bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity of discharge ICD-10 codes in detecting the etiologies of endogenous Cushing’s syndrome
Authors: Zhou Jingya , Zhang Meng , Lu Lin , Guo Xiaopeng , Gao Lu , Yan Weigang , Pang Haiyu , Wang Yi , Xing Bing 
Published: July 2019

Objective
To investigate the validity of discharge ICD-10 codes in detecting the etiology of endogenous Cushing’s syndrome (CS) in hospitalized patients.

Methods
We evaluated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CS etiology-related ICD-10 codes or code combinations by comparing hospital discharge administrative data (DAD) with established diagnoses from medical records.

Results
Coding for patients with adrenocortical adenoma (ACA) and those with bilateral macronodular adrenal hyperplasia (BMAH) demonstrated disappointingly low sensitivity at 78.8% (95% CI: 70.1–85.6%) and 83.9% (95% CI: 65.5–93.9%), respectively. BMAH had the lowest PPV of 74.3% (95% CI: 56.4–86.9%). In confirmed ACA patients, the sensitivity for ACA code combinations was higher in patients initially admitted to the Department of Endocrinology before surgery than that in patients directly admitted to the Department of Urology (90.0 vs 73.1%, P = 0.033). The same phenomenon was observed in the PPV for the BMAH code (100.0 vs 60.9%, P = 0.012). Misinterpreted or confusing situations caused by coders (68.1%) and by the omission or denormalized documentation of symptomatic diagnosis by clinicians (26.1%) accounted for the main source of coding errors.

Conclusions
Hospital DAD is an effective data source for evaluating the etiology of CS but not ACA and BMAH. Improving surgeons’ documentation, especially in the delineation of symptomatic and locative diagnoses in discharge abstracts; department- or disease-specific training for coders and more multidisciplinary collaboration are ways to enhance the applicability of administrative data for CS etiologies.
Toward Value Based Health Care in pituitary surgery: application of a comprehensive outcome set in perioperative care
Authors: Lobatto Daniel J , Zamanipoor Najafabadi Amir H , de Vries Friso , Andela Cornelie D , van den Hout Wilbert B , Pereira Alberto M , Peul Wilco C , Vliet Vlieland Thea P M , van Furth Wouter R , Biermasz Nienke R 
Published: July 2019

Objective
Although widely advocated, applying Value Based Health Care (VBHC) in clinical practice is challenging. This study describes VBHC-based perioperative outcomes for patients with pituitary tumors up to 6 months postoperatively.

Methods
A total of 103 adult patients undergoing surgery were prospectively followed. Outcomes categorized according to the framework of VHBC included survival, degree of resection, endocrine remission, visual outcome (including self-perceived functioning), recovery of pituitary function, disease burden and health-related quality of life (HRQoL) at 6 months (Tier 1); time to recovery of disease burden, HRQoL, visual function (Tier 2); permanent hypopituitarism and accompanying hormone replacement (Tier 3). Generalized estimating equations (GEEs) analysis was performed to describe outcomes over time.

Results
Regarding Tier 1, there was no mortality, 72 patients (70%) had a complete resection, 31 of 45 patients (69%) with functioning tumors were in remission, 7 (12%, with preoperative deficits) had recovery of pituitary function and 45 of 47 (96%) had visual improvement. Disease burden and HRQoL improved in 36–45% at 6 months; however, there were significant differences between tumor types. Regarding Tier 2: disease burden, HRQoL and visual functioning improved within 6 weeks after surgery; however, recovery varied widely among tumor types (fastest in prolactinoma and non-functioning adenoma patients). Regarding Tier 3, 52 patients (50%) had persisting (tumor and treatment-induced) hypopituitarism.

Conclusions
Though challenging, outcomes of a surgical intervention for patients with pituitary tumors can be reflected through a VBHC-based comprehensive outcome set that can distinguish outcomes among different patient groups with respect to tumor type.
Tiempo de espera y calidad de atención en pacientes de odontoestomatología intervenidos en sala de operaciones
Authors: Gutierrez Alejandro , Mendoza Pedro 
Published: July 2019

Introducción. Los tiempos de espera para cirugía electiva son indicadores que legitiman socialmente los servicios sanitarios públicos, si su situación es la adecuada. Objetivo. Determinar la relación entre el tiempo de espera y la percepción de la calidad de atención, en pacientes de odontoestomatologia de un hospital de la seguridad social. Métodos. Los niveles de satisfacción e insatisfacción se determinaron por medio del instrumento SERVQUAL modificado. Los resultados se correlacionaron con el tiempo de espera superior a 180 días y con la afectación de la calidad de vida; además, se evaluaron los factores con mayor influencia sobre el grado de insatisfacción. Resultados. El grado de satisfacción fue del 44%. Los pacientes que esperaron más de 180 días presentaron 2,6 veces más posibilidad de insatisfacción, los pacientes afectados presentaron 3,4 veces más posibilidad de insatisfacción. Finalmente, los pacientes afectados presentaron 3,3 más posibilidad de insatisfacción, en relación con que esperaron más de 180 días, los cuales presentaron 2.5 más posibilidad de insatisfacción. Conclusión: Existe relación inversa entre el tiempo de espera y la percepción de la calidad de atención; además, el grado de insatisfacción está asociado, sobre todo, a la afectación de la calidad de vida más que al propio tiempo de espera.
Tipologi Sikap Masyarakat Timur terhadap Hegemoni Barat dalam Naskah Drama Abthal Al-Yarmuk: Analisis Oksidentalisme Hassan Hanafi
Authors: Reflinaldi Reflinaldi , Hadi Syofyan , Busyrowi Ahmad 
Published: July 2019

This research aims to observe the terrain of morpho-semantic meaning of the word auliya’ in the Qur'an; what words are included in the morpho-semantic field of the word auliya’, and how the features are useful. This study aims to gather words that are in the morpho-semantic field of the auliya’ word 'in the Qur'an, find their meaning features, common components of the meaning and components of differentiating meaning (diagnostic communication) so that the meaning can be obtained representative of the word auliya'. The study found 234 words incorporated into the auliya’ 'morpho-semantic field' in 69 forms, spread over 55 letters in 208 verses. All these words come from six basic forms which are classified into three classes of words. Firstly, the componential analysis reveals root meanings (general meaning components), i.e., assembling, reducing, governing (action), near / no distance, help, full of love, responsible, always supervising (characters) . Next, distinguishing components consist of the meaning of the basic form, namely, god, king / authority / master, religion, heritage, culture (perpetrator), time and institution (etc.). Lastly, the grammatical meaning, namely, Al-Syakhsh (pronoun), Al-'Adad (numeral) , Al-Ta'yin (definite) and Al-Nau '(gender), besides the meaning of' ‘time' specifically for the class of verb.
"Nativos digitais", "geração internet", "Homo zappiens", "ciborgue": juventude conectada às tecnologias digitais
Authors: Ferreira Aline Gonçalves , Sales Shirlei Rezende 
Published: July 2019

O objetivo deste artigo é analisar como é descrita a relação dos/as jovens com as tecnologias digitais e os principais conceitos utilizados para nomear esses/as jovens que vivem conectados/as ao ciberespaço. Utilizamos como metodologia de pesquisa a bibliográfica, analisando uma tese e 17 dissertações. O argumento desenvolvido é o de que os trabalhos pesquisados operam com diferentes conceitos e termos para nomear os/as jovens. Eles são de ordens distintas, mas possuem um ponto em comum: destacam a íntima relação que os/as jovens possuem com as tecnologias e com a cibercultura. "Geração internet", "Homo Zappiens","Ciborgue", são alguns dos conceitos utilizados para nomear a conexão entre os/as jovens e as tecnologias digitais. PALAVRAS-CHAVE: Juventude, tecnologias digitais, pesquisa bibliográfica.
Shallow Nonvolcanic Tremor Activity and Potential Repeating Earthquakes in the Chile Triple Junction: Seismic Evidence of the Subduction of the Active Nazca–Antarctic Spreading Center
Authors: Sáez Miguel , Ruiz Sergio , Ide Satoshi , Sugioka Hiroko 
Published: July 2019

ABSTRACT
In southern Chile, at ∼46.2°S and ∼75.2°W, the active spreading center between the Nazca and Antarctic plates is colliding with the South American plate, forming the Chile triple junction (CTJ). For 1 yr, from March 2009 to February 2010, five ocean‐bottom seismometers (OBSs) were deployed over the CTJ. We used a portion of the OBS data to study the seismic signatures of the subduction of the active Nazca–Antarctic spreading center. Using the envelope technique, we detected long episodes of shallow nonvolcanic tremor (NVT) activity. To improve the identified location of the NVT activity, we cross‐correlated the vertical and horizontal components of all located NVTs. In different months, we measured the local maximum of the lag‐time correlation near 2 s, which is associated with the lag between the S and P waves (S−Ptime). Furthermore, we observed that in the days with intense tremor activity, the maxima corresponding to S−Ptime emerged in windows without observable NVTs. We suggest that days with intense tremor activity correspond to an almost continuous slow slip, which may accelerate and decelerates nearly randomly, with spatial and temporal heterogeneity. In addition, we detected some potential repeating earthquakes with an S−Ptime near 2 s, as well as NVTs. The detected NVT activity and potential repeating earthquakes suggest the existence of a shallow region close to the CTJ that is able to generate brittle (earthquakes) and brittle–ductile (potential repeating earthquakes and NVTs) ruptures.
Even preoperative carbohydrate loading is too hard? Why RCT’s should not be considered the gold standard for nutrition research in acute hip fracture: results of a feasibility study
Authors: Barrimore Sally E. , Rapchuk Ivan L. , Pulle Ranjeev Chrysanth , Crawford Ross , Ferrier Rebecca , Crawford Scott , Bell Jack J. 
Published: July 2019

<p class="abstract"><strong>Background:</strong> Malnutrition is a high-risk co-morbidity in acute hip fracture patients. Pre-operative carbohydrate loading may improve nutritional status and therefore patient outcomes. The feasibility of nutrition focused randomised control trial designs in hip fracture is at best questionable. This study was designed to undertake efficacy testing of pre-operative carbohydrate loading and explore the broader feasibility of conducting randomised controlled trials in acute hip fracture.</p><p class="abstract"><strong>Methods:</strong> This two arm randomised controlled feasibility study recruited patients previously living in the community who had fractured their hip undergoing surgery at our institution. Patients in the intervention arm received a 400 mL (50g) carbohydrate load 2 hours prior to surgery. Information was collected regarding the fidelity of pre-operative carbohydrate provision and consumption as well as patient demographic and admission details.</p><p class="abstract"><strong>Results:</strong> Thirty-two patients consented to participate, 60% of the eligible patient cohort. Results demonstrated evenly matched intervention and control groups in terms of demographic details and pre-surgical morbidity and mortality risk. However, of the 17 patients allocated to the intervention arm less than half (41%) completed the carbohydrate loading intervention and even fewer 23.5% (n=4) completed all follow up due to a number of patient and system related factors.</p><p class="abstract"><strong>Conclusions: </strong>Evaluating the clinical effectiveness of providing pre-operative carbohydrate loading in hip fracture and the associated outcomes is not feasible using a randomised control trial methodology. It is recommended that researchers consider a ‘silver standard’ of research and practice such as pragmatic, registry-based cluster randomised trials to ensure feasibility, relevancy and applicability when evaluating nutritional interventions in this cohort.</p><p class="abstract"> </p>
Assessment of medication adherence, quality of life and risk factors among patients with tuberculosis in a South Indian tertiary care hospital: a cross-sectional study
Authors: Salma Shaik , Siddiqua Abdul Amreen , Keerthana R. S. S. Lakshmi , Suryadevara Meghana , Prabhakar Dhadala Victor , Pingili Ravindrababu 
Published: July 2019

<p class="abstract"><strong>Background:</strong> The main objective of the current study was to assess the level of medication adherence, quality of life, risk factors for better treatment outcomes and to improve patient quality of life by giving TB education.</p><p class="abstract"><strong>Methods:</strong> A prospective observational study was conducted on 278 patients (139 tubercular patients and 139 health volunteers). A data collection form of various socio-demographic factors, lifestyle factors, and co-morbid conditions for tuberculosis were collected. The quality of life (QOL) was assessed by interviewing the subjects using WHO-QOL BREF questionnaire. Morisky – 8 item medication Adherence Questionnaire was used for assessing adherence. </p><p class="abstract"><strong>Results:</strong> In a total of 139 TB patients, high adherence (60.06%), medium adherence (20.86%) and low adherence (10.07%) are reported. WHOQOL-BREF mean domain scores were physical health (54.10±12.33), psychological health (51.73±16.24), social health (62.04±15.35) and environmental health (57.14±16.90) respectively. In present study male (67.63%) are higher than females (32.37%). Risk factors observed in study were statistically significant and discussed in present study.</p><p class="abstract"><strong>Conclusions:</strong> This study showed that the MMAS-8 had good reliability and validity for measuring adherence levels in rural TB patients. There was a high level of adherence to anti-TB treatment was seen in study area. WHO-QOL BREF questionnaire had good reliability and validity for measuring quality of life and Improved quality of life observed in patients with high adherence to anti tubercular drugs. Risk factors such as age, education, locality, food habits, income, smoking and alcoholism are independently associated with Tuberculosis.</p>
Study of genital dermatoses in pregnant females attending a tertiary care hospital
Authors: Sivanu Seeniammal , Babu Maalik , Savadamoorthi Soundharyaa Moorthi 
Published: July 2019

<p class="abstract"><strong>Background:</strong> Sexually transmitted infections (STI) prevalence in pregnancy is high and causes severe risk of transmission to the newborn. Usually they are asymptomatic and underdiagnosed. Most common STI’s are VVC, HPV, genital herpes, HIV, etc.</p><p class="abstract"><strong>Methods:</strong> A hospital-based cross-sectional study was done for a period of one year (September 2017- August 2018) and 31 pregnant genital dermatoses were encountered.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 31, infective etiology was seen in 15 cases (48%), non-infective etiology was seen in 3 cases (10%) and no STI’s were seen in 13 patients (42%). Vulvovaginal candidiasis was most common among pregnant females in 9 patients (60%) followed by genital warts in 3 patients (20%) followed by molluscum contagiosum, herpes genitalis and oral candidiasis in one patient (7%) respectively among infective etiology. Non-infective causes include vulval lymphangiectasia, epidermoid cyst and vascular swelling in one patient respectively (33.3%).</p><p><strong>Conclusions:</strong> Screening of antenatal cases is more important to prevent complications. </p>
A comparative study on fourth generation ELISA and rapid assay for diagnosing HIV infection in the high risk group
Authors: Mathupal Sukanya , Rajendran Sathya Narayanan 
Published: July 2019

<p class="abstract"><strong>Background:</strong> Enzyme linked immunosorbent assay (ELISA) is a widely employed method for detecting HIV. Following its successful detection of HIV, the fourth generation ELISA was approved by FDA. The advantage of the FDA approved fourth generation ELISA is it detects p24 antigen, HIV 1&amp;2 antibodies simultaneously and that too 5-7 days prior to conventional tests so that it detects HIV seroconversion earlier reducing its further spread.</p><p class="abstract"><strong>Methods:</strong> The study was conducted in a tertiary level medical centre after obtaining ethical approval. 200 patients from high risk group and their contacts were selected after a thorough physical examination and tests were done using fourth generation ELISA and rapid assay and these results were compared.<strong></strong></p><p class="abstract"><strong>Results:</strong> As per our observations, the percentage of patients tested positive by fourth generation ELISA out of 200 subjects was 37% and negative was 63%. The detection rate of HIV positivity by rapid assay in high risk group was 11% and negative was 89%. The detection rate was also higher with fourth generation ELISA when various other parameters were compared.</p><p><strong>Conclusions:</strong> In this study, the percentage of HIV positivity detected by fourth generation ELISA was higher than that detected by rapid assay showing that fourth generation ELISA is a more sensitive test than rapid assay as well as a better diagnostic modality to opt for when coming to early detection in HIV. </p>
O Papel do Tutor-Professor na EaD em Nível Superior: Aspectos Históricos e o Reconhecimento Legal
Authors: Azevedo Érica de Melo 
Published: July 2019

A EaD vem crescendo em números, em todo o Brasil e no mundo, sendo um fator de impacto social, econômico e tecnológico. Por essa razão, é importante discutir e propor a padronização da Legislação da EaD nos estados brasileiros, de forma a sistematizar essa modalidade, consolidando-a e garantindo uma educação de qualidade em todos os níveis. O Decreto nº 9057/17 é um importante avanço em direção a este caminho, mas é necessário unificar os pareceres, resoluções e decretos, de forma a esclarecer o papel dos profissionais atuantes na modalidade e as diretrizes e critérios a serem seguidos para a garantia de uma educação superior de qualidade. Dentro do Sistema Universidade Aberta do Brasil, os tutores são profissionais que não possuem vínculo empregatício com as universidades e apresentam a remuneração mais baixa no sistema. A Lei Estadual nº 8030, no Rio de Janeiro, veda a utilização do termo tutor para profissionais que atuam no acompanhamento de disciplinas ofertadas na modalidade EaD. Essa lei, apesar de estar em vigor, ainda não foi aplicada de forma efetiva no estado. Como é possível avaliar, essa mudança na legislação acarretará aumento considerável dos custos e mudança significativa na organização e no papel do tutor nos cursos dessa modalidade.
Palavras-chave: Tutor. Legislação EaD. Decreto nº 9057/17. Plano Nacional de Educação.
Manejo de evisceración intestinal transvaginal secundaria a dehiscencia de la cúpula vaginal posterior a histerectomía: reporte de caso y revisión de la literatura
Authors: Rueda-Espinel Santiago , Cobos-Mantilla Facundo 
Published: July 2019

Objetivos: reportar un caso de evisceración intestinal transvaginal posterior a histerectomía abdominal total y realizar una revisión de la literatura sobre su diagnóstico y tratamiento.
Materiales y métodos: se presenta el caso de una paciente de 48 años que consulta a una institución de alta complejidad por evisceración intestinal transvaginal de 10 horas de evolución, se realiza laparotomía para reducción de la evisceración y reparación del defecto de cúpula vaginal. Se hace una búsqueda en Medline vía PubMed, Embase, Elsevier, Medigraphic, Wolters Kluwer Health y UpToDate con los términos: “dehiscencia de cúpula vaginal”, “evisceración intestinal transvaginal”, “dehiscencia posterior a histerectomía”, “complicaciones histerectomía”, y en bola de nieve a partir de los estudios identificados, en idiomas inglés y español.
Resultados: se incluyeron 14 estudios. El diagnóstico de la evisceración transvaginal es eminentemente clínico al observar salida de contenido abdominal por vagina, se puede asociar a signos de peritonitis u obstrucción intestinal. Su manejo inicial debe intentar el empaquetamiento vaginal y la profilaxis antibiótica. Se han descrito varias técnicas quirúrgicas para corregir el defecto de la cúpula vaginal y reforzar el cierre de la dehiscencia de la cúpula.
Conclusiones: la evisceración transvaginal se considera una urgencia quirúrgica. Se requieren más estudios que evalúen la seguridad y la efectividad de las diferentes intervenciones para el manejo.
PENERAPAN STRATEGI PEMBELAJARAN AKTIF TIPE CARD SORT UNTUK MENINGKATKAN HASIL BELAJAR KIMIA SISWA KELAS X
Authors: Astuti Resti 
Published: July 2019

Abstrak: Penelitian ini bertujuan untuk mengetahui peningkatan hasil belajar siswa pada mata pelajaran kimia dengan menerapkan strategi pembelajaran aktif tipe card sort di kelas X.F SMA Negeri 1 Indralaya. Materi Yang digunakan dalam Penelitian ini yaitu materi hidrokarbon. Metode yang digunakan dalam penelitian ini adalah Penelitian Tindakan Kelas, dilakukan dalam tiga siklus. Teknik pengumpulan data menggunakan lembar observasi dan tes akhir siklus. Hasil penelitian menunjukkan rata-rata nilai hasil belajar siswa sebelum dilakukan tindakan (T0) yaitu 62,3 dengan ketuntasan klasikal 33,33%, siklus I (T1) yaitu 64,46 dengan ketuntasan klasikal 57,14%, siklus II (T2) yaitu 73,83 dengan ketuntasan klasikal 73,33% dan pada siklus III (T3) yaitu 79,82% dengan ketuntasan klasikal 85,71%. Hasil penelitian menunjukkan bahwa penerapan strategi pembelajaran aktif tipe card sort dapat meningkatkan hasil belajar kimia siswa. Peneliti memberikan saran kepada guru, sekolah, dan peneliti lain dapat menerapkan strategi pembelajaran aktif tipe card sort dikelas sebagai salah satu alternatif untuk meningkatkan hasil belajar siswa.
Kata kunci : hasil belajar, card sort, penelitian tindakan kelas
PENERAPAN MODEL PEMBELAJARAN BERPUSAT SISWA DALAM MENGEMBANGKAN KETERAMPILAN PROSES SAINS DAN PEMECAHAN MASALAH SISWA
Authors: Ningrum Wiwid Pungki 
Published: July 2019

Penelitian ini bertujuan untuk mengungkapkan perbedaan keterampilan proses sains (KPS) dan pemecahan masalah (PM) siswa yang belajar dengan model pembelajaran berpusat siswa (MPBS) dengan siswa yang belajar dengan direct instruction (DI). MPBS diterapkan pada materi asam-basa di kelas XI SMA. Aspek KPS yang diukur ialah observasi, inferensi, merancang percobaan, mengukur, mengkontruksi tabel, dan komunikasi. PM diukur dengan tes yang mengukur proses kognitif C2, C3 dan C4 dengan dimensi pengetahuan faktual, konseptual dan prosedural. Desain penelitian yang diterapkan ialah post-test control group. Sampel pada kelas kontrol dan kelas eksperimen sebanyak 27 siswa. Kedua data dianalisis dengan MANOVA. Test of between-subjects effects dilakukan pada data PM, sedangkan uji U-Mann Whitney dilaksanakan pada variabel KPS sebab data tidak normal. Hasil menunjukkan pada taraf signifikansi 0,05 tidak terdapat perbedaan yang signifikan pada KPS dan PM siswa pada kedua kelas, namun ada effect size sebesar 0,071. Hasil uji U-Mann Whitney menunjukkan terdapat perbedaan signifikan pada KPS siswa di kedua kelas terutama pada aspek merancang percobaan dan observasi. Test of between-subject effects menunjukkan terdapat perbedaan signifikan pada PM siswa pada kedua kelas, dengan effect size sebesar 5,7%. Perbedaan PM paling signifikan terdapat pada sub-materi pH asam kuat dan pH basa lemah.
Kata kunci : model pembelajaran berpusat siswa, keterampilan proses sains, PM