bluuebunny/crossref_metadata_2025 huggingface dataset:
Deformations of reducible representations of knot groups into SL(n, C)
Authors: Heusener Michael , Medjerab Ouardia
Published: January 2017

Let
Multiple solutions of nonlinear fractional impulsive integro-differential equations with nonlinear boundary conditions
Authors: Wang Xuhuan , Lu Liang , Liang Jitai
Published: January 2017

In this paper, we study the existence of multiple solutions of fractional impulsive integrodifferential equations with nonlinear boundary conditions. By applying the Amann theorem and the method of upper and lower solutions, we obtain some new results on the multiple solutions.
Sharp inequalities for bounding Seiffert mean in terms of the arithmetic, centroidal, and contra-harmonic means
Authors: Jiang Wei-Dong , Cao Jian , Qi Feng
Published: January 2017

In the paper, the authors find two sharp and double inequalities for bounding the second Seiffert mean either by a one-parameter family of means derived from the centroidal mean or by a convex combination of the arithmetic and contra-harmonic means.
Fuzzy entropy of action of semi-groups
Authors: Rahimi Mehdi , Riazi Abdolhamid
Published: January 2017

In this paper, a type of fuzzy entropy of action of a semi-group on a metric space is introduced. Then we apply this concept to specific semi-groups to state this entropy in terms of the known entropies.
Bounded solutions of nonlinear discrete volterra equations
Authors: Migda Małgorzata , Migda Janusz
Published: January 2017

We give sufficient conditions, under which for every real constant, there exists a solution of the nonlinear discrete Volterra equation

convergent to this constant. We give also conditions under which all solutions are asymptotically constant. Sufficient conditions for the existence of asymptotically periodic solutions of the above equation are also derived.
Korovkin type theorem for linear k-positive operators in a polydisc of analytical functions
Authors: Gadjiev Akif D. , Aliev Rashid A.
Published: January 2017

In this work we obtained Korovkin type theorem for linear
On some basic properties of cones with proofs independent of Zorn’s Lemma
Authors: Zhang Guowei , Zhang Peng
Published: January 2017

Without the use of Zorn’s Lemma there are the proofs for such two basic properties of cones given in normed spaces that a regular minihedral cone is strongly minihedral and that an increasing self-mapping on order interval induced by regular cone has minimal and maximal fixed points which have been proved in some references by virtue of Zorn’s lemma. We also show that a strongly minihedral generating cone is minihedral. At last, two cones in continuous function space are discussed as examples.
Application of Perov’s fixed point theorem to Fredholm type integro-differential equations in two variables
Authors: Aghajani Asadollah , Pourhadi Ehsan , Rivero Margarita , Trujillo Juan J.
Published: January 2017

In this paper, we consider the concept of the so-called generalized metric space and give some results on the existence, uniqueness and estimation of the solutions of Fredholm type integrodifferential equations in two variables using Perov’s fixed point theorem. Furthermore, we give some illustrative examples to verify the effectiveness and applicability of our main result.
A Schur-type theorem for CR-integrable almost Kenmotsu manifolds
Authors: Wang Yaning , Liu Ximin
Published: January 2017

In this paper, we mainly investigate a necessary and sufficient condition for a
Monotonicity of error and Schur-convexity of a general two-point quadrature formula
Authors: Franjić Iva
Published: January 2017

In this work, the behaviour of the error of a general two-point quadrature formula is studied. It is established that the error in question has a monotonicity property and that this is equivalent to the fact that the function defined as the difference of the average value of the integral and the quadrature — that is, the error — is Schur-convex.
Stolarsky’s inequality for Choquet-like expectation
Authors: Agahi Hamzeh , Mesiar Radko
Published: January 2017

Expectation is the fundamental concept in statistics and probability. As two generalizations of expectation, Choquet and Choquet-like expectations are commonly used tools in generalized probability theory. This paper considers the Stolarsky inequality for two classes of Choquet-like integrals. The first class generalizes the Choquet expectation and the second class is an extension of the Sugeno integral. Moreover, a new Minkowski’s inequality without the comonotonicity condition for two classes of Choquet-like integrals is introduced. Our results significantly generalize the previous results in this field. Some examples are given to illustrate the results.
The existence of solutions to a class of boundary blow-up elliptic problems
Authors: Mi Ling , Ding Haiyan
Published: January 2017

In this paper, we study the existence of solutions to boundary blow-up elliptic problems
Preserving an obscure bird: achievements and future challenges of Corncrake (Crex crex Linnaeus, 1758) conservation in Hungary
Authors: Szentirmai István , Boldogh Sándor András , Nagy Károly , Habarics Béla , Szép Tibor
Published: January 2017

The Corncrake is a strictly protected species in Hungary and a qualifying species of many Natura 2000 sites. Despite its Least concern global conservation status, it receives much attention and was elected as “Bird of the Year” by MME BirdLife Hungary in 2016. In this paper, we estimate its population trends and analyse the suitability of the protected area system and agri-environment schemes for the species. We compiled information on major threatening factors and conservation measures applied for the species. We reviewed international publications on the ecology and conservation management of the species to extract information for practical conservation. We estimated that 500–2000 pairs of Corncrakes breed in Hungary. Although their breeding sites are well covered by protected areas, Natura 2000 sites (42%) and High Nature Value Areas (67%), their population has declined by 55% over the last 20 years. We found that most of the major threatening factors are addressed by conservation management, and appropriate measures are applied in most cases. Recent research findings and recommendations by the BirdLife International Corncrake Conservation Team suggest that mowing of grasslands around nesting places should be delayed until 1–15 August either in the entire field or at least on 2 hectares around nests. Prescriptions of agri-environment schemes should also be adjusted to the above requirements and more farmers should be encouraged to enrol in Corncrake conservation programmes. We strongly suggest that more emphasis should be devoted to combat important threats for the most important breeding sites such as aridification and flooding.
Liability of physicans and dentists – key issues
Authors: Zalewski Michał , Fux-Zalewska Kamila
Published: January 2017

Physicians and dentists can be held liable for commissions and omissions relating to the exercise of medical activity. Medical liability involves the obligation to redress the damage (harm) which occurred as a result of acts or omissions committed in the course of medical activity. Whether liability will arise depends on the occurrence of damage which stands in an adequate causal relationship to the event provided for in applicable regulations. This event may be non-performance or improper performance of a contract for the provision of medical services (contractual liability) or unlawful and culpable conduct in the exercise of medical action taken toward the patient who is not bound to the doctor by a legal relationship (tort liability). When a physician or a dentist is assigned a liability, he/she is obliged to redress the pecuniary damage and compensate for the non-pecuniary injury (wrong) suffered by the injured party.
Economic aspect of treatment in geriatrics
Authors: Zarębska Aneta , Pencuła Marcin , Jabłoński Mirosław
Published: January 2017

Introduction.There are few publications related to the economic analysis of the cost of care and treatment of geriatric patients as compared with other fields of medicine. Aging of the population, especially in highly civilized countries is inevitable. Cost index is used in the literature to analyse the utility costs. They reflect the so-called cost-effectiveness of medical procedures with the estimated remaining number of years adjusted quality of life.

Aim.Economic evaluation of treatment in geriatrics. Rating demographic and economic situation in Poland on the basis of statistical data.

Material and methods.PubMed database was searched through and the base of Polish Central Statistical Office (CSO) was used. Qualified articles on the economic efficiency of the treatment of older people in terms of coexistence of multi morbidity were used for the analysis. Also, the existing legal acts and publications of the Polish National Health Fund, the reports from the Supreme Chamber of Control, data from the CSO, the Ministry of Health and Social Insurance Office were taken into account. Statistical analyses were performed basing on data from the CSO.

Conclusions.Multiple morbidities are usually correlated with a significant increase in the use of resources, as it “multiplies” the costs of health and social care. The incidence of comorbidities has increased due to the effectiveness of treatment of chronic diseases, such as cancer, together with the increasing age of the patients. So there is a need for a system of health and social care, which will take into account the economics, and which will evolve and follow the problems that emerge. First of all, the authors recognize the need to create a properly equipped hospital wards and geriatric clinic. It is also important to take into account the cost-incurrence of geriatric treatment so that the provider would have the ability to optimally treat patients comprehensively and not only their singular particular diseases.
Electrical conductivity of carbon nanotube/polypropylene composites prepared through microlayer extrusion technology
Authors: Li Changjin , Jiao Zhiwei , Xiong Liangzhao , Yang Weimin
Published: January 2017

The morphological distribution of carbon nanotubes (CNTs) in polymer matrix has a crucial impact on the performance of CNT-filled polymer composites. A novel microlayer extrusion technology used in the dispersion and orientation of CNTs was proposed, and polypropylene (PP)/multiwalled CNT (MWCNT) composites with different numbers of layers were prepared with it. The MWCNT dispersion was investigated by scanning electron microscopy and Raman mapping method, and the MWCNT orientation was quantified by Raman spectroscopy. The influences of the dispersion and orientation of MWCNTs on the electrical conductivity and crystallization behavior of the composites were investigated. The results showed that the anisotropic conducting properties of the multilayered composites varied distinguishably with the increase of layer numbers and rotation speed. Furthermore, the degree of crystallinity of PP increased when the layer number increased from 1 to 729. All of these results suggest that with the increase of the layer numbers and the rotation speed, the dispersion and orientation of MWCNTs in PP matrix improve greatly. Overall, we provide an efficient and practical approach to control the dispersion and orientation of CNT in polymer matrix, which has a promising application prospect in the field of plastic processing.
Butanol reforming: an overview on recent developments and future aspects
Authors: Kumar Brajesh , Kumar Shashi , Kumar Surendra
Published: January 2017

Recently, hydrogen is utilized by numerous chemical industries as an alternate over non-renewable fuels, and surely it will be considered as an important fuel in the near future. This paper reports a review of various reforming technologies for hydrogen production from butanol produced by fermentation of feedstocks like wheat, sugar beets, sugar cane, etc. with a number of aspects involving selection of an appropriate catalyst to suppress undesirable products as many reforming reactions are dependent on the catalyst properties to enhance the formation of significant fuels which may fulfill the future energy needs. An overview of butanol reforming processes with experimental and theoretical studies in order to grasp possibilities and restrictions of these processes is not comprehensively presented yet. In this paper, an assessment of published articles in brief related to essential parameters to carry out a pertinent research in the future is presented for the advancement of fuel processing technologies.
Activation-Dependent Rapid Postsynaptic Clustering of Glycine Receptors in Mature Spinal Cord Neurons
Authors: Nakahata Yoshihisa , Eto Kei , Murakoshi Hideji , Watanabe Miho , Kuriu Toshihiko , Hirata Hiromi , Moorhouse Andrew J. , Ishibashi Hitoshi , Nabekura Junichi
Published: January 2017

Inhibitory synapses are established during development but continue to be generated and modulated in strength in the mature nervous system. In the spinal cord and brainstem, presynaptically released inhibitory neurotransmitter dominantly switches from GABA to glycine during normal developmentin vivo. While presynaptic mechanisms of the shift of inhibitory neurotransmission are well investigated, the contribution of postsynaptic neurotransmitter receptors to this shift is not fully elucidated. Synaptic clustering of glycine receptors (GlyRs) is regulated by activation-dependent depolarization in early development. However, GlyR activation induces hyperpolarization after the first postnatal week, and little is known whether and how presynaptically released glycine regulates postsynaptic receptors in a depolarization-independent manner in mature developmental stage. Here we developed spinal cord neuronal culture of rodents using chronic strychnine application to investigate whether initial activation of GlyRs in mature stage could change postsynaptic localization of GlyRs. Immunocytochemical analyses demonstrate that chronic blockade of GlyR activation until mature developmental stage resulted in smaller clusters of postsynaptic GlyRs that could be enlarged upon receptor activation for 1 h in the mature stage. Furthermore, live cell-imaging techniques show that GlyR activation decreases its lateral diffusion at synapses, and this phenomenon is dependent on PKC, but neither Ca2+nor CaMKII activity. These results suggest that the GlyR activation can regulate receptor diffusion and cluster size at inhibitory synapses in mature stage, providing not only new insights into the postsynaptic mechanism of shifting inhibitory neurotransmission but also the inhibitory synaptic plasticity in mature nervous system.
Systematic Variation in Rhythm Production as Tempo Changes
Authors: Barton Scott , Getz Laura , Kubovy Michael
Published: January 2017

We investigated the effect of tempo on the production of the syncopated 3-2 son clave rhythm. We recorded eleven experienced percussionists performing the clave pattern at tempi ranging from 70 bpm to 210 bpm. As tempo increased, percussionists shortened the longest intervals and lengthened the shortest interval towards an intermediate interval that is located in the first and second positions in the pattern. This intermediate interval was stable across tempi. Contrary to prior studies, we found that the complexity of interval ratios had little effect on production accuracy or stability and the “short” interval in the pattern was not particularly stable. These results suggest that as tempo is varied, (1) experienced musicians systematically distort rhythmic intervals, (2) rhythmic configuration, and not just the complexity of interval ratios, affects the production of rhythmic intervals, and (3) the distinction between long and short intervals is context-dependent.
Generality of the Memory Advantage for Vocal Melodies
Authors: Weiss Michael W. , Schellenberg E. Glenn , Trehub Sandra E.
Published: January 2017

Children and adults, with or without music training, exhibit better memory for vocal melodies (without lyrics) than for instrumental melodies (Weiss, Schellenberg, Trehub, & Dawber, 2015; Weiss, Trehub, & Schellenberg, 2012; Weiss, Trehub, Schellenberg, & Habashi, 2016; Weiss, Vanzella, Schellenberg, & Trehub, 2015). In the present study, we compared adults’ memory for vocal and instrumental melodies, as before, but with two additional singers, one female (same pitch level as the original female) and one male (7 semitones lower). In an exposure phase, 90 participants (M = 4.1 years training, SD = 3.9) rated their liking of 24 melodies—6 each in voice, piano, banjo, and marimba. After a short break, they heard the same melodies plus 24 timbre-matched foils (6 per timbre) and rated their recognition of each melody. Recognition was better for vocal melodies than for melodies in every other timbre, replicating previous findings. Importantly, the memory advantage was comparable across voices, despite the fact that liking ratings for vocal melodies differed by singer. Our results provide support for the notion that the vocal advantage in memory for melodies is independent of the idiosyncrasies of specific singers or of vocal attractiveness, arising instead from enhanced processing of a biologically significant timbre.
Testosterone prevents protein loss via the hepatic urea cycle in human
Authors: Lam Teresa , Poljak Anne , McLean Mark , Bahl Neha , Ho Ken K Y , Birzniece Vita
Published: January 2017

Context

The urea cycle is a rate-limiting step for amino acid nitrogen elimination. The rate of urea synthesis is a true indicator of whole-body protein catabolism. Testosterone reduces protein and nitrogen loss. The effect of testosterone on hepatic urea synthesis in humans has not been studied.

Objective

To determine whether testosterone reduces hepatic urea production.

Design

An open-label study.

Patients and intervention

Eight hypogonadal men were studied at baseline, and after two weeks of transdermal testosterone replacement (Testogel, 100 mg/day).

Main outcomes measures

The rate of hepatic urea synthesis was measured by the urea turnover technique using stable isotope methodology, with15N2-urea as tracer. Whole-body leucine turnover was measured, from which leucine rate of appearance (LRa), an index of protein breakdown and leucine oxidation (Lox), a measure of irreversible protein loss, were calculated.

Results

Testosterone administration significantly reduced the rate of hepatic urea production (from 544.4 ± 71.8 to 431.7 ± 68.3 µmol/min;P < 0.01), which was paralleled by a significant reduction in serum urea concentration. Testosterone treatment significantly reduced net protein loss, as measured by percent Lox/LRa, by 19.3 ± 5.8% (P < 0.05). There was a positive association between Lox and hepatic urea production at baseline (r2 = 0.60,P < 0.05) and after testosterone administration (r2 = 0.59,P < 0.05).

Conclusion

Testosterone replacement reduces protein loss and hepatic urea synthesis. We conclude that testosterone regulates whole-body protein metabolism by suppressing the urea cycle.
Overactivation of hedgehog signaling in the developing Müllerian duct interferes with duct regression in males and causes subfertility
Authors: Migone Fernando F , Hung Pei-hsuan , Cowan Robert G , Selvaraj Vimal , Suarez Susan S , Quirk Susan M
Published: January 2017

The influence of the hedgehog signaling pathway on reproduction was studied in transgenic mice in which a dominant active allele of the hedgehog signal transducer, smoothened (Smo), was conditionally expressed in the developing Müllerian duct and gonads through recombination mediated by anti-Müllerian hormone receptor 2-cre (Amhr2cre). Previous studies showed that development of the oviduct and uterus are abnormal in femaleAmhr2cre/+SmoM2mice. In the current study, focusing on mutant males, litter size was reduced 53% in crosses with wild-type females. An extra band of undifferentiated tissue extended along each epididymis and vas deferens, a position suggesting derivation from Müllerian ducts that failed to regress fully. Hedgehog signaling was elevated in this tissue, based on mRNA levels of target genes.Amhr2mRNA was dramatically reduced in the uterus of mutant females and in the extra tissue in the tract of mutant males, suggesting that AMHR2 signaling was inadequate for complete Müllerian duct regression. Spermatogenesis and sperm motility were normal, but testis weight was reduced 37% and epididymal sperm number was reduced 36%. The number of sperm recovered from the uteri of wild-type females after mating with mutant males was reduced 78%. This suggested that sperm transport through the male tract was reduced, resulting in fewer sperm in the ejaculate. Consistent with this, mutant males had unusually tortuous vas deferentia with constrictions within the lumen. We concluded that persistence of a relatively undifferentiated remnant of Müllerian tissue is sufficient to cause subtle changes in the male reproductive tract that reduce fertility.
De NovoTranscriptome Characterization of a Sterilizing Trematode Parasite (Microphallussp.) from Two Species of New Zealand Snails
Authors: Bankers Laura , Neiman Maurine
Published: January 2017

Snail-borne trematodes represent a large, diverse, and evolutionarily, ecologically, and medically important group of parasites, often imposing strong selection on their hosts and causing host morbidity and mortality. Even so, there are very few genomic and transcriptomic resources available for this important animal group. We help to fill this gap by providing transcriptome resources from trematode metacercariae infecting two congeneric snail species, Potamopyrgus antipodarum and P. estuarinus. This genus of New Zealand snails has gained prominence in large part through the development of P. antipodarum and its sterilizing trematode parasite Microphallus livelyi into a textbook model for host–parasite coevolutionary interactions in nature. By contrast, the interactions between Microphallus trematodes and P. estuarinus, an estuary-inhabiting species closely related to the freshwater P. antipodarum, are relatively unstudied. Here, we provide the first annotated transcriptome assemblies from Microphallus isolated from P. antipodarum and P. estuarinus. We also use these transcriptomes to produce genomic resources that will be broadly useful to those interested in host–parasite coevolution, local adaption, and molecular evolution and phylogenetics of this and other snail–trematode systems. Analyses of the two Microphallus transcriptomes revealed that the two trematode types are more genetically differentiated from one another than are the M. livelyi infecting different populations of P. antipodarum, suggesting that the Microphallus infecting P. estuarinus represent a distinct lineage. We also provide a promising set of candidate genes likely involved in parasitic infection and response to salinity stress.
Regulators of Lysosome Function and Dynamics inCaenorhabditis elegans
Authors: Gee Kevin , Zamora Danniel , Horm Teresa , George Laeth , Upchurch Cameron , Randall Justin , Weaver Colby , Sanford Caitlin , Miller Austin , Hernandez Sebastian , Dang Hope , Fares Hanna
Published: January 2017

Lysosomes, the major membrane-bound degradative organelles, have a multitude of functions in eukaryotic cells. Lysosomes are the terminal compartments in the endocytic pathway, though they display highly dynamic behaviors, fusing with each other and with late endosomes in the endocytic pathway, and with the plasma membrane during regulated exocytosis and for wound repair. After fusing with late endosomes, lysosomes are reformed from the resulting hybrid organelles through a process that involves budding of a nascent lysosome, extension of the nascent lysosome from the hybrid organelle, while remaining connected by a membrane bridge, and scission of the membrane bridge to release the newly formed lysosome. The newly formed lysosomes undergo cycles of homotypic fusion and fission reactions to form mature lysosomes. In this study, we used a forward genetic screen in Caenorhabditis elegans to identify six regulators of lysosome biology. We show that these proteins function in different steps of lysosome biology, regulating lysosome formation, lysosome fusion, and lysosome degradation.
Conceptual Frameworks for Building Online Citizen Science Projects
Authors: Yadav Poonam , Darlington John
Published: January 2017

In recent years, citizen science has grown in popularity due to a number of reasons, including the emphasis on informal learning and creativity potential associated with these initiatives. Citizen science projects address research questions from various domains, ranging from Ecology to Astronomy.  Due to the advancement of communication technologies, which makes outreach and engagement of wider communities easier, scientists are keen to turn their own research into citizen science projects. However, the development, deployment and management of these projects remains challenging. One of the most important challenges is building the project itself. There is no single tool or framework, which guides the step-by-step development of the project, since every project has specific characteristics, such as geographical constraints or volunteers' mode of participation. Therefore, in this article, we present a series of conceptual frameworks for categorisation, decision and deployment, which guide a citizen science project creator in every step of creating a new project starting from the research question to project deployment.  The frameworks are designed with consideration to the properties of already existing citizen science projects and could be easily extended to include other dimensions, which are not currently perceived.
CCLTracker Framework: Monitoring user learning and activity in web based citizen science projects
Authors: Fernandez-Marquez Jose Luis , Charalampidis Ioannis , Abu-Amsha Oula , Grey Francois , Schneider Daniel K. , Segal Ben , Mohanty Sharada P.
Published: January 2017

Analytics tools have been widely used over the last years for the development of web-based application and services. Analytics data allows improving user interfaces through planning, executing, and evaluating actions intended to increase user engagement. Measuring and improving user engagement in citizen science projects is not different from other web applications such as on-line shopping, newspapers, or sites for recommending music or movies. However, citizen science projects also aim to produce learning outcomes on the participants. Current analytics tools do not present sufficient information regarding user behaviour with the application, thus making measuring engagement and learning outcomes difficult. This paper presents the CCLTracker analytics framework that is intended to overcome current limitations in analytics tools, by providing an API for monitoring user activities such as time spent watching a video, time to complete a task, or how far down a page is scrolled. CCLTracker has been integrated in 3 different citizen science projects which have proved its value for measuring user engagement and learning.
Accuracy of Echocardiography in Low Birth Weight Infants With Congenital Heart Disease
Authors: Dorfman Adam L. , Levine Jami C. , Colan Steven D. , Geva Tal
Published: January 2017

Objective. Echocardiography has been shown to be highly accurate in infants and children, but its accuracy has not been studied in detail in low birth weight (LBW) infants with structural congenital heart disease (CHD). This study was undertaken to examine the diagnostic accuracy of echocardiography in the evaluation of CHD in these infants.

Methods. All echocardiograms performed between 1995 and 2000 on infants who had structural CHD and weighed ≤2.5 kg were reviewed (n = 251). Infants who weighed >2.5 kg, matched for type of CHD, were control subjects (n = 319). The results of initial echocardiograms were compared for diagnostic accuracy with consensus diagnoses on the basis of all confirmatory data available. An observer who was blinded to patient group graded a sample of randomly selected echocardiograms (n = 100) for technical quality.

Results. There were 13 major diagnostic errors in the LBW infants (5.2%) and 6 in the control subjects (1.9%). There were 20 minor errors in the LBW group (8.0%) and 21 in the control subjects (6.6%). The technical quality scores of the 2 groups were not significantly different, but a higher proportion of the LBW studies were graded as “poor” or “borderline” quality, compared with the control subjects (40% vs 28%). The majority (54%) of major errors in the LBW infants could potentially be explained by alterations in blood flow secondary to pulmonary hypertension.

Conclusions. Although echocardiography is an accurate imaging modality in premature and LBW infants with structural CHD, the incidence of clinically important diagnostic errors is higher than in infants who weigh >2.5 kg. As surgical and transcatheter interventions are extended to this population, heightened awareness of clinicians to pitfalls of echocardiography in this group of patients is warranted.
Pediatric Residency Education: Is Sports Medicine Getting Its Fair Share?
Authors: Demorest Rebecca A. , Bernhardt David T. , Best Thomas M. , Landry Gregory L.
Published: January 2017

Introduction. Sports are the leading injury-related cause for pediatric primary care visits. Pediatric residency education guidelines suggest incorporating sports medicine (SM) education into curricula; however, research is lacking regarding effective teaching methods.

Objective. To assess reported US pediatric residency SM curricula, teaching methods, and resident evaluation of SM education.

Design/Methods. Chief residents (CRs) and third-year residents (PL3s) from 100 randomly selected US Accreditation Council for Graduate Medical Education–accredited residency programs, stratified by size and geographic location, received surveys regarding programs' SM curriculum and teaching methods and individuals' methods for learning SM.

Results. Response rates were 63% and 39% for CRs and PL3s, respectively. According to CRs, 34% of programs had no one in charge of their SM curriculum. Lecture (77%) was the primary method used for teaching SM. Hands-on teaching (37%) was used less frequently. CRs stated that 29% of programs did not include musculoskeletal examination teaching in their curriculums; 24% did not include formal teaching of concussion management, and 29% did not include reasons for medical disqualification. PL3s rated teaching of joint examinations and the preparticipation physical as the most poorly taught components of the physical examination. PL3s rated hands-on teaching and patient experience as the best methods for improving SM education. CRs reported that only 36% of programs have discussed incorporating more SM into their curriculum.

Conclusions. SM education is deficient in US pediatric residency programs. Standardized curricula should be developed with a focus on hands-on training as a means for teaching SM to pediatric residents.
Quality Early Education and Child Care From Birth to Kindergarten
Authors:   Committee on Early Childhood, Adoption, and Dependent Care
Published: January 2017

High-quality early education and child care for young children improves their health and promotes their development and learning. Early education includes all of a child’s experiences at home, in child care, and in other preschool settings. Pediatricians have a role in promoting access to quality early education and child care beginning at birth for all children. The American Academy of Pediatrics affords pediatricians the opportunity to promote the educational and socioemotional needs of young children with other advocacy groups.
Emergency Department Allies: A Web-Based Multihospital Pediatric Asthma Tracking System
Authors: Kelly Kevin J. , Walsh-Kelly Christine M. , Christenson Peter , Rogalinski Steven , Gorelick Marc H. , Barthell Edward N. , Grabowski Laura
Published: January 2017

OBJECTIVE. To describe the development of a Web-based multihospital pediatric asthma tracking system and present results from the initial 18-month implementation of patient tracking experience.

DESIGN. The Emergency Department (ED) Allies tracking system is a secure, password-protected data repository. Use-case methodology served as the foundation for technical development, testing, and implementation. Seventy-seven data elements addressing sociodemographics, wheezing history, quality of life, triggers, and ED managment were included for each subject visit.

SETTING. The ED Allies partners comprised 1 academic pediatric ED and 5 community EDs.

POPULATION. Subjects with a physician diagnosis of asthma who presented to the ED for acute respiratory complaints composed the asthma group; subjects lacking a physician diagnosis of asthma but presenting with wheezing composed the wheezing group.

RESULTS. The tracking-system development and implementation process included identification of data elements, system database and use case development, and delineation of screen features, system users, reporting functions, and help screens. For the asthma group, 2005 subjects with physician-diagnosed asthma were enrolled between July 15, 2002 and January 14, 2004. These subjects accounted for 2978 visits; 10.4% had ≥3 visits. Persistent asthma was noted in 68% of the subjects. During the same time period, 1297 wheezing subjects with a total of 1628 ED visits (wheezing group) were entered into the tracking system. After enrollment, 57% of the subjects with ≥1 subsequent ED visits received a physician diagnosis of asthma.

CONCLUSIONS. Our sophisticated tracking system facilitated data collection and identified key intervention opportunities for a diverse ED wheezing population. A significant asthma burden was identified with significant rates of hospitalization, acute care visits and persistent asthma in 68% of subjects. The surveillance component provided important insights into health care issues of both asthmatic subjects and wheezing subjects, many of whom subsequently were diagnosed with asthma.
Improving Pediatric Asthma Care Through Surveillance: The Illinois Emergency Department Asthma Collaborative
Authors: Lenhardt Richard O. , Catrambone Catherine D. , McDermott Michael F. , Walter James , Williams Seymour G. , Weiss Kevin B.
Published: January 2017

OBJECTIVES. To better understand and improve the care of asthma patients who require emergency department (ED) care, the Illinois Emergency Department Asthma Collaborative (IEDAC) was created to develop, test, and disseminate an ED-based surveillance system. This report describes the development and testing of the pediatric IEDAC surveillance instruments and demonstrates how these instruments can be used to describe the health status, healthcare delivery, and outcome of children using ED services.

METHODS. A convenience sample of 128 children presenting to 5 EDs in Illinois for asthma care was the study base. Data were collected on monthly samples of children aged 2 through 17 years who presented to these EDs from May to November 2003. Three instruments were used to collect data regarding the children’s pre-ED, ED, and post-ED experience.

RESULTS. At the ED visit, 73.4% of children met national guideline criteria for persistent-level asthma symptoms. Among this group, 53.2% were using inhaled corticosteroid (ICS) medications. At 1 month follow-up, 66.6% of the children met the criteria for persistent-level asthma symptoms, which was statistically unchanged from the ED visit. Among the latter group, 64.2% were using ICS medications, again statistically unchanged compared with the ED visit. At follow-up, 24.5% of children were reported to have returned to an ED or were subsequently hospitalized. The majority of children were noted at follow-up to have limitation of at least some activity.

CONCLUSIONS. Children who presented to IEDAC EDs were found to have a high level of asthma burden that continued at follow-up despite treatment. Moreover, a substantial proportion of children had returned to an ED or were subsequently hospitalized. Encouraging trends in medication use were observed, although suboptimal medication use was also observed.
California's Experience Implementing a Pilot Newborn Supplemental Screening Program Using Tandem Mass Spectrometry
Authors: Feuchtbaum Lisa , Lorey Fred , Faulkner Lisa , Sherwin John , Currier Robert , Bhandal Ajit , Cunningham George
Published: January 2017

OBJECTIVE. In response to a California legislative mandate, a pilot tandem mass spectrometry (MS/MS) screening program was undertaken by the Genetic Disease Branch of the California Department of Health Services between January 2002 and June 2003. This article outlines the Genetic Disease Branch approach to implementing the MS/MS pilot program and the program evaluation strategies used.

METHODS. Through the use of multiple data collection methods, we were able to describe hospital participation patterns, screening test uptake, screening test performance, follow-up services utilization, and provider and family satisfaction with the educational materials and follow-up services provided.

RESULTS. During the 18-month pilot program, just more than one half of California's 755698 newborns were offered MS/MS screening; among this group, 90% of parents chose to have their newborns screened. Fifty-one newborns were identified with MS/MS-detectable disorders, among 461 patients referred for follow-up testing (0.13% of the screened population). One disorder was diagnosed successfully for every 6939 newborns screened and for every 9 infants referred (excluding phenylketonuria). The overall California population prevalence of MS/MS-detectable disorders was 1 case per 6500 infants (excluding phenylketonuria). The positive predictive value for medium-chain acyl-CoA dehydrogenase deficiency was 86.7%, whereas the positive predictive value for short-chain acyl-CoA dehydrogenase deficiency was 21.6%. For a sample from Hawaii, 1 isovaleric aciduria case was detected among 6132 newborns.

CONCLUSIONS. Evaluation of the California MS/MS screening pilot program demonstrated that this technology was effective in identifying additional metabolic disorders. The positive predictive value of screening was particularly good for medium-chain acyl-CoA dehydrogenase deficiency. Overall, patient referral rates were very acceptable. The utility of the program was also demonstrated by positive reviews from patients and providers.
Children’s Hospital Characteristics and Readmission Metrics
Authors: Auger Katherine A. , Teufel Ronald J. , Harris J. Mitchell , Gay James C. , Del Beccaro Mark A. , Neuman Mark I. , Tejedor-Sojo Javier , Agrawal Rishi K. , Morse Rustin B. , Eghtesady Pirooz , Simon Harold K. , McClead Richard E. , Fieldston Evan S. , Shah Samir S.
Published: January 2017

BACKGROUND AND OBJECTIVE:

Like their adult counterparts, pediatric hospitals are increasingly at risk for financial penalties based on readmissions. Limited information is available on how the composition of a hospital’s patient population affects performance on this metric and hence affects reimbursement for hospitals providing pediatric care. We sought to determine whether applying different readmission metrics differentially affects hospital performance based on the characteristics of patients a hospital serves.

METHODS:

We performed a cross-sectional analysis of 64 children’s hospitals from the Children’s Hospital Association Case Mix Comparative Database 2012 and 2013. We calculated 30-day observed-to-expected readmission ratios by using both all-cause (AC) and Potentially Preventable Readmissions (PPR) metrics. We examined the association between observed-to-expected rates and hospital characteristics by using multivariable linear regression.

RESULTS:

We examined a total of 1 416 716 hospitalizations. The mean AC 30-day readmission rate was 11.3% (range 4.3%–19.6%); the mean PPR rate was 4.9% (range 2.9%–6.9%). The average 30-day AC observed-to-expected ratio was 0.96 (range 0.63–1.23), compared with 0.95 (range 0.65–1.23) for PPR; 59% of hospitals performed better than expected on both measures. Hospitals with higher volumes, lower percentages of infants, and higher percentage of patients with low income performed worse than expected on PPR.

CONCLUSIONS:

High-volume hospitals, those that serve fewer infants, and those with a high percentage of patients from low-income neighborhoods have higher than expected PPR rates and are at higher risk of reimbursement penalties.
Magyar Szívelégtelenség Regiszter 2015–2016. Kezdeti eredmények
Authors: Nyolczas Noémi , Heltai Krisztina , Borbély Attila , Habon Tamás , Járai Zoltán , Sziliczei Erzsébet , Stadler Péter , Faludi Réka , Herczeg Béla , Papp Előd , Lakatos Ferenc , Nagy Katalin , Katona András , Kovács Imre , Tomcsányi János , Nagy András , Sepp Róbert
Published: January 2017

Abstract:

Heart failure is associated with a poor prognosis despite significant advances in the pharmacological and device therapy and incurs very high cost because of frequent hospitalizations. Therefore, professional high-quality care is essential for both patients and the healthcare system. The best way to evaluate the quality of care for a particular disease is the use of disease-specific registries. Until now, there has not been a registry evaluating characteristics and management of heart failure patients in Hungary. For that reason, the Hungarian Society of Cardiology initiated the set-up of the Hungarian Heart Failure Registry. The Aim of this paper is to present the goals, methods and first year results of the Hungarian Heart Failure Registry. The goal of the Registry is to create a modern, web-based database that summarizes the data of large number of patients who are currently or were previously admitted to hospital or who are currently or were previously patients in an outpatient department due to severe heart failure (NYHA III–IV). Currently 17 cardiology departments participate in the development of the Registry. The planned number of patients is 2000. Initially follow-up was planned for one year (pilot study). After the evaluation of the relevant experiences of the pilot study, long-term follow-up is planned. The Registry collects information about the type of heart failure (heart failure with reduced – LVEF≤45% – vs. preserved – LVEF>45% – ejection fraction), etiology, co-morbidities, diagnostic methods, treatment as well as morbidity and mortality. After the first year, assessing the baseline parameters of 698 patients enrolled in the Registry we found that the majority of patients (87.8%) has heart failure with reduced ejection fraction and in 39.8% of the patients heart failure has an ischaemic origin. The most frequent co-morbidity was hypertension followed by diabetes, renal insufficiency and COPD. The patients were treated with ACE inhibitors or ARBs in 94.4%, with beta blockers in 95.9%, and mineralocorticoid receptor antagonists in 73.9%. The mean dose of neurohormonal antagonists was higher than half of the target dose defined by current guidelines. The use of cardiac resynchronisation therapy was 11.7% and implantable cardioverter defibrillator was 25.8%. The pharmacological and device therapy of patients who were enrolled in the Registry until now was fit the current guidelines’ recommendations. This, however, does not mean that the management of heart failure is without problems in our country but that high quality patient care is available with adequate heart failure treatment in cardiology departments dedicated to heart failure care. Orv. Hetil., 2017, 158(3), 94–100.
PENGGUNAAN ALAT TANGKAP SOLODOK DI WADUK JATILUHUR
Authors: Sukamto Sukamto , Taryana Nana
Published: January 2017

Abstrak bisa dilihat di Lampiran
TEKNIK PEMBUATAN PEREAKSI KIMIA UNTUK ANALISA BEBERAPA PARAMETER KIMIA AIR DI LAPANGAN
Authors: Mariyam Siti , Heryana Heryana , Sumedi Sumedi
Published: January 2017

Abstrak bisa dilihat di Lampiran
INKSTO TRANSPLANTATO PAŽEIDIMO BIOŽYMENYS
Authors: Mačionienė Ernesta , Miglinas Marius
Published: January 2017

Reikšminiai žodžiai: inksto transplantatas, biožymenys.
Pacientams po inksto transplantacijos stebėti ir atmetimui diagnozuoti taikoma inksto transplantato biopsija, tačiau tai invazinis
tyrimo metodas, esant indikacijoms, atliekamas atsižvelgiant į gana vėlyvus ir nespecifinius rodiklius – kreatinino
koncentraciją kraujo serume arba proteinuriją. Ieškoma naujų neinvazinių transplantato pažeidimo žymenų, kurie leidžia
anksčiau nustatyti transplantato pažeidimą ar diferencijuoti atmetimą nuo kitų transplantato funkcijos pablogėjimo priežasčių.
Vieni tokių perspektyvių žymenų – chemokinai 9 ir 10, įvairios mikro RNR molekulės (miRNR-10b, miRNR-10a ir
miRNR-210) bei ankstyvi, bet nespecifiniai žymenys – NGAL ir KIM-1. Tikimasi, kad šie biožymenys leis anksčiau diagnozuoti
transplantato pažeidimą ir skirti atitinkamą gydymą.
NAUJAGIMIŲ MAITINIMAS VILNIAUS MIESTO KLINIKINĖJE LIGONINĖJE: KELIAS PALANKIOS NAUJAGIMIAMS LIGONINĖS LINK
Authors: Drejerienė Violeta , Langienė Vita , Strucienė Jolanta
Published: January 2017

Reikšminiai žodžiai: naujagimis, žindymas, veiksniai, turintys įtakos žindymui, naujagimiui palanki ligoninė. Tyrimo tikslas. Įvertinti, kokia yra žindymo praktika Vilniaus miesto klinikinėje ligoninėje (VMKL), kokios dažniau pasitaikančios priežastys, kai reikalingas papildomas naujagimio maitinimas. Metodika. Atliktas prospektyvinis tyrimas, kurio metu vertinti veiksniai, turintys įtakos naujagimių maitinimui. Duomenys rinkti VMKL visų naujagimių, gimusių nuo 2015 m. rugsėjo iki 2016 m. rugpjūčio mėnesio įskaitytinai. Nagrinėjome, kokios priežastys dažniausiai nulėmė išnešiotų naujagimių mišrų maitinimą. Tyrime dalyvavo 2 893 naujagimiai. Duomenys apdoroti „Excel“, SPSS17 programomis. Rezultatai laikyti statistiškai reikšmingi, kai p < 0,05. Rezultatai. Nustatyta, kad statistiškai reikšmingai dažniau buvo žindyti naujagimiai, gimę 37–41 gestacijos savaitę nei 34–36 savaitę (p < 0,001). Tarp gimusių per cezario pjūvio operaciją, taip pat naujagimių, kuriems buvo diagnozuota hipotrofija, hipoglikemija, įgimta infekcija, kurie buvo gydyti intensyviosios terapijos skyriuje ar gimė iš daugiavaisio nėštumo, buvo reikšmingai didesnė dalis išimtinai nežindytų naujagimių (p < 0,001). Įgimta paratrofija nebuvo statistiškai reikšminga ir nenulėmė mažesnės žindymo sėkmės. Išvados. 90,1 proc. VMKL gimusių natūraliais takais naujagimių išvyksta į namus išimtinai žindomi. Statistiškai reikšmingai buvo mažiau išimtinai žindytų naujagimių tarp tų, kurie sirgo hipoglikemija, įgimta hipotrofija. Tokie veiksniai, kaip neišnešiotumas, daugiavaisis nėštumas ar cezario pjūvio operacija taip pat nulėmė dažniau pasirenkamą mišrų maitinimą.
INKSTO CISTA (BOSNIAK IV): KLINIKINIS ATVEJIS
Authors: Jaškevičius Arūnas , Štarolis Edmundas , Šilinis Darius , Grybas Aivaras
Published: January 2017

Reikšmingi žodžiai: inksto cista, inksto rezekcija, Bosniak klasifikacija, papilinė inksto ląstelių karcinoma. Tikslas. Pristatyti paciento atvejį, kai, įvertinus klinikinius simptomus, laboratorinių ir radiologinius tyrimų rezultatus, nustatyta inksto cista su malignizacijos požymiais (Bosniak IV), o vėliau histologiškai patvirtinta papilinės inksto ląstelių karcinomos, esančios cistos viduje, klinikinė diagnozė. Supažindinti su rizikos veiksniais, ligos eiga, diagnostikos ir gydymo taktika. Medžiaga ir metodai. Pristatomas klinikinis atvejis – 57 metų vyras be gretutinės patologijos hospitalizuotas į VšĮ Vilniaus miesto klinikinės ligoninės Urologijos skyrių dėl ženkliai padidėjusios pilvo apimties ir echoskopiškai pastebimo gigantiško darinio neskaidriu turiniu retroperitoniniame tarpe, besiliečiančio su kairiuoju inkstu. Rezultatai. Remiantis klinikiniais simptomais, laboratorinių ir instrumentinių tyrimų rezultatais nustatytas kairiojo inksto 24,5 x 17,3x 26,3 cm dydžio cistinis darinys neskaidriu turiniu su supiktybėjimo požymiais (Bosniak IV). Pacientui atlikta kairiojo inksto rezekcija. Histologiškai patvirtinta papiliarinės inksto ląstelių karcinomos diagnozė. Pooperacinė eiga sklandi. Išvados. Remiantis Bosniak klasifikacijos IV tipo cistos diagnoze, gydymas turi būti toks, kaip inksto karcinomos atveju – inksto rezekcija arba nefrektomija.