bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical repair of the moderately dilated ascending aorta combined with bicuspid aortic valve replacement
Authors: Uspenskiy V. E. , Malev E. G. , Gavriliuk N. D. , Salavatov B. K. , Ermolov S. A. , Cvetkova Je. V. , Malashicheva A. B. , Gordeev M. L. 
Published: August 2019

Background: Ascending aortic (AA) dilatation is common in patients with bicuspid aortic valve (BAV). In BAV replacement, surgery of the AA is indicated in the case if AA diameter exceeds 45 mm. Aortic valve replacement combined with an AA intervention is associated with increased risk of complications. The feasibility of the reduction ascending aortoplasty for correction of the dilated AA remains disputable.Aim: To analyze the results of BAV surgical replacement with simultaneous surgical correction of the borderline AA dilatation (45-50 mm) by the reduction aortoplasty (RAP) or supracoronary AA replacement (SPR).Materials and methods: This single center prospective non-randomized study included 53 patients with significant BAV stenosis and AA dilatation (45-50 mm), divided into 2 groups: BAV surgical replacement combined with RAP AA replacement (group 1, 36 patients) and BAV replacement with SPR (group 2, 17 patients). There were no significant differences between the patients of the two groups in their characteristics of the underlying disease, complications and comorbidities.Results: Hospital mortality was 0%. No between-group differences in the early postoperative course were found. At later term, 44 (81.5%) patients were assessed; median (dispersion) of the follow-up was 36 (25; 50) months. Two patients from the group 2 died during the follow-up. The long-term survival was better in the group 1 (p = 0.028). No differences in the combined adverse event rate were observed between the groups (p = 0.633). The median (dispersion) of the AA absolute increment and the rate of dilatation after RAP were 1.0 (0.0; 3.0) mm and 0.24 (0.00; 0.95) mm/year, respectively. The predictor of AA increment rate ≥ 2 mm/year was the baseline blood pressure level (odds ratio 1.321, 95% confidence interval 1.050-1.662; p=0.017). The threshold preoperative blood pressure value for the increased risk of the long-term AA expansion rate was 138 mmHg.Conclusion: The efficacy and safety of RAP and SRP combined with BAV replacement in AA borderline dilatation are similar. Combined BAV surgery and RAP is effective and safe in patients with systolic blood pressure level ≤ 135 mmHg. Combined BAV replacement with SRP seems reasonable in patients with arterial hypertension.
Acil yardım istasyonu çalışanlarında işe bağlı gerginliğin, anksiyete ve depresyon riski ile ilişkisi
Authors: KILIÇ Ümit , YÖN Burcu , YILDIRIM ŞİŞMAN Nuriye 
Published: August 2019

Amaç: Bu çalışma Düzce ili 112 acil
yardım istasyonu çalışanlarında işe bağlı gerginliğin, anksiyete ve depreyon riski ile ilişkisinin
saptanması amacıyla yapılmıştır. Yöntem: Kesitsel tipteki çalışma, Düzce ili 112 acil
yardım istasyonlarında çalışan 123 kişide yapılmıştır. Veri, katılımcıların
demografik özelliklerini ve işle ilgili düşüncelerini içeren anket, işe bağlı
gerginlik ölçeği ve hastane anksiyete ve depresyon ölçeği ile toplanmıştır.
Verinin istatistik değerlendirilmesinde, sayı, yüzde, ikili lojistik regresyon
analizleri kullanılmıştır. Bulgular: Katılımcıların %61’i erkek, %63.4’ü evli, %50.4’ü acil tıp
teknisyeni, %40.7’si 49-64 saat çalışmakta ve yaş ortalamaları 30.7 ± 9.0’dur.
Çalışanların %17.1’inde anksiyete, %19.5’inde depresyon riski saptanmıştır.
Hastane anksiyete ve depresyon ölçeğine göre anksiyete ve depresyon riski saptananların
işe bağlı gerginlik ölçeği puan ortalamaları, risk saptanmayanlara göre
istatistiksel olarak anlamlı düzeyde yüksek bulunmuştur (p&lt; 0.05). İBGÖ
puanının yüksek olması depresyon riskini 1.1 kat (OR= 1.10, GA 1.02-1.19),
paramedik olmak depresyon riskini 9 kat (OR=9.05, GA 1.34 – 60.82) ve ATT olmak
ise depresyon riskini 8.4 kat (OR=8.46 GA 1.60 – 44.56) artırmaktadır. İBGÖ puanının yüksek olmasının 1.1 kat (OR=
1.12, GA 1.02-1.22) ve tükenmişlik yaşama durumunun da 6.5 kat (OR=6.53, GA
1.76-23.88) anksiyete riskini artırdığı saptanmıştır. Sonuç: 112 acil yardım istasyonu çalışanlarında
anksiyete ve depresyon riski yüksektir. 112 acil yardım istasyonu çalışanlarına
yönelik hizmet içi eğitim programlarında, işe bağlı gerginlik, anksiyete ve
depresyon düzeylerinin değerlendirilmesine ve risklerin azaltılmasına yönelik
müdahalelere gereksinim duyulmaktadır.
MENINGKATKAN KETERAMPILAN PROSEDURAL SISWA MELALUI MODEL PENGAJARAN LANGSUNG PADA MATERI AJAR CAHAYA DAN ALAT-ALAT OPTIK KELAS VIII F SMPN 26 BANJARMASIN
Authors: Anggraini Anggun Novita , Zainuddin Zainuddin , Miriam Sarah 
Published: August 2019

Kemampuan penyelesaian masalah siswa tergolong rendah. Hal ini disebabkan oleh guru yang masih kurang tepat dalam menerapkan model atau strategi mengajar. Penelitian ini bertujuan untuk mendeskripsikan cara meningkatkan keterampilan prosedural siswa dengan menggunakan model pengajaran langsung. Secara khusus, penelitian ini bertujuan untuk mendeskripsikan: (1) keterlaksanaan RPP selama proses pembelajaran, (2) keterampilan prosedural siswa, (3) hasil belajar siswa. Jenis penelitian ini adalah penelitian tindakan kelas dengan model Kemmis dan Mc Taggart. Data yang diperoleh pada penelitian ini melalui observasi, lks, dan tes. Hasil penelitian menunjukkan bahwa (1) keterlaksanaan RPP selama proses pengajaran langsung meningkat yaitu pada siklus I diperoleh skor rata-rata 3,67 menjadi 3,9 pada siklus II dengan kategori sangat baik, (2) keterampilan prosedural siswa dalam menjalankan langkah-langkah pemecahan masalah juga meningkat dari siklus I ke siklus II dengan dari siklus I sebanyak 3,6 menjadi 3,8 dengan kategori sangat terampil, (3) hasil belajar siswa meningkat dari ketuntasan secara klasikal 62,07% belum tuntas pada siklus I menjadi 86,7% pada siklus II sudah tuntas. Diperoleh simpulan bahwa model pengajaran langsung dapat meningkatkan keterampilan prosedural siwa dan hasil belajar siswa.
Implementasi Model Pembelajaran Berbasis Fenomena untuk Meningkatkan Pemahaman Konsep Siswa pada Materi Tekanan
Authors: Saudah Saudah , Arifuddin Muhammad , Suyidno Suyidno 
Published: August 2019

Tingkat pemahaman konsep fisika siswa yang rendah memberikan dampak rendah aktivitas dan hasil belajar siswa. Oleh karena itu dilakukan penelitian untuk mendiskripsikan cara meningkatkan pemahaman konsep fisika siswa melalui model PBF. Penelitian tindakan kelas model Kemmis dan Taggart terdiri dari 2 siklus, yangmencakup perencanaan tindakan, pelaksanaan, pengamatan, dan refleksi. Subjek penelitian adalah siswa kelas VIII-B SMP Muhammadiyah 1 Banjarmasin yang berjumlah 15 orang. Pengumpulan data melalui observasi keterlaksanaan Rencana Pelaksana Pembelajaran (RPP) dan observasi aktivitas siswa, dan tes pemahaman konsep, Kemudian data dianalisis secara deskriptif kualitatif dan kuantitatif. Hasil penelitian menyatakan: (1) keterlaksanaan RPP pada siklus I maupun siklus II dapat tercapai dengan baik/sangat baik, (2) siklus I aktivitas siswamemperoleh kriteria baik (mendengarkan penjelasan guru dan berdiskusi dengan kelompok) dan kriteria kurang (memberikan pendapat dan mengajukan pertanyaan), mengalami peningkatan pada siklus II menjadi baik/sangat baik, dan (3) secara klasikal ketuntasan pemahaman konsep siswa untuk siklus I sebesar 13,33% (belum tuntas) meningkat pada siklus II menjadi 86,67% (tuntas). Diperoleh simpulan yaitu pemahaman konsep fisika siswa kelas VIII-B SMP Muhammadiyah 1 Banjarmasin dapat ditingkatkan melalui model PBF pada materi tekanan.
Treatment of dental polyclinic -induced gingivitis caused by secondary caries: a case report
Authors: Dinyati Maisaroh , Mapanggara Surijana , Adam Andi M. , Oktawati Sri 
Published: August 2019

Objective: This case report aims to present gingival therapy with gingivectomy due to secondary caries and overhanging filling.Methods: A 21-year-old male patient come to the periodontal clinic for treatment. The initial examination revealed deep probing pocket depth with sulcus bleeding at 11, 12, 21 and 22. Teeth 34, 36, 37 were extracted. Patients was in a good health, smoker, and didn’t take any medication. The patient had scalling a week ago but the gingiva remains enlargement. Periapical radiograph showed bone in good density. Initial treatment performed by non-surgery treatment included Scalling and Root Planing (SRP) and 0.2% chlorhexidine solution twice daily for one week. Gingivectomy with conventional blade. The result of control showed reduced enlarged of gingiva and patient feel satisfied with the treatment. Control one week after surgery. After being cured clinically, composite filling applied on teeth 11 and 21.Results: Gingivitis caused by secondary caries, because of bacterial invasion of caries to the gingival mucosa. Gingivitis therapy performed by gingivectomy, the removal of amount of the hyperplated gingival mucosa. Conventional gingivectomy is an option of gingival enlargement therapy.Conclusion: The aim of gingival therapy is to eliminate inflammatory process and prevent the progression of gingival disease. Gingival disease including gingival enlargement or gingivitis. Gingivitis can be caused by various factors such as secondary caries and overhanging filling. Keywords: Gingival enlargement, Gingivectomy, Seconder caries.
Cohort Profile: Effectiveness of a 12-month patient-centred medical home model of primary care versus standard care for chronic disease management of high risk patients in Sydney, Australia
Authors: John James Rufus , Jones Amanda , Neville Munro , Ghassempour Shima , Girosi Federico , Atlantis Evan , Tannous Kathy 
Published: August 2019

Abstract
Background: Patients presenting with multiple chronic conditions have complex healthcare needs that are challenging to manage in primary care. This paper aims to evaluate the effectiveness of a patient-centred medical home (PCMH) model for improving clinical outcomes in high risk patients in Sydney, Australia. Methods: A cohort study design with a comparison group and a case-series study design were used to evaluate ‘between-group’ and ‘within-group’ effectiveness of a 12-month PCMH treatment called ‘WellNet’ delivered across several general practices in Sydney, Australia. The intervention group consists of 636 eligible participants who had been diagnosed with one or more chronic diseases and/or one or more elevated clinical risk factors; and had a Hospital Admission Risk Profile (HARP) score of greater than 10 at study enrolment between October 2016 and October 2017. The comparison group consists of 7750 randomly selected and well-matched patients receiving usual general practice (GP) care at four geographically comparable general practices in Sydney. Data collected from the general practices include socio-demographics; clinical measures; and self-completed health surveys. Outcomes include 12-month changes in clinical outcomes and patient reported general and disease-specific health assessments. Paired sample t-test and independent samples t-test will be used to determine significant ‘within-group’ and ‘between-group’ differences respectively. In addition, analysis of covariance (ANCOVA) and repeated measures ANCOVA will be used to determine any differences in the clinical measures and assessments after adjusting for covariates such as age, gender and baseline values. Discussion: To our knowledge, the WellNet study is the first study in Australia to generate evidence on the feasibility of recruitment, retention, and adherence into, as well as effectiveness of a comprehensive PCMH model using GP-based data. Baseline findings show that mean age of the study participants was 70.05 years with nearly even gender distribution of males and females. The most prevalent chronic diseases in descending order were: circulatory system disorders (69.8%), diabetes (47.4%), musculoskeletal disorders (43.5%), respiratory diseases (28.7%), mental illness (18.8%), and cancer (13.6%). Findings of this study may be beneficial to both patients and providers in terms of improved health outcomes, shared-decision making, and increased satisfaction in delivery of care respectively.
Describing progression of health literacy skills: Establishing the HLS-Q12 cut-off scores
Authors: Guttersrud Øystein , Le Christopher , Pettersen Kjell Sverre , Helseth Sølvi , Finbråten Hanne Søberg 
Published: August 2019

Abstract
Background The self-reported European Health Literacy Survey Questionnaire (HLS-EU-Q47) is a widely used health literacy measure. Based on confirmatory factor analyses and Rasch-modelling, the short form HLS-Q12 was developed to meet the Rasch unidimensional measurement model expectations. After its publication, there has been a worldwide call to identify HLS-Q12 cut-off scores and establish clearly delineated standards in terms of the skills assessed. This study therefore aims to identify the HLS-Q12 scores associated with statistically distinct levels of proficiency and construct a proficiency scale that expresses progression – what individuals typically know and can do at increasingly more sophisticated levels of health literacy. Methods We applied the unidimensional Rasch measurement model for polytomous items to responses from 900 randomly sampled individuals and 388 individuals with type 2 diabetes. Using Rasch-based item calibration, we constructed a proficiency scale by locating the ordered item thresholds along the scale; by applying Wright’s method for the maximum number of strata, we determined the cut-off scores for significantly different levels. By directly referring to item content that people who reached the cut-off scores view as ‘easy’, we could describe these gradually more advanced levels of health literacy. Results We identified statistically distinct levels of health literacy at the empirically identified cut-off scores 27, 33 and 39 and confirmed them by analysing the responses from individuals with diabetes. Individuals who reach these cumulative benchmarks of marginal, intermediate and advanced literacy can typically access, appraise and apply information relevant to stay healthy, improve health and critically judge health claims and compare treatments, respectively. Conclusions By revealing progression in health literacy, we extended the current models of health literacy and inform policy-makers aiming to bridge literacy gaps. Determining how to best adapt information to patients’ literacy level and thereby assist them in managing their own health is a significant clinical outcome. A substantial methodological consequence is the inevitability of Rasch modelling in measurement. We also found that Wright’s method identified rating scale cut-off scores consistently across independent samples. To unveil sources of potential biases, threats to validity and imprecision of benchmarks, replicating our study in other contexts is required.
Comparison of the Oncological and Renal Function Outcomes of Partial Ureterectomy and Radical Nephroureterectomy in Upper Tract Urothelial Carcinoma: a Meta-analysis
Authors: Jiang Yu-Li , Qian Lu-Jie , Li Zhen , Wang Kang-Er , Zhou Xie-Lai , Zhou Jin , Ye Chun-Hua 
Published: August 2019

Abstract
Background

To perform a meta-analysis of comparative studies reporting oncological and renal function outcomes of of partial ureterectomy and radical nephroureterectomy in upper tract urothelial carcinoma (UTCC).

Methods

A literature search of PubMed, Embase, and the Cochrane library was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and a meta-analysis was performed to assess cancer-specific survival (CSS), overall survival (OS), recurrence-free survival (RFS), and perioperative variations in the estimated glomerular filtration rate (eGFR).

Results

Nineteen studies involving 4940 patients were included in our meta-analysis. No significant differences were found in the 5-year OS (HR=1.20, p=0.40), 5-year RFS (HR=1.21, p=0.37) and CSS (HR=0.89, p=0.20). A better preservation of renal function of PU compared with RNU changes in (eGFR) (WMD=-9.75, p=0.0006) between the patients undergoing the two types of surgery.

Conclusions

PU could achieve equal oncological outcomes and better postoperative renal function than RNU.
Positioning value of objective analysis of macular ganglion cell complex (mGCC) in optic pathway-related neuro-ophthalmology
Authors: zhang Wei , sun xin-quan , peng xiao-yan 
Published: August 2019

Abstract
Objective This study aimed to explore the positioning value of objective analysis of macular ganglion cell complex (mGCC) in optic pathway-related neuro-ophthalmology diseases. Methods In this retrospective case study, a total of 32 patients with optic pathway-related neuro-ophthalmology diseases were enrolled. A swept-source optical coherence tomography (SS-OCT) was used to scan and analyze the morphological characteristics of the mGCC thickness and the peripapillary retinal nerve fiber layer (pRNFL) thickness in these patients, which were compared with the vision changes at the corresponding phase to analyze their relationship. Results In optic pathway-related neuro-ophthalmologic diseases, the morphological characteristics of mGCC thickness demonstrated characteristic changes that are similar to that of vision, and mGCC analysis remained to be objective. Conclusion The application of SS-OCT to examine the morphological changes of mGCC thickness has the value of objective positioning analysis in the diagnosis and treatment of optic pathway-related neuro-ophthalmologic diseases.
An analysis of certain fields of interventional drug trials registered with Clinical Trials Registry – India
Authors: Pillamarapu Mounika , Mohan Abhilash , Saberwal Gayatri 
Published: August 2019

Abstract
Background There has been a significant increase in the number of trials registered with Clinical Trials Registry – India (CTRI) recently. We therefore wished to understand the current landscape of interventional, drug trials that have run in India. Methods We downloaded all trial records on 4 April 2018, and queried the data after it was formatted into an SQLite database. We distinguished trials hosted by India (India-only trials) and those co-hosted by India and other countries (India-etc trials). Results We analyzed eight fields of data, with the following key results: (a) Year of registration: The India-etc set suffered a serious dip in 2013. Both sets increased sharply in 2017. (b) Phase: Phase 3 trials were the most common in both sets of data, but were manifold more common in the India-etc set. 30% of the India-only trials had no phase information. (c) Trial sites: Four states each account for 50% or more of the sites in both sets of data. Also, 7–8 cities accounted for 50% or more sites in both sets. (d) Ethics committees: Over 70% of India-only trials had a single ethics committee, but the India-etc trials had a much greater spread. For each set, the maximum exceeded 60 committees per trial. (e) Principal Investigator (PI): 84% and 73% of PIs in the India-only and India-etc sets, respectively, had run a single trial each. One PI had run as many as 44 trials. (f) Primary sponsors: global pharma companies sponsored less than 5% of the India-only set but 92% of the India-etc set. (g) Fraction of subjects from India in India-etc trials: An abnormally large fraction of participants are not recruited from India. (h) Countries co-hosting the India-etc trials: The pattern was similar to that found for international trials co-hosted by Australia. Conclusions It is important to understand the landscape of trials being run in any country, to understand the recent past, in case of any red flags, and to serve as inputs to changes in policy. The data also serves as a baseline for the future, to ascertain the impacts of new policies, locally or globally.
Strategies used to implement Hospital at Home: a description of an approach to scaling a complex healthcare intervention
Authors: Zimbroff Robert M. , Siu Albert , DeCherrie Linda V. , Wajnberg Ania , Morano Barbara , Lubetsky Sara , Catalan Elisse , Leff Bruce 
Published: August 2019

Abstract
Background Advances have been made in recent years to characterize facilitators and barriers to implementation of complex health care intervention and to classify the implementation strategies available to address these determinants. We study the implementation of a Hospital at Home (HaH) intervention in a multi-hospital health system to understand the selection and use of implementation strategies in its launch, sustainment, and scaling. Methods We report on the implementation portion of an effectiveness-implementation study of the hybrid type 1 design. First, we retrospectively identified determinants of practice most relevant to the HaH intervention using of the Integrated Checklist of Determinants (TICD) assisted by review of archived documents. We also identified implementation strategies using the listing created by the Expert Recommendations for Implementing Change (ERIC) that could potentially address each determinant. Second, we then identified which of the ERIC strategies were actually employed using a modified Delphi process to obtain consensus among HaH program leaders involved in the program implementation. Program leaders also rated the importance and effort expended on each strategy on 1-9 Likert scales. The most relevant implementation strategies identified through these steps were detailed with respect to actors, targets, dosing and justification, and associated with prospectively collected implementation outcomes. Results The majority of ERIC implementation strategies (57 of 73, 78%) were utilized; 7 strategies (10%) were not used. On the remaining 9 strategies (12%), program leaders did not reach consensus regarding utilization. For used strategies, mean importance was 6.87 and mean effort expended was 6.22. Implementation strategies rated most important by program leaders had a broad target of actions that included clinical staff, patients, leadership, external vendors, health plans, and government officials. The strategies varied in temporality and dosing. Over the course of the implementation, adoption, acceptance, and penetration increased over time, while measures of fidelity remained stable. Conclusions Considerable effort and multiple strategies were required to implement Hospital at Home. While potentially daunting, use of existing implementation frameworks can help focus limited efforts and resources by targeting strategies that address the key barriers and enablers to implementation of complex healthcare interventions.
O nadziei
Authors: Delsol Chantal 
Published: August 2019

Mimo różnic w tłumaczeniu mitycznych początków świata, we wszystkich kulturach aż do judaizmu i chrześcijaństwa przyjmowano taką samą kolistą koncepcję czasu. Judaizm, a za nim chrześcijaństwo, zastępują ją wizją linearną. Przyszłość zatem nie jest jedynie powtórzeniem przeszłości, ale obietnicą spełnienia. Oświecenie, sekularyzując nadzieję na zbawienie, przemienia ją w wiarę w postęp, w spełnienie w ramach tego świata. Mesjanistyczne obietnice nie mogły jednak być spełnione w wymiarze doczesności, za sprawą zwykłej akumulacji wytwarzanych dóbr. Efektem tego podejścia jest zatem rozczarowanie i próba znalezienia pociechy w czerpaniu przyjemności z bieżącej chwili, uwalniającej człowieka od ryzyka i niepewności. Przeciwieństwem nadziei nie jest rozpacz, ale pewność. Prawdziwa nadzieja domaga się antropologii ryzyka i skończoności. Tylko „szalone nadzieje” (Kierkegaard) i przekonanie, że w sytuacji rozpaczy mogą nadejść nieoczekiwane odpowiedzi, nadają życiu smak przygody i poczucie szczęścia „pomimo wszystko”