bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating Emotional and Biological Sensitivity to Maternal Behavior Among Self-Injuring and Depressed Adolescent Girls Using Nonlinear Dynamics
Authors: Crowell Sheila E. , Butner Jonathan E. , Wiltshire Travis J. , Munion Ascher K. , Yaptangco Mona , Beauchaine Theodore P.
Published: March 2017

High sensitivity and reactivity to behaviors of family members characterize several forms of psychopathology, including self-inflicted injury (SII). We examined mother-daughter behavioral and psychophysiological reactivity during a conflict discussion using nonlinear dynamics to assess asymmetrical associations within time-series data. Depressed, SII, and control adolescents and their mothers participated ( N = 76 dyads). We expected that (a) mothers’ evocative behaviors would affect behavioral and psychophysiological reactivity among depressed and, especially, SII adolescents, (b) adolescents’ behaviors would not evoke mothers’ behavioral or physiological reactivity, and (c) control teens and mothers would be less reactive, with no dynamic associations in either direction. Convergent cross-mapping with dewdrop regression, which identifies directional associations, indicated that mothers’ behaviors evoked behavioral responses among depressed and SII participants, but evoked psychophysiological reactivity for SII teens only. There were no effects of adolescents’ behavior on mothers’ reactivity. Results are interpreted based on sensitivity theories and directions for further research are outlined.
Is Home-Based, High-Intensity Interval Training Cycling Feasible and Safe for Patients With Knee Osteoarthritis?
Authors: Keogh Justin W. L. , Grigg Josephine , Vertullo Christopher J.
Published: March 2017

Background:

Osteoarthritis (OA) is a degenerative joint disease affecting the knee joint of many middle-aged and older adults. As OA symptoms typically involve knee pain and stiffness, individuals with knee OA are often insufficiently physically active, have low levels of physical function, and are at increased risk of other comorbidities and reduced quality of life. While moderate-intensity continuous training (MICT) cycling is often recommended, little is known about the feasibility, safety, and benefits of high-intensity interval training (HIIT) cycling for this population, even though the feasibility, safety, and benefits of HIIT have been demonstrated in other chronic disease groups.

Purpose:

The primary objective of this pilot study was to examine the feasibility and safety of home-based HIIT and MICT cycling in middle-aged and older adults with knee OA. A secondary objective was to gain some insight into the relative efficacy of HIIT and MICT for improving health status (pain, stiffness, and disability), muscle function, and body composition in this population. This study protocol is being published separately to allow a detailed description of the research methods, explain the rationale for choosing the methodological details, and to stimulate consideration of the best means to simulate a research protocol that is relevant to a real-life treatment environment.

Study Design:

Randomized pilot study protocol.

Methods:

This trial sought to recruit 40 middle-aged and older adults with knee OA. Participants were randomly allocated to either continuous (MICT) or HIIT home-based cycle training programs, with both programs requiring the performance of 4 cycling sessions (approximately 25 minutes per session) each week. Participants were measured at baseline and postintervention (8 weeks). Feasibility and safety were assessed by adherence rate, dropout rate, and number of adverse events. The relative efficacy of the cycling programs was investigated by 2 knee OA health status questionnaires (Western Ontario and McMaster Universities Osteoarthritis Index scale[WOMAC] and the Lequesne Index) as well as the timed up and go, sit to stand, preferred gait speed, and body composition.

Discussion:

This pilot study appears to be the first study assessing the feasibility and safety of a home-based HIIT training program for middle-aged and older adults with knee OA. As HIIT has been demonstrated to be more effective than MICT for improving aspects of health status, body composition, and/or muscular function in other chronic disease groups, the current study has the potential to improve patient outcomes and inform the design of future randomized controlled trials.
Spatially continuous probabilistic prediction of sparsely measured ground properties constrained by ill-posed tomographic imaging considering data uncertainty and resolution
Authors: Asadi Abduljabbar , Dietrich Peter , Paasche Hendrik
Published: March 2017

Probabilistic prediction of 2D or 3D distributions of sparsely measured borehole or direct-push logging data can contribute to solving hydrological, petroleum, or engineering exploration tasks. We use and improve a recently developed workflow constrained by ill-posed geophysical tomography to achieve 2D probabilistic predictions of geotechnical exploration target parameters that could only be measured by 1D borehole or direct-push logging. We use artificial neural networks (ANNs) to find the optimal prediction models between ensembles of equivalent geophysical tomograms and sparsely measured logging data. During the training phase of ANNs, we consider four different training strategies taking into account the logging data uncertainty and geophysical tomographic ambiguity to avoid data overfitting of the ANNs. Thus, we successfully transform the logging data uncertainty and geophysical tomographic reconstruction ambiguity as well as differences in spatial resolution of logging and tomographic models into the probabilistic 2D prediction of our target parameters in a data-driven manner, which allows application of our methodology to any combination of geophysical tomograms and hydrologic, petroleum, or engineering target parameters solely measured in boreholes. To illustrate our workflow, we use an available field data set collected at a field site south of Berlin, Germany, to characterize near-subsurface sedimentary deposits. In this example, we employ cross-borehole tomographic radar-wave velocity, P-wave velocity, and S-wave velocity models to constrain the prediction of tip resistance, sleeve friction, and dielectric permittivity as target parameters.
Preconditioning point-source/point-receiver high-density 3D seismic data for lacustrine shale characterization in a loess mountain area
Authors: Wang Wei , Wang Xiangzeng , Zeng Hongliu , Liang Quansheng
Published: March 2017

In the study area, southeast of Ordos Basin in China, thick lacustrine shale/mudstone strata have been developed in the Triassic Yanchang Formation. Aiming to study these source/reservoir rocks, a 3D full-azimuth, high-density seismic survey was acquired. However, the surface in this region is covered by a thick loess layer, leading to seismic challenges such as complicated interferences and serious absorption of high frequencies. Despite a specially targeted seismic processing workflow, the prestack Kirchhoff time-migrated seismic data were still contaminated by severe noise, hindering seismic inversion and geologic interpretation. By taking account of the particular data quality and noise characteristics, we have developed a cascade workflow including three major methods to condition the poststack 3D seismic data. First, we removed the sticky coherent noise by a local pseudo [Formula: see text]-[Formula: see text]-[Formula: see text] Cadzow filtering. Then, we diminished the random noise by a structure-oriented filtering. Finally, we extended the frequency bandwidth with a spectral-balancing method based on the continuous wavelet transform. The data quality was improved after each of these steps through the proposed workflow. Compared with the original data, the conditioned final data show improved interpretability of the shale targets through geometric attribute analysis and depositional interpretation.
Rescued Children and Unfit Mothers: Dreiser’s Social Work in the Delineator’s Child-Rescue Campaign
Authors: Hainze Emily
Published: March 2017

This essay explores the 1907–11 Child-Rescue Campaign run by the Delineator, a fashion magazine for women edited by Theodore Dreiser. I argue that the campaign mobilized social science to reconceptualize maternity as based in affective expertise rather than biological reproduction. Readers were able to write in to the magazine to adopt “dependent” children whose images and stories were featured in each issue. The essay suggests that these serialized images and “tragic histories” constructed a form of realism in which the Delineator’s readers were invited to act as maternal experts, saving “future citizens” by rescuing them “out of a life of crime” and into white, middle-class domesticity, at the same time articulating the child’s biological mother as criminal and nonwhite.
“I’m Very Happy to Be in the Reality-Based Community”: Alison Bechdel’sFun Home, Digital Photography, and George W. Bush
Authors: Bernstein Robin
Published: March 2017

This essay historicizes Alison Bechdel’s 2006 graphic memoir Fun Home in the context of the presidency of George W. Bush. Bechdel created Fun Home from 1999 through 2005—dates that corresponded with Bush’s campaign, election, and presidency. As Bechdel frequently laments in her serialized comic strip Dykes to Watch Out For, the Bush presidency posited truth as unknowable, facts as infinitely flexible, and faith as constitutive of reality. Fun Home never mentions the president (nor any historical figure or event after the mid-1980s), but the memoir uses newly available digital technology to resist Bush-era “truthiness.” In Fun Home, Bechdel combines digital photography, her body in performance, and hand drawing to create a new form of graphic narrative. This essay draws out Fun Home’s political engagement with the Bush administration and simultaneously claims the proliferation of digital photography as a watershed event in the history of graphic narratives.
Metadata, Metafiction, and the Stakes of Surveillance in Jennifer Egan’s A Visit from the Goon Squad
Authors: Johnston Katherine D.
Published: March 2017

This essay analyzes increasingly ubiquitous data collection and posits that metafiction is especially well suited to grapple with the significance of metadata and data surveillance, given its own preoccupation with watching itself watch. Making a critical intervention in the historically male-centered canon of US metafiction, Egan’s A Visit from the Goon Squad (2010) conscientiously engages the power relations of watching. In the background of the novel and at its chronological center are the 9/11 attacks and also, incidentally, the launch of the iPod. In a sense, these two events structure the novel’s investments in data surveillance. Moreover, to the extent that the novel’s form mirrors a musical album it also forms a network of characters, speaking to the constellation of forces that not only convert analog recordings into digital data, but also translate relationships, habits, and subjectivity into metadata.
Conditions of Critique
Authors: Morgensen Scott L.
Published: March 2017

Indigenous critics are interrogating the violences of modernity as conditions for understanding or debating gender, alongside critical works in trans studies and in queer-of-color, queer diaspora, and women-of-color feminist theories. This essay asks how two-spirit, queer indigenous, and indigenous feminist critiques call scholars in gender studies to ensure that discussions of gender respond to indigenous decolonization and its relationships with antiracist and anticolonial projects. In particular, two-spirit, queer indigenous, and indigenous feminist theories present resurgence as a means to challenge and transform colonial authority. The centering of indigenous epistemologies within resurgence work questions who defines language or the knowable within colonial situations. This essay asks how responding to indigenous resurgence can help to challenge and transform the racial and colonial violences that condition conversations about gender, including those addressing trans and feminist relationships.
Discussing Transnormativities Through Transfeminism
Authors: Ruin
Published: March 2017

This essay explores four aspects of transnormativities through transfeminism. In South Korea, transnormativity is a key issue in transgenderism. However, it has been seriously marginalized in discussions about transgender. Furthermore, mass media, nontrans people, and nontrans social systems, transgender communities, and nontransfeminist scholars re/produce and re/enforce transnormativity by citing hegemonic gender norms. In the same way, they re/enforce and re/produce the hegemonic gender norms by citing transnormativity. In this essay, the author argues that transnormativities include the elimination of temporality, excluding the ways that may threaten the norms, naturalizing the myth that there is natural gender without any instability, and translation without thinking the hierarchy of language.
Broadening the Gendered Polis
Authors: Voli Stefania
Published: March 2017

In the late 1970s to the early 1980s, the Italian transsexual movement began gaining visibility in the public sphere, also making use of the feminist political lexicon. This contamination emerged in the life stories of some trans pioneers, who consider feminism a fundamental element of their political and individual trajectory of subjectivation. In contrast, historiographical reconstructions of Italian feminist movements as well as feminists' accounts never mention the transsexual movement. During battles for the right to change one's gender, transsexuals were supported by only a few feminist members of Left parties. The article analyzes the reasons that prevented Italian feminist and transsexual movements from establishing an open alliance against the patriarchal system deeply rooted in the Italian society of the time.
A Conversation with Jeanne Córdova
Authors: Bettcher Talia M.
Published: March 2017

This interview with long-time Los Angeles–based feminist, lesbian, and butch activist Jeanne Córdova, conducted by TSQ: Transgender Studies Quarterly guest editor and editorial board member Talia Bettcher in June and July 2015, explores the relationship between butch and transgender identities and the place of transgender issues in feminist and lesbian histories and cultures. It pays particular attention to the involvement of transsexual lesbian singer Beth Elliott at the 1973 Lesbian Conference organized by Córdova and others, which became a flashpoint in second-wave feminist dialogs about transsexual involvement in the women's movement and in lesbian feminism.
Pore Clogging of Colloidal Mesoporous Silica Nanoparticles for Encapsulating Guest Species
Authors: Yamamoto Eisuke , Nagata Kouya , Onishi Kenta , Urata Chihiro , Shimojima Atsushi , Wada Hiroaki , Takeoka Shinji , Kuroda Kazuyuki
Published: March 2017

Colloidal mesoporous silica nanoparticles (CMS) are useful as carriers for imaging probes because of their unique features. A simple method for the pore clogging of CMS has been proved by the addition of tetraethoxysilane under weakly basic conditions. The pore clogging of CMS is useful for encapsulation of thermoresponsive dyes.
Sonographic Evaluation of Structural Changes in Post-Stroke Hemiplegic Shoulders
Authors: Idowu Bukunmi Michael , Ayoola Oluwagbemiga Oluwole , Adetiloye Victor Adebayo , Komolafe Morenikeji Adeyoyin
Published: March 2017

Background: Stroke and hemiplegia are frequent complications of stroke. This study was performed to sonographically evaluate post-stroke hemiplegic shoulders and explore possible relationship(s) between the sonographic findings and clinical indices.

Material/Methods: Forty-five stroke patients and 45 age- and sex-matched controls were recruited. Standard sonographic examination of both shoulders was performed to assess for joint subluxation, rotator cuff tears, tendinosis, subacromial-subdeltoid bursitis or effusion and adhesive capsulitis.

Results: Hemiplegic shoulders exhibited significantly higher number of pathologies compared to the unaffected shoulders and shoulders of controls (p=0.000). One or more structural abnormalities were found in all 45 (100%) hemiplegic shoulders, 25 (55.6%) unaffected shoulders of the stroke subjects, and 39 (43.3%) control shoulders. The most frequent pathologies in the hemiplegic shoulders were the following: tendinosis of the long head of bicep tendon (48.9%), inferior shoulder subluxation (44.4%), co-existing subacromial-subdeltoid bursa/long head of bicep tendon sheath effusion (44.4%), and long head of bicep tendon sheath effusion only (40%). Tendinosis of the long head of bicep tendon was commoner in hemiplegic shoulders with poor motor status than those with good motor status.

Conclusions: Hemiplegic shoulders have significantly higher number of structural abnormalities than unaffected shoulders and the shoulders of controls. Hemiplegic stroke patients should undergo ultrasonography of the hemiplegic shoulder to define the nature and extent of soft tissue injuries

prior to physical therapy.
Cost-effectiveness of early versus delayed antiretroviral therapy in tuberculosis patients infected with HIV in sub-Saharan Africa
Authors: Uthman Rashidah T. , Uthman Olalekan A.
Published: March 2017

Background:The most challenging issue physicians are facing is the appropriate timing of introducing antiretroviral therapy (ART) along with ongoing tuberculosis (TB) therapy in HIV and TB co-infected patients. This study examined the cost-effectiveness of early versus delayed ART initiation in TB patients, infected with HIV (co-infected patients) in a sub-Saharan Africa setting. Methods:A decision analytic model based on previously published and real-world evidence was applied to evaluate clinical and economic outcomes associated with early versus delayed ART in TB and HIV co-infection. Incremental cost-effectiveness ratio (ICER) was calculated with both costs and quality-adjusted life years (QALYs). Different assumptions of treatment benefits and costs were taken to address uncertainties and were tested with sensitivity analyses. Results:In base case analysis, the expected cost of giving early ART to TB patients infected with HIV was $1372, with a QALY gain of 0.68, while the cost of delayed ART was $955, with a QALY gain of 0.62. The ICER shows $6775 per QALYs, which suggests that it is not as cost-effective, since it is greater than 3 x GDP per capita ($5,086) for sub-Saharan Africa willingness to pay (WTP) threshold. At $10,000 WTP, the probability that early ART is cost effective compared to delayed ART is 0.9933. At cost-effectiveness threshold of $5086, the population expected value of perfect information becomes substantial (≈US$5 million), and is likely to exceed the cost of additional investigation. This suggests that further research will be potentially cost-effective. Conclusions:From the perspective of the health-care payer in sub-Saharan Africa, early initiation of ART in HIV and TB co-infection cannot be regarded as cost-effective based on current information. The analysis shows that further research will be worthwhile and potentially cost-effective in resolving uncertainty about whether or not to start ART early in HIV and TB co-infection.
Assessing the species composition of tropical eels (Anguillidae) in Aceh Waters, Indonesia, with DNA barcoding gene cox1.
Authors: Muchlisin Zainal A. , Batubara Agung Setia , Fadli Nur , Muhammadar Abdullah A. , Utami Afrita Ida , Farhana Nurul , Siti-Azizah Mohd Nor
Published: March 2017

The objective of the present study was to evaluate the species diversity of eels native to Aceh waters based on genetic data. Sampling was conducted in western coast waters of Aceh Province, Indonesia, from July to August 2016. Genomic DNA was extracted from the samples, a genomic region from the 5’ region of the cox1 gene was amplified and sequenced, and this was then used to analyse genetic variation. The genetic sequences were blasted into the NCBI database. Based on this analysis there were three valid species of eels that occurred in Aceh waters, namely Anguilla marmorata, A. bicolor bicolor, and A. bengalensis bengalensis.
Optimal Stopping Under Probability Distortions
Authors: Belomestny Denis , Krätschmer Volker
Published: March 2017

In this paper we study optimal stopping problems with respect to distorted expectations with concave distortion functions. Our starting point is a seminal work of Xu and Zhou in 2013, who gave an explicit solution of such a stopping problem under a rather large class of distortion functionals. In this paper, we continue this line of research and prove a novel representation, which relates the solution of an optimal stopping problem under distorted expectation to the sequence of standard optimal stopping problems and hence makes the application of the standard dynamic programming-based approaches possible. Furthermore, by means of the well-known Kusuoka representation, we extend our results to optimal stopping under general law invariant coherent risk measures. Finally, based on our representations, we develop several Monte Carlo approximation algorithms and illustrate their power for optimal stopping under absolute semideviation risk measures.
Optimizing Inbound Baggage Handling at Airports
Authors: Frey Markus , Kiermaier Ferdinand , Kolisch Rainer
Published: March 2017

In this paper we consider the planning and scheduling of inbound baggage that is picked up by passengers at the baggage claim hall. Although this is a standard process at airports, to our knowledge there has been no mathematical model proposed in the literature optimizing the inbound baggage handling process. As the inbound baggage handling problem turns out to be NP-hard, we propose a hybrid heuristic combining a greedy randomized adaptive search procedure with a guided fast local search and path-relinking. We demonstrate how we implemented the algorithm at Munich’s Franz Josef Strauss Airport where it is in use to operate the inbound baggage handling process. In a case study, we compare the results of the mathematical model with the solutions of the hybrid heuristic and the solutions provided by the airport. The proposed algorithm reduces baggage peaks at the baggage carousels by 38% and waiting times for passengers by 11%. All computational results are based on an extensive simulation incorporating real world data.

The online appendix is available at https://doi.org/10.1287/trsc.2016.0702 .
Factors associated with mortality in newborn infants with meconium aspiration syndrome
Authors: Aminullah Asril , Sarmili Jonardi , Sastroasmoro Sudigdo
Published: March 2017

Meconium aspiration syndrome (MAS) is still one of the common causes of morbidity and mortality in neonatal period. A retrospective study was conducted from January 1993 to December 1999, to identify factors associated with mortality in MAS. Univariate analysis disclosed that preeclampsia/eclampsia, sex, Apgar scores, consistency of meconium, and use of mechanical ventilation were significantly associated with mortality in MAS, while gestational age, mode of delivery, hypertension, birth weight, tracheal suctioning, blood cultures, and complications were not. Logistic regression analysis showed that mode of delivery, preeclampsia/eclampsia, Apgar scores, consistency of meconium, and use of mechanical ventilation were associated with mortality in MAS, while other variables were not.
A case of pediatric AIDS in Dr. Sutomo Hospital Surabaya, Indonesia
Authors: Ismoedijanto Ismoedijanto , Yustina Rosanti , Lestari Rahayu Tri , Burhan Hidayat
Published: March 2017

We report a 2-year old girl who suffered from HIV. The diagnosis was based on history, clinical findings, andlaboratory work-up. Suspicion of the presence of HIV was started when the girl continued to have wasting syndrom e withseveral focal infections unresponsice to ordinary treatment. The patient past away following severe diarrhea and apparentlysepsis.
Genetic inheritance pattern in prurigo Hebra
Authors: Boediardja Siti Aisah , Ramelan Wahyuning , Cornain Santoso
Published: March 2017

A study was conducted to analyze the multifactorial genetic inheritance pattern in prurigo Hebra (PH). Fiftyprobands (PH patients) consisting of 11 males and 39 females, with age ranged from 5-30 years were included in this study.A three-generation family tree was obtained from each subject, from which a total of 79 families were eligible for analysis. Foreach family the possible mode of inheritance, namely autosomal dominant (AD) or autosomal recessive (AR), was predicted.The families were then grouped according to the mode of inheritance. Analysis was conducted using Chi-square test,comparing the observed occurrence of PH and the expected value for each mode. To rule out mutation, the second methodwas applied, which only families with more than one affected child were analyzed, was used. The genetic inheritancepattern was not consistently compatible either with AR or AD. This finding, and other supporting facts, such as femalepreponderace, the role of HLA and the lower morbidity rate compared to the expected rate in AR or AD mode, indicated thatthe genetic inheritance of PH follows a multi-factorial pattern.
Antidiarrheal characteristics of tempe produced traditionally and industrially in children aged 6-24 months with acute diarrhea
Authors: Soenarto Yati , I Sudigbia , Herman Herman , M Karmini , D Karyadi
Published: March 2017

A randomized controlled double-blind clinical trial was conducted to evaluate tempe-based formulated foods fortreatment of young Indonesian children suffering from acute diarrhea. A total of 214 cases aged between 6 and 24 monthsvisiting two teaching hospitals, i.e., Sardjito hospital (n=102) in Yogyakarta and Karyadi hospital (n=112) in Semarang. Twocases from one hospital were dropped because they moved to other towns. In addition to their hospital food given duringhospitalization and daily food at home, 72 cases were given tempe-based formulated foods with tempe produced traditionally(group TT), 72 were given tempe produced industrially (group IT), whereas a control group of 68 received soybean powderformulated foods (group IS). Formula feedings were started immediately following WHO (world health organization) standardoral rehydration therapy (ORT) and continued at the patients homes for up to 90 consecutive days, including feedings duringhospitalization. Follow-up observations at patients homes were conducted twice weekly. The initial clinical characteristics ofthe cases in each group were similar. Using analysis of variance there was a non significant trend towards a shorter durationof diarrhea in the groups using tempe based formula (p=0.079). Using the t-test, the duration of diarrhea appeared to besignificantly shorter only for the group using formula with traditional tempe compared with the group using soy formula(p=0.035). The total amount of feeding formula and the total amount of calories consumed at the hospital and at home wassimilar for all three groups, although the group receiving the control formula consumed a somewhat higher amount of breastmilk (p=0.045) and a lower amount of solid food at home. Weight for age was below normal at the start of the study or afterrehydration (Z-score between -1.0 and -1.4) and approached the normal value at the end of the study for all three groups (Zscorebetween -0.51 and -0.27). The increase in Z-score was highest in the groups receiving tempe based formula (+1.0 inthe TT group and +0.9 in the IT group) and lowest in the IS group (+0.7). This implies that a tempe based formula can diminishthe duration of acute diarrhea and improve weight gain following an episode of acute diarrhea.
Pattern of newborn babies delivered by cesarean section
Authors: Tjipta Guslihan D , Nasution Riza I , Aldy Dachrul , Siregar Zakaria
Published: March 2017

Background The birth rate in Indonesia is still high and abnormallabor constitutes 15% of all deliveries which needs cesarean sec-tion as a solution for complicated cases.Objectives To find the general physical condition of babies bornafter cesarean section as well as the characteristics of motherswho underwent cesarean section.Methods A retrospective study on newborn babies delivered bycesarean section conducted in Subdivision of Neonatology, Medi-cal School, University of North Sumatera-Pirngadi Hospital Medan,in period of 2 years (1991-1992).Results There were 8762 babies born during the study period,1484 babies (16.93%) delivered by cesarean section due to pla-centa previa (26.2%), prolonged labor (15.8%), cephalopelvic dis-proportion (10.3%), neglected labor (9.9%), eclampsia/preeclamp-sia (8.1%), fetal distress (7.5%), previous section (6.6%), breechpresentation (5.7%), solutio placenta (4.0%), and others (5.9%). Itwas shown that mothers undergoing caesarean section was mainly20-30 years old (66.4%), multigravida (47.8%), term gestationalage (79.4%), and minimal antenatal care (61.3%). There were 1224(82.5%) babies with birth weight >2500 grams and 894 (60.2%)suffered from asphyxia.Conclusions The evidence of asphyxia by cesarean section andlow birth weight group was significantly different from those nor-mally delivered (p<0.001). The mortality rate was 11.5% due tostill birth 29.2%, RDS 18.3%, sepsis 15.5%, pneumonia 12.3%,and gastroenteritis 11.5%
The correlation between ferritin level and cardiac dysfunction in patients with thalassemia
Authors: Subroto Fajar , Munthe Bulan Ginting , Advani Najib , Firmansyah Agus
Published: March 2017

Background Patients with b-thalassemia major, long-term trans-fusion, extravasal hemolytic, and increased intestinal absorptionof iron result in systemic iron overload, which may accumulate inmyocardium causing cardiac dysfunctions. Congestive heart fail-ure usually develops in adolescence or early adult years, and pa-tient usually dies within 1 year after the onset of symptoms. There-fore, it is important to detect early signs of cardiac dysfunction inpatient with thalassemia.Objective This study aimed to assess the correlation betweenferritin level and cardiac dysfunction in patients with thalassemia.Methods A cross sectional study was conducted on 62 b-thalas-semic patients (34 males and 28 females) with age ranging from3.5 to 23 years. They received 3,150 – 94,985 mL of blood; withthe serum ferritin level of 812.2 – 12,175 ng/mL. Each patient un-derwent laboratory examinations and clinical cardiac evaluationwith ECG and echocardiography.Results Cumulative blood transfusions correlated well with theserum ferritin values (p=0.001). The serum ferritin level did notshow correlation with deferoxamine (DFO) treatment. ECG exami-nation revealed 5 patients (8.1%) with dysrhythmia, LVH, and heartblock grade II and I. Echocardiography examination showed 18patients (29%) with systolic or diastolic dysfunction. There was nocorrelation between the serum ferritin level and cardiac dysfunc-tions (p=0.640). The serum ferritin prediction value against car-diac dysfunctions could not be established.Conclusion There was no correlation between serum ferritin lev-els with cardiac dysfunctions. In detecting cardiac dysfunctions inthalassemic patients, echocardiography was more sensitive thanECG
The prevalence of hyaline membrane disease and the value of shake test and lamellar body concentration in preterm infants
Authors: DLH Dzulfikar , Usman Ali , Nataprawira Melinda D , Primadi Aris
Published: March 2017

Background The morbidity and mortality of hyaline membrane dis-ease (HMD) are quite high due to delayed diagnosis and intervention.Commonly, HMD occurs in preterm infants with surfactant deficiencybecause of lung immaturity. Lung maturity test could be performedusing biochemical, biophysical, and amniotic fluid turbidity test.Objective To find out HMD prevalence and the value of shaketest and lamellar body concentration in diagnosing HMD in preterminfants.Methods This was a cross-sectional study carried out at HasanSadikin Hospital Bandung on preterm infants born during October-December 2001. The shake test was performed using gastric fluidand amniotic fluid while the lamellar body concentration was per-formed using amniotic fluid.Results During the 3-month period, 571 infants were born, of 64(11.2%) preterm infants, only 41 (64%) fulfilled the inclusion crite-ria; among those preterm infants, 14 (34%) suffered from respira-tory distress and 7 suffered from HMD (prevalence 17%). All HMDcases occurred in infants less than 32 weeks for gestational age.In 7 preterm infants with HMD, the shake test of gastric fluid ob-tained by lavage showed negative results in 3 and +1 in 4 infants;while the shake test of amniotic fluid revealed negative result in 5and +1 in 2 infants. Lamellar body concentration of amniotic fluidwas ≤18,000/ml in all HMD infants. Among three infants less than32 weeks for gestational age who did not suffer from HMD, +1shake test of gastric fluid was found in 2 infants and +2 in 1 infant;while shake test of amniotic fluid showed negative result in 1 infantand +1 in 2; the lamellar body concentration of amniotic fluid was≤18,000/ml in 2 infants and >18,000/ml in 1 infant.Conclusions We concluded that HMD occurred in 17% of preterminfants. The shake test of gastric and amniotic fluids revealed nega-tive or +1 results whereas lamellar body concentration had valueof less than or equal to 18,000/mL. More extensive studies arewarranted to assess the validity (sensitivity, specificity and predic-tive values) of these measurements
Electroencephalogram and clinical manifestations of Rett syndrome in children
Authors: Herini E S , Mangunatmadja I , S Purboyo , Pusponegoro Hardiono D , Sunartini Sunartini
Published: March 2017

Background Rett Syndrome (RS) is a severe neurodevelopmentaldisorder. Epileptic seizures occur in 80-90%; grandmal, psychomo-tor (complex partial), and focal motor seizures have been reported.The electroencephalogram(EEG) is almost always abnormal.Objective This study aimed to investigate the EEG and clinicalmanifestations of children with RSResults We investigated EEG on 5 patients with RS aged 30–66month. One patient was in clinical stage II and 4 patients in clini-cal stage III. Four patients had history of seizures, however onlytwo patients suffered from epilepsy. The EEG demonstrated slow-ing background activity in occipital region in two patients. In addi-tion, epileptic form activities were observed in 4 of 5 patients.Conclusion We concluded that epileptic spike discharge with orwithout clinical seizures were found in almost all of our RS pa-tients. These paroxysmal discharges suggested the process andthe sequences of cortical involvement. Compelling clinical, neuro-physiological evidences were very important to decide the stageof Rett disorder
Liver dysfunction in children with hematologic malignancy or solid tumor
Authors: Carmelia Rita , Lubis Bidasari , Sutjipto Adi , Hariweni Trie
Published: March 2017

Background Deficiencies in liver synthetic function can only bedetected if the damage is severe, which are more often due to nonhepatic factors such as malignancies, both hematologic and solidtumor.Objective To assess liver function in children with either hemato-logic malignancy or solid tumor and to find out which one of themmostly affects liver function.Methods A retrospective study was conducted on 125 childrenwith malignancies in the Sub division of Hemato-Oncology De-partment of Child Health, Adam Malik Hospital, Medan, from Janu-ary 1999 until May 2000. The inclusion criteria included all pa-tients who were younger than 15 years and had not received anytreatment yet. The differences between prevalent liver dysfunctionin both groups were assessed by using chi-square test; Fisher’sexact test was used to know the type of liver cell damage.Results Liver dysfunction occurred in both types of malignancies. Adecrease of albumin level was not significant in both groups. Therewas a statistically significant difference between the prolongedprothrombine time (PT) in hematologic malignancy (26.4%) and thatin solid tumor (10.4%) with p=0.03. There was no significant differ-ence in the elevation of serum transaminase concentration, totalbilirubin, and alkaline phosphatase. Based on aspartate aminotrans-ferase (AST) and alanine aminotransferase (ALT) ratio, we foundthat the type of liver cell damages was infiltrative disorders, occurred13 out of 20 cases with elevated AST and ALT.Conclusion Liver dysfunction occurred in both types of malig-nancy; it occurred more frequently in hematologic malignancy thanin solid tumors
Nonspecific symptoms of intussusception
Authors: Wahyudin Bob , Abbas Nassir , Budi Setia , Tanra Azis
Published: March 2017

This paper reports 2 cases of intussusception withnonspecific symptoms.
The occurrence of pulmonary hypertension in patients with thalassemia major
Authors: Basri Hasan , Firman Armijn , Rusmil Kusnandi , Fadlyana Eddy
Published: March 2017

Background The life of patients with thalassemia major dependson blood transfusions, while repeated blood transfusions may causeadverse effects such as iron deposition in various organs, includ-ing heart and lungs, which eventually increases the pulmonaryarterial pressure.Objective This study was proposed to know the occurrence ofpulmonary hypertension in patients with thalassemia major, mea-sured by echocardiography in the Thalassemia Clinic, Departmentof Child Health, Medical School, Padjadjaran University/HasanSadikin Hospital, Bandung.Methods A descriptive cross-sectional study was carried outon 30 patients with thalassemia major, aged 10-14 year-old whoreceived repeated blood transfusions. The study was conductedfrom April to May 2002. Subjects were examined right after ablood transfusion completed and the pulmonary arterial pres-sure was assessed using Doppler–echocardiography and 2-Dechocardiography.Results Twenty two out of 30 subjects showed pulmonary hyper-tension, with pulmonary arterial pressure ranged between 32.3 to46.2 mmHg. According to the age group, pulmonary hypertensionwas found in 12 out of 17 subjects aged 10-12 years old and 10out of 13 subjects aged 13-14 years old.Conclusion The occurrence of pulmonary hypertension in patientswith thalassemia major at Hasan Sadikin Hospital was 22/30 andseemed to increase with the age of the patients
Comparison of continuous infusion and bolus administration of tramadol in postoperative children
Authors: Tikoalu Jeanne-Roos , Darwis Darlan , Madiyono Bambang
Published: March 2017

Objective To appraise the efficacy of tramadol therapy given bycontinuous infusion and bolus in handling child’s postoperative painthat is mostly inadequate.Methods This was a randomized, single-blinded clinical trial withparallel design. The study was done in the operation room, recov-ery room, pediatric intensive care unit, pediatric surgery, and pedi-atric ward of Cipto Mangunkusumo Hospital, Jakarta, Indonesia.There were sixty patients, 1-12 year-old, with elective operationbetween January and April 2002. Both groups received bolus of2mg/kg tramadol as an initial dose. Twenty-nine subjects receivedcontinuous infusion of 0.22 mg/kg/h tramadol in 15 minutes after-wards. The other 31 subjects received the same boluses for every6 hours. Before each tramadol administration, evaluation was doneby observer using objective pain scale (OPS) and evaluation sheetthat had been tested before the study. The study was done within24 hours post surgery.Results In the first 6 postoperative hours, mean total dose givenby continuous infusion was significantly greater than that given bybolus (p=0.006). On the contrary, mean total dose given within 24hours by continuous infusion was significantly less than that givenby bolus (p=0.037). All subjects showed OPS result of 36 in 0 minute.After that, the result decreased, except in 9 subjects it was still >6in the 15 th minute. Vomiting was the commonest side effect.Conclusion Continuous infusion of tramadol within 24 hours canbe recommended as an analgesic in postoperative children
Macro- and micronutrient intakes among severely malnourished under-five children during the economic crisis in Yogyakarta
Authors: Prawirohartono Endy P , Werdiningsih Atiek
Published: March 2017

Objective To evaluate macro and micronutrient intakes amongunder five-year children with severe malnutrition during the periodof economic crisis.Methods We conducted a longitudinal study from August untilNovember 2000 in Bantul and Sleman districts, Yogyakarta Spe-cial Territory of Indonesia. Two-weekly home visits were performedto collect data about food intakes.Results Of 46 children, 26 experienced an improvement in nutri-tional status, whereas 20 children did not. The median intakes ofmacro and 8micronutrients were lower than the RecommendedDaily Allowances (RDA), ranged from 22% (vitamin C) to 69%(phosphorus), except for vitamin A (406%). The median intakes ofprotein, vitamin A, thiamin, vitamin C, calcium, iron and phospho-rus were higher in severely malnourished children who experiencedimprovement in nutritional status compared to children who didnot, and in breastfed compared to non-breastfed, but Mann WhitneyU-test was not able to detect significant differences (p>0.05). Strati-fication using age group showed that calories and thiamin intakesof older children (348 months) were lower than those of youngerchildren (Kruskal Wallis tests p = 0.016 and 0.022 respectively).Conclusions The macro and micronutrients intakes of severelymalnourished under five-year children were lower than RDA, ex-cept for vitamin A. There were differences in nutrient intakes ac-cording to the improvement in nutritional status and age group
Clinical predictors of hypoxemia in pneumonia
Authors: Gunawijaya Eka , Widia I M
Published: March 2017

Background Pneumonia is one of the main causes of death ininfants in developing countries. The device of oxygen saturationmeasurement for detecting hypoxemia is limited in district hospi-tals.Objective The aim of our study was to find the best clinical pre-dictor for hypoxemia that could be used in Indonesia.Methods Between June 2001 until May 2002, the diagnostic testwas performed in 125 infants aged 2–12 month-old who sufferedfrom pneumonia. The oxygen saturation measured by pulse oxim-etry was used as the gold standard.Results The samples were divided into two groups, 52 infants withhypoxemia and 73 normal. The base characteristics of both groupswere not statistically different. The prevalence of hypoxemia was41.6%. The best single clinical predictor of hypoxemia was cyano-sis (the sensitivity 92%, specificity 86%, likelihood ratio 6.74, post-test probability 83%), as well as the combination of two clinicalpredictors i.e., cyanosis and nasal flaring. The best combination ofthree clinical predictors was cyanosis, nasal flaring, and refusal todrink (the sensitivity 92%, specificity 86%, likelihood ratio 6.74,post-test probability 81%).Conclusion The combination of cyanosis and nasal flaring isgood enough as a predictor to detect hypoxemia in area with nofacility of oxygen saturation measurement
Acute renal failure in children: outcome and prognostic factors
Authors: Trihono Partini P , Soesilo Ommy A , Suradi Rulina
Published: March 2017

Background Acute renal failure (ARF) is an emergency conditionwith a high mortality rate despite the long-known dialysis and ad-vanced supportive care. Only few studies on prognostic factors ofARF in children are available in the literature, which are difficult tocompare to each other due to the different definitions of the ARFoutcome used.Objective To find out the clinical and laboratory characteristics ofchildren with acute renal failure and the prognostic factors affect-ing the outcome.Methods This observational prospective study was conducted onchildren with acute renal failure hospitalized in the Department ofChild Health, Cipto Mangunkusumo Hospital, between July andDecember 2001. Patients with acute on chronic renal failure wereexcluded. Clinical and laboratory data were taken at the time ofdiagnosis and the outcomes were noted after 2 weeks of observa-tion. We classified the outcome as cured, uncured, and dead. Ana-lytical study was done to find out the relationships among variousprognostic factors.Results Fifty-six children with ARF were recruited in this study.Male to female ratio was 1.3:1; the mean age was 4.4 year-old.The most frequent presenting symptom was dyspnea (34%), fol-lowed by oliguria (29%). The most frequent primary disease wasmalignancy (20%). Most of the patients had renal-type of ARF(73%). The outcomes were cure (71%), no cure (16%), and death(13%). Bivariate analysis and logistic regression revealed thatyounger age (OR=13.6; 95%CI 1.01;183.60) and the need for di-alysis (OR=10; 95%CI 1.53;65.97) had significant relationships withmortality or no cure.Conclusion We should be aware when finding ARF patientsless than 5 year-old and have the indications for dialysis, due tothe poor prognosis they might have
Parents’ perceptions of food intolerance among under-five children in Gianyar Bali
Authors: Prawirohartono Endy P , Gumala Ni Made Yuni
Published: March 2017

Objective To estimate the proportion of food intolerance in chil-dren based on parents’ perception and to analyze factors associ-ated with food elimination.Methods A cross-sectional study was done among 250 mothersof under-five children in Gianyar District, Bali. Mothers were inter-viewed with a questionnaire concerning basic characteristics ofthe children, the family, a list of allergic diseases, disturbance afteringesting certain foods, food avoidance, the reason for eliminatingcertain foods, the person who gave advice, and probable parentalhistory of allergic diseases.Results Fifty-three children (21.2%) were suspected to have ‘prob-able allergic diseases’ and six (2.4%) had ‘probable food intoler-ance’. Food elimination was practiced in 27 (10.8%) families. ‘Prob-able allergic parents’ was found in 49 (19.6%) families. There wasa significant difference in child allergy in proportion to parentalallergy (x 2 test p<0.0001). Food elimination was not associatedwith parental allergies, children’s allergies or children’s ages (x 2test p=0.36, 0.47, and 0.56), but seemed to be related to loweducational status of mothers (x 2 test p<0.0001) and fathers(Fisher’s exact tests p< 0.0001).Conclusions The proportion of children with ‘probable allergic dis-eases’ was higher in families with ‘probable allergic parents’. Theproportion of food elimination was greater than the prevalence of‘probable food intolerance’. Low educational status of parentsplayed an important role in this discrepancy of food elimination inchildren
The relation of BCG vaccination and severe malnutrition with the occurrence of tuberculous meningitis
Authors: Nofareni Nofareni , Saing Bistok , Daulay Ridwan M. , Lubis Bidasari
Published: March 2017

Objectives To assess BCG vaccination and nutritional states inchildren with tuberculous meningitis and their relations with theoccurrence of tuberculous meningitis.Methods A case-control study was conducted at the Divisionof Neurology, Department of Child Health, Adam Malik Hospi-tal, Medan, from January 1997 to December 2000. Subjects ofthis study were all tuberculous meningitis patients and primarytuberculosis patients as the control group. Odds ratio (OR) wasused to assess the risk of tuberculous meningitis in patientswith positive BCG vaccination and (1-OR) was used to assessthe efficacy of BCG to prevent tuberculous meningitis.Results Four out of sixteen tuberculous meningitis patients werevaccinated, while 10 of 16 primary tuberculosis patients were vac-cinated (p=0.03). OR of vaccinated patients to get tuberculousmeningitis was 0.2 (95%CI 0.04;0.91). The efficacy of BCG vacci-nation to prevent tuberculous meningitis was 1-0.2 = 0.8. The riskof severe malnourished patients to get tuberculous meningitis was2.33 (95%CI 0.52;10.48; p=0.26).Conclusion Most tuberculous meningitis patients were not BCGvaccinated. Severe malnutrition did not play role in the occurrenceof this disease