA 10-item survey was administered to members of the American Society of Pediatric Neurosurgeons (ASPN) in order to evaluate attitudes and opinions regarding the development of a formal advocacy effort by the organization.RESULTSSeventy-nine of 178 registered members of the ASPN (44.38%) participated in the survey. Participants were 82.61% male, with age, stage of career, and practice type varied. Although there was unequivocal support for participation in organized advocacy, respondents were divided on methods and topics for advocacy. In this survey, the ASPN membership prioritized public health and clinical issues over economic issues that affected children.CONCLUSIONSMost respondents favored the drafting of position statements on key issues and partnerships with larger organizations to pursue an advocacy agenda. The survey provides data regarding pediatric neurosurgeons’ attitudes that may assist with the design of a successful advocacy program.
GÜMÜŞHANE YÖRESİNDE TÜRK KOZMOLOJİSİNİN VE ESKİ TÜRK İNANCININ İZLERİ
Authors: KARAÇAY TÜRKAL Merve , PALANCI Rıdvan 
Published: June 2019

Bu
çalışmada, Merkez Gümüşhane ve ilçelerinde eski Türk inançlarının kültürel bir
belirleyici olup olmadığını ortaya koymak amaçlanmıştır. Eski çağlarda,
tabiatüstü güçlere hayranlık duyulduğu, Türklerin İslamiyet’le tanışmadan önce
Gök Tanrı inancına sahip olduğu ve Türkler üzerinde Şamanizm’in etkisi
bilinmektedir. Bu
bilgilere dayanarak, Gümüşhane’de geçmişten günümüze gelen eski Türk
inanışlarının sürdürülür olup olmadığını araştırmak için nitel araştırma
yöntemlerinden görüşme tekniği kullanılmıştır. Araştırmada, Gümüşhane yöresinde
nazardan korunma yolları, ateş ve ocak kültleri, ağaç kültü, su pınarları ve
nehirler ile ilgili inanışlar ve uygulamaların yanı sıra kargalardan haber
bekleme, yerin altındaki öküz ve balık, kapı eşiğine oturanın çarpılacağı veya
uğursuzluğa uğrayacağı ile cenaze ve yas törenlerindeki bazı inanışlar ve
uygulamalar başlıklar halinde incelenmiştir ve bu gün, Gümüşhane yöresinde
yaygın birçok inanışın, gelenek ve göreneğin eski Türk inancı ile bağlantılı
olduğu tespit edilmiştir.

Çalışmadan
elde edilen verilerin, eski Türk halklarının kültürleri ve aile yapıları ile
ilgilenen, ayrıca Gümüşhane ilinin kültürel yapısını ve bu çerçevede tarihsel
gelişimini araştıran konunun uzmanlarına önemli katkıda bulunacağı
düşünülmektedir.
PRINSIP-PRINSIP KESANTUNAN BERBAHASA DALAM INTERAKSI ANTARA SESAMA PENUTUR AMBON
Authors: Hitijahubessy Michele 
Published: June 2019

Kesantunan berbahasa berperan dalam membangun hubungan baik dengan seseorang karena kesantunan berbahasa dapat membuat interaksi yang dilakukan berjalan lancar, efektif, dan tidak mengancam muka. Melihat fenomena tersebut peneliti melakukan penelitian dengan tujuan untuk mendeskripsikan tipe prinsip berbahasa dalam interaksi penutur Ambon. Penelitian ini menggunakan metode kualitatif dengan pendekatan pragmatik. Kemudian dalam pengumpulan data, peneliti menggunakan tiga teknik yaitu: teknik simak bebas libat cakap, teknik rekam, dan teknik catat. Setelah data diperoleh, kemudian peneliti mengklasifikasikan data dan menganalisis menggunakan konsep prinsip-prinsip kesantunan dari Leech (1983) dan strategi kesantunan dari Brown dan Lavison (1987). Hasil dari penelitian ini peneliti menemukan bahwa penutur Ambon dalam berinteraksi sehari-hari menggunakan keenam maksim yaitu maksim kebijaksanaan, maksim kedermawaan, maksim pujian, maksim kerendahan hati, maksim kesepakatan, dan maksim simpati. Serta strategi kesantunan yang dipakai adalah strategi kesantunan positif dan strategi kesantunan negatif. Hal ini agar interaksi yang dilakukan dapat berjalan lancar, menjaga hubungan baik, dan efektif.
PROKLITIK PRONOMINA PERSONA BAHASA TABA
Authors: Taha Mujahid 
Published: June 2019

Penelitian ini bertujuan untuk mengetahui bentuk proklitik pronomina persona pertama, kedua, dan ketiga bahasa Taba (BT). Metode yang dipakai adalah metode kumpul data dan analisis data. Data penelitian ini merupakan morfem yang mengandung unsur proklitik yang melekat pada kata kerja (verba), kata depan (partikel preposisi), dan kata benda (nomina) yang bersifat singularis posesif. Sumber data penelitian ini adalah data lisan yang dituturkan langsung oleh penutur asli BT di Desa Waigitang, Kecamatan Pulau Makeang, Kabupaten Halmahera Selatan, Provinsi Maluku Utara. Berdasarkan hasil penelitian, ditemukan kata kerja BT berproklitik pronomina persona pertama dan jamak, persona pertama: k-, n-, (benda), dan n- (insani), persona pertama jamak: tit/tat- dan a-; persona kedua tunggal dan jamak, persona kedua tunggal pada morfem m- dan persona kedua jamak pada morfem h-; dan persona ketiga tunggal pada morfem i-, serta persona ketiga jamak pada morfem l-.