Grammatical Relations and Grammatical Categories in Malay; the Indonesian Prefix MeN- Revisited

The lexical roots of Malay are flexible with regard to their grammatical categories, which presents a problem in providing grammatical evidence for their category determination. This paper attempts to propose the use of affixes as one way to deal with the issue. Data from Indonesian and Ambon (Malay) language are among others given for clarification. The grammatical evidence from Indonesian active meN-, together with other affixes, are revisited as they can contribute to our understanding of the matter

Radial basis function network learns ceramic processing and predicts related strength and density

Radial basis function (RBF) neural networks were trained using the data from 273 Si3N4 modulus of rupture (MOR) bars which were tested at room temperature and 135 MOR bars which were tested at 1370 C. Milling time, sintering time, and sintering gas pressure were the processing parameters used as the input features. Flexural strength and density were the outputs by which the RBF networks were assessed. The 'nodes-at-data-points' method was used to set the hidden layer centers and output layer training used the gradient descent method. The RBF network predicted strength with an average error of less than 12 percent and density with an average error of less than 2 percent. Further, the RBF network demonstrated a potential for optimizing and accelerating the development and processing of ceramic materials

A grammar of Mualang : an Ibanic language of Western Kalimantan, Indonesia

This dissertation deals with Mualang, an Ibanic (Malayic-Dayak) language spoken in the interior of western Kalimantan (Borneo), Indonesia. Given the relatively large number of speakers (approximately 40,000 people), and due to its fairly isolated geography and some well-maintained socio-cultural traditions, the study of the language considerably broadens our knowledge of the Ibanic language family and the Malayic language group in general. Western Borneo has been posited as a possible homeland-candidate of Proto Malayic speakers. Therefore, linguistic contributions about inland languages in areas such as that of the Mualang language and people will provide Austronesian linguists with more information regarding this issue. This study presents a descriptive account of the grammar of Mualang covering the major features of its sound system, word and sentence structure as well as text grammar topics. The description results from a combination of textual analysis, elicitation and participant observation. The grammar is supplemented by wordlists and an extensive collection of glossed and translated texts.LEI Universiteit LeidenAsian Studie

A fatigue damage estimator using RBF, backpropagation, and CID4 neural algorithms

Fatigue damage estimation using neural networks is described in the paper. Attention is focused on the method of data generation for both the training and test data used by radial basis function (RBF), backpropagation, and CID4 algorithms used in this study. The performance results of the three neural algorithms are analyzed in terms of their strengths and weaknesses in training

Quaternary Reef Record of Differential Uplift at Luwuk, Sulawesi East Arm, Indonesia.

The coastal morphology of Luwuk (Sulawesi) is dominated by raised coral reef terraces, reaching elevations of over 400 m. A lower group of 6 to 10 terraces reach maximum heights varying between 30 and 100 m. A middle group, elevated up to 250 m, forms an 18° to 22° seaward sloping surface that is bordered by coast-parallel faults. The upper group of terraces is more than 400 m above sea level. Four reef terraces at 410, 62, 19 and 6.6 m above high tide have U/Th ages ranging from 350 ka to 67 ka and, except for the oldest terrace, can be correlated with several stages of interglacial reef growth at Huon Peninsula, New Guinea. Using the sea level curve established for the Huon reefs, uplift rates for the Luwuk area can be calculated. The highest terrace has risen at an average rate of 184 cm·ka-1. The 3 dated terraces of the lower group also indicate net uplift, but at a much lower rate, which is partially due to subsidence at 53 cm·ka-1 between 101 ka and 67 ka. Intermittent subsidence could be due to isostatic compensation and/or drag by the downthrown parts during periods of crustal relaxation in the fault zone

Statin Discontinuation among Nursing Home Residents with Advanced Dementia

Background: Statin use in elderly individuals with life-limiting illness such as advanced dementia is controversial. Objective: To describe factors associated with statin discontinuation and estimate impact of discontinuation on 28-day hospitalizations in nursing home (NH) residents with advanced dementia. Methods: Retrospective cohort study of NH residents ≥ 65 years with recent progression to advanced dementia from 5 large U.S. states drawn from the 2007-2008 Minimum Data Set 2.0. We identified residents using statins. Clinical characteristics and 28-day hospitalization risk were compared for residents discontinuing and continuing statins. Multivariable Cox proportional hazard models identified factors associated with time to statin discontinuation and time to hospitalization. Sensitivity analysis using self-controlled case series examined the role of confounding-by-indication on risk estimation from the cohort approach. Results: Of 10,212 residents with decline to advanced dementia, 16.6% were prescribed statins (n=1,699). Statin users had mean age of 83.1 yrs, 68.9% were female, and mean medication burden was 10.3 (SD 4.8, range 1-31). Over one-third (n=632) discontinued in follow-up. Median time to discontinuation was 36 days after decline to advanced dementia (IQR [25%, 75%]: 12 days, 110 days). After adjustment, factors independently associated with increased hazard of discontinuation included residence in a NH in Florida relative to California, hospitalization in the 30 days prior to decline to advanced dementia, greater medication burden, and having cancer. The 28-day hospitalization risk was higher for residents discontinuing statins compared to continuing (adjusted hazard ratio = 1.78, CI 1.61,2.58). The SCCS estimate for 28-day hospitalization risk following statin discontinuation compared to a 28-day pre-discontinuation control period was lower than the cohort estimate (IRR= 0.79, CI 0.76, 0.83). Conclusion: A significant proportion of nursing home residents with dementia who use statins when they progress to advanced stage disease discontinue use. Hospitalization outcomes following discontinuation differ depending on method of estimation

Factors Associated With Ordering Laboratory Monitoring Of High-Risk Medications

Background Knowledge about factors associated with provider ordering of appropriate testing is limited. Objective To determine physician factors correlated with ordering of recommended laboratory monitoring tests for high-risk medications, accounting for patient characteristics. Methods Analysis of the administrative claims and electronic medical records of patients prescribed a high-risk medication requiring laboratory monitoring in a large multispecialty group practice between January 1, 2008 and December 31, 2008. The outcome is a physician order for each recommended laboratory test for each prescribed medication. Key predictor variables include physician characteristics, including age, gender, specialty training, years since completing training, and prescribing volume. We used multivariable logistic regression to identify the independent association of physician and patient characteristics with ordering of laboratory tests to monitor medications after adjustment for potential confounders, taking into account clustering of drugs within patients and patients within providers. Results Physician orders for laboratory testing varied across drug-test pairs and ranged from 9% (Primidone–Phenobarbital level) to 97% (Azathioprine–CBC) with 50% of drug-test pairs in the 85-91% ordered range. Failure to order a test was associated with lower provider prescribing volume for study drugs and whether the physician was a specialist (primary care providers were more likely to order tests than specialists). Patients with lower patient comorbidity burden and younger patients were less likely to have appropriate tests ordered. Drug-test combinations with black box warnings were more likely to have tests ordered. Conclusions Interventions targeting providers should be addressed at those subgroups with the greatest potential for improvement: providers with lower frequencies of prescribing high-risk medications, and healthier and younger patients. Drug-test combinations with black box warnings have higher ordering rates, but many medications without such warnings also have evidence of harm, thus efforts to improve testing are necessary for all medications shown to be high-risk

Patient Adherence to Laboratory Tests to Monitor Medication Therapy: A Mixed-Methods Study

Background Little is known about the contribution of patient behavior to incomplete laboratory monitoring and the reasons for patient non-completion of ordered laboratory tests remain unclear. Objective To describe factors, including patient-reported reasons, associated with non-completion of ordered laboratory tests. Design Mixed-methods study including a quantitative assessment of the frequency of patient adherence to ordered monitoring tests combined with qualitative, semi-structured, patient interviews. Participants Quantitative assessment included patients 18 years or older from a large multispecialty group practice prescribed a medication requiring monitoring. Qualitative interviews included a subset of adherent and non-adherent patients prescribed a cardiovascular, anti-convulsant, or thyroid replacement medication. Main Measures Proportion of recommended monitoring tests for each medication not completed, factors associated with patient non-adherence, and patient-reported reasons for non-adherence. Results Of 27,802 patients who were prescribed one of 34 medications, patient non-completion of ordered tests varied (range: 0% to 29%, by drug-test pair). Factors associated with higher odds of test non-completion included younger patient age (\u3c 40 years vs. ≥80 years, adjusted odds ratio [AOR] 1.52, 95% confidence interval [95% CI] 1.27-1.83), lower medication burden (1 medication vs. more than 1 drug, AOR for non-completion 1.26, 95% CI 1.15-1.37), and lower visit frequency (0-5 visits/year vs. ≥19 visits/year, AOR 1.41, 95% CI 1.25 to 1.59). Drug-test pairs with black box warning status were associated with greater odds of non-completion compared to drugs included only in the PDR (AOR 1.91, 95% CI 1.66-2.19). Qualitative interviews, with 16 non-adherent and 7 adherent patients, identified forgetting as the main cause of non-adherence. Conclusions Patient non-adherence contributed to missed opportunities to monitor medications and was associated with younger patient age and lower medication burden and black box warning status. Interventions to improve laboratory monitoring should target patients as well as physicians

Technological Resources and Personnel Costs Required to Implement an Automated Alert System for Primary Care Physicians When Patients Transition from Hospitals to Home

Background With the adoption of electronic medical records by medical group practices, there are opportunities to improve the quality of care for patients discharged from hospitals. However, there is little guidance for medical groups outside of integrated hospital systems to automate the flow of patient information during transitions in care. Objective To describe the technological resources, expertise and time needed to develop an automated system providing information to primary care physicians when their patients transition from hospitals to home. Development Within a medical group practice, we developed an automated alert system that provides notification of discharges, reminders of the need for follow-up visits, drugs added during in-patient stays, and recommendations for laboratory monitoring of high risk drugs. We tracked components of the information system required and the time spent by team members. We used US national averages of hourly wages to estimate personnel costs. Application Critical components of the information system are notifications of hospital discharges through an admission, discharge and transfer registration (ADT) interface, linkage to the practice’s scheduling system, access to information on pharmacy dispensing and lab tests, and an interface engine. Total personnel cost was $76,314. Nearly half (47%) was for 614 hours by physicians who developed content, provided overall project management, and reviewed alerts to ensure that only “actionable” alerts would be sent. Conclusion Implementing a system to provide information about patient transitions requires strong internal informatics expertise, cooperation between facilities and ambulatory providers, development of electronic linkages, and extensive commitment of physician time