bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic factor of heart failure in children with left-to-right shunt acyanotic congenital heart disease
Authors: Inrianto Weny , Murni Indah K. , Mulatsih Sri , Nugroho Sasmito 
Published: July 2019

Background Anemia is highly prevalent and affects morbidity and mortality in adults with acquired heart disease. However, its role in children with acyanotic congenital heart disease (CHD) is unclear.
Objective To assess anemia and other potential prognostic factors of congestive failure in children with left-to-right shunt acyanotic CHD.
Methods We conducted a case-control study in the Pediatric Cardiology Clinic, Dr. Sardjito Hospital from January to December 2017 in children with left-to-right shunt acyanotic CHD. The case and control groups consisted of subjects with and without heart failure, respectively. Anemia was defined as hemoglobin concentration <11 g/dL. Measured outcome was the prevalence of congestive heart failure, as determined by the Ross criteria. Anemia, defect type, defect size, age at diagnosis, and gender were analyzed by logistic regression analysis as potential predictive factors of heart failure.
Results Of 100 children with left-to-right shunt acyanotic CHD, 50 had heart failure (the case group) and 50 did not (the control group). The prevalence of anemia was 45%. Multivariable logistic regression revealed that defect size was the most significant factor for predicting heart failure, with adjusted OR 7.6 (95%CI 2.5 to 22.8) for moderate shunts and 21.1 (95%CI 6.8 to 65.4) for large shunts. Anemia, type of defect, age of diagnosis, and gender were not statistically significant factors for predicting outcomes.
Conclusion Anemia is not a significant, prognostic factor for heart failure in children with left-to-right shunt acyanotic CHD. However, moderate and large shunts in children with left-to-right shunt acyanotic CHD are predictive of the occurrence of congestive heart failure.
Corticosteroids for pediatric septic shock patients
Authors: Yuniar Irene , Manusita Vembricha Nindya , Low Sonya Leonardy 
Published: July 2019

Background Septic shock remains a major cause of mortality and admission to the pediatric intensive care unit (PICU) in children. Management includes adequate fluid resuscitation, followed by catecholamine infusion, if needed. Corticosteroid therapy is advised for catecholamine-refractory shock, although this practice is controversial, as it was not beneficial in other studies.
Objective To assess corticosteroid use in pediatric septic shock patients in Cipto Mangunkusumo Hospital.
Methods This cross-sectional study included all patients aged 1 month-18 years with a diagnosis of septic shock during the study period of January 2014 to July 2018 admitted in PICU Dr. Cipto Mangunkuskumo Hospital, Jakarta. Data obtained from medical records were, age, sex, immunology status, port d’entrée of sepsis, inotropic and vasopressor usage, mechanical ventilation, corticosteroid type, hospital length of stay (LOS), and mortality outcome.
Results Of 217 children with septic shock, 12 patients (5.5%) received corticosteroid therapy. The most common corticosteroid given was hydrocortisone (80%), with a 2 mg/kg BW loading dose, followed by a continuous infusion dose of 2-50 mg/kg BW/day. Almost all patients (11/12) received corticosteroid therapy until they died. Median duration of corticosteroid use was 2 (range 1-7) days, median number of inotropes and vasopressors used was 3 (range 2-4) agents, median LOS was 3 (range 1-9) days, and mortality rate was 100%.
Conclusion A small proportion of pediatric septic shock patients received corticosteroid therapy. Their mortality rate was 100%. Further clinical study is needed to evaluate the benefit of corticosteroid therapy in pediatric septic shock patients.
Waist circumference, body mass index, and skinfold thickness as potential risk factors for high blood pressure in adolescents
Authors: Dewi Roslina , Ramayati Rafita , Rosdiana Nelly , Ramayani Oke Rina , Siregar Rosmayanti , Siregar Beatrix 
Published: July 2019

Background The prevalence of hypertension in children and adolescents has increased with the rising obesity epidemic. Recent studies have found that prevalence of hypertension was higher in obese children or adolescents than in the normal weight ones. Anthropometric measurements such as body mass index (BMI), waist circumference, and skinfold thickness have been used as criteria to determine obesity in children and adolescents. Increased waist circumference has been most closely related to increased blood pressure.
Objective To compare waist circumference, BMI, and skinfold thickness as potential risk factors for hypertension in adolescents.
Methods This cross-sectional study was conducted in May 2014 in three senior high schools in Medan, North Sumatera, and included 253 students with normal urinalysis test. All subjects underwent blood pressure, waist circumference, tricep- and subscapular-skinfold thickness (TST and SST), body weight, and body height measurements. The study population was categorized into underweight, normoweight, overweight, and obese, according to four different criteria: waist circumference, BMI, TST, and SST; all variables were analyzed for possible correlations with systolic and diastolic blood pressure.
Results There were significant positive correlations between systolic blood pressure and waist circumference (OR 7.933; 95%CI 2.20 to 28.65; P=0.011) as well as BMI (OR 4.137; 95%CI 1.16 to 14.75; P=0.041). There were also significant correlations between diastolic blood pressure and waist circumference (OR 3.17; 95%CI 1.83 to 5.51; P=0.002), BMI (P=0.0001; OR=3.69), TST (OR 4.73; 95%CI 2.31 to 9.69; P=0.0001), and SST (OR 3.74; 95%CI 2.35 to 5.94; P=0.0001). Multivariate analysis showed that waist circumference was a predictive factor for systolic blood pressure (OR 9.667), but not for diastolic blood pressure.
Conclusion Waist circumference is the strongest, significant, predictive factor for elevated systolic blood pressure; meanwhile BMI, SST, and TST could be predictive factors for elevated diastolic blood pressure.
Diagnostic value of electrocardiography for ventricular septal defect
Authors: Sarmila Besse , Iskandar Burhanuddin , Daud Dasril 
Published: July 2019

Background Congenital heart disease (CHD) in children requires attention from medical practitioners, because CHDs that are diagnosed early and treated promptly have good prognoses. Ventricular septal defect (VSD) is the most common type of congenital heart disease.
Objective To compare the accuracy of electrocardiography (ECG) to echocardiography in diagnosing VSD.
Methods This diagnostic study was conducted from November 2013 until July 2015. It involved patients with acyanotic CHDs who were suspected to have VSD at Dr. Wahidin Sudirohusodo Hospital, Makassar, South Sulawesi.
Results Of 114 children screened, 97 were included and analyzed. The frequency of positive VSD was 69.1% based on ECG, and 99% based on echocardiography. There was a significant difference between ECG and echocardiography (P=0.000). However, when small VSDs were excluded, there was no significant difference between the two diagnostic tools [(P=1.000), Kappa value was 0.66, sensitivity was 98.5%, specificity was 100%, positive predictive value (PPV) was 100%, and negative predictive value (NPV) was 50%].
Conclusion There were significant differences between the ECG and echocardiography, for diagnosing VSD. However, if small VSDs were not included in the analysis, there was no difference between the two examinations, suggesting that ECG might be useful for diagnosing VSD in limited facilities hospitals.
Predictors of mortality in children with acute kidney injury in intensive care unit
Authors: Rakhmawati Umi , Murni Indah K. , Rusmawatiningtyas Desy 
Published: July 2019

Background Acute kidney injury (AKI) can increase the morbidity and mortality in children admitted to the pediatric intensive care unit (PICU). Previous published studies have mostly been conducted in high-income countries. Evaluations of possible predictors of mortality in children with AKI in low- and middle-income countries have been limited, particularly in Indonesia.
Objective To assess possible predictors of mortality in children with AKI in the PICU.
Methods We conducted a retrospective cohort study at Dr. Sardjito Hospital, Yogyakarta, Indonesia. All children with AKI admitted to PICU for more than 24 hours from 2010 to 2016 were eligible and consecutively recruited into the study. Logistic regression analysis was used to identify independent predictors.
Results Of the 152 children with AKI recruited, 119 died. In order to get a P value of <0.25, multivariate analysis is run to degree AKI, ventilator utilization, primary infection disease, MOF and age.Multivariate analysis showed that ventilator use, severe AKI, and infection were independently associated with mortality in children with AKI, with odds ratios (OR) of 19.2 (95%CI 6.2 to 59.7; P<0.001), 8.6 (95%CI 2.7 to 27.6; P<0.001), and 0.2 (95%CI 0.1 to 0.8; P=0.02), respectively.
Conclusion The use of mechanical ventilation and the presence of severe AKI are associated with mortality in children with AKI admitted to the PICU. Interestingly, the presence of infection might be a protective factor from mortality in such patients.
Relationship between serum zinc and homocysteine in children with nephrotic syndrome
Authors: Hamik Welli , Hilmanto Dany , Rahayuningsih Sri Endah 
Published: July 2019

Background In children, most idiopathic nephrotic syndrome (NS) is a minimal lesion, which responds well to steroids. Hyperhomocysteinemia is pathologic and worsens NS by causing chronic inflammation, leading to glomerular sclerosis. Zinc metalloenzymes are involved in homocysteine metabolism.
Objective To assess for a possible relationship between serum zinc and homocysteine in children with NS.
Methods A cross-sectional study was conducted in children with NS aged 1-18 years, who were admitted to Hasan Sadikin Hospital from November 2017 - January 2018. Subjects were selected consecutively. Serum zinc and homocysteine were measured in all subjects. Statistical analysis was done with Pearson’s correlation test. If the distribution was not linear, the analysis was continued with non-linear regression.
Results There were 23 children who met the inclusion criteria. Mean serum homocysteine and zinc levels were 10.37 (SD 4.11) µmol/L and 51.13 (SD 29.69) µg/dL, respectively. Pearson’s correlation analysis showed no linear correlation between them (r coefficient -0.173; P=0.430). However, after adjusting for age and serum albumin level, multiple regression analysis suggested a cubical relationship between serum homocysteine and zinc, using the equation: homocysteine = -4.572 + 0.735 x zinc - 0.0012 x zinc2 + 0.00005 x zinc3 x age (months) (R2 multiple=53.2%; P=0.012). This equation indicates that 53.2% of homocysteine variation was influenced by serum zinc concentration.
Conclusion In childhood NS, homocysteine is not correlated linearly with zinc, but related with cubical model.
Iatrogenic Bilothorax: A Rare Complication of Orthotopic Liver Transplant
Authors: Karnik Nihaal P. , Shair Kamal A. 
Published: July 2019

ABSTRACT
Bilothorax is a rare condition involving drainage of bile from the biliary system into the lung's pleural space. Several cases have been reported in the literature, where the most commonly reported cause is iatrogenic injury. To date, no cases of bilothorax as a complication of liver transplantation have been reported. Given its rarity and concurrent morbidity, early recognition is paramount as this condition can quickly deteriorate into adult respiratory distress syndrome.
Military Expenditures and Shadow Economy in the Central and Eastern Europe: is There a Link?
Authors: Fedotenkov Igor , Schneider Friedrich 
Published: July 2019

AbstractThe main goal of our paper is to determine the existence of a link between government (military) expenditures and the shadow economy in the Central and Eastern European countries, which are the members of the European Union. The empirical investigation is conducted for the years 2003–2015. We show that there is a high statistically significant positive dependence between the size of the shadow economy and military expenditures in the Baltic States. Our conclusion is that higher military expenditures indeed lead to a larger shadow economy and this result is robust to different model specifications. In order to demonstrate the importance of our results, we undertook a simulation, where we calculated how much the size of the shadow economy would increase if the size of military expenditure as a percentage of GDP were to double. For example, in the Czech Republic, such an expansion would have led to an increase in the size of the shadow economy from 11.50% to 12.96%, and in Estonia, from 18.34% to 22.72% in 2012.
Hamiltonian Graph Analysis – Mixed Integer Linear Programming (HGA-MILP) Based Link Failure Detection System in Optical Data Center Networks
Authors: Gupta Rajat , Aggarwal Mona , Swaran Ahuja and 
Published: July 2019

Abstract
The internet services have become more popular rapidly over the decades. This is because of the inspiration created by new content-hungry applications on end-user devices like smart phones. Wavelength division multiplexed mesh networks are the optical backbone, working as the aggregating point of huge volume traffic, interconnecting several access networks and end users. The need of virtual data center is to retain services in case of failures such as optical link failures and resource or power outage in data centers that occurs in the cloud infrastructure and improve the survivability. The physical infrastructure may disconnect the virtual machines and physical data centers. This leads to the reduction in computational as well as communicational capabilities of the cloud. To overcome these issues, an integer linear programming model called hamiltonian graph analysis – mixed integer linear programming (HGA-MILP) is proposed in this work by utilizing hamiltonian graph model. The main motive of this research is to design a survivable data centre network mapping problem against physical link failures. Use of hamiltonian path methodology is helpful to organize data and improve network performance.
PAPR Reduction for O-OFDM UOWC System
Authors: Bai Jurong , Dai Hang , Zhao Feng , Yang Yi , Wang Yanben 
Published: July 2019

Abstract
In this paper, a combination of Tone Reservation-Signal to Clipping noise Ratio (TR-SCR) and Companding schemes is proposed for underwater wireless optical communication (UOWC), in order to solve the problem of high peak-to-average power ratio (PAPR) of underwater Optical-Orthogonal Frequency Division Multiplexing (O-OFDM) system. Two optical modulation schemes, namely Direct Current-biased Optical OFDM (DCO-OFDM) and Asymmetrically Clipped Optical OFDM (ACO-OFDM), are adopted separately to achieve intensity modulation/direct detection over the seawater channel, with a distance of 100 meters of wireless optical transition to obtain the system bit error rate (BER). In the TR-SCR scheme, only the maximum amplitude signal is selected to reduce the complexity of the algorithm. The LSA method is introduced in the TR-SCR scheme for iteratively updating the signal to speed up the convergence. Finally, with the combination of the Companding scheme, the PAPR performance is significantly improved. The PAPR of the underwater optical OFDM system is reduced to 3.85 dB with its BER still satisfying the UOWC system requirements.
Zielkonflikte und Fehlanreize: Eine Analyse der Anreizwirkungen im Schweizer Finanzausgleich
Authors: Leisibach Patrick , Schaltegger Christoph A. 
Published: July 2019

ZusammenfassungDer Finanzausgleich ist ein wichtiges Element im ausgeprägten Schweizer Steuerföderalismus. Die sich daraus ergebende Reduktion von Finanzkraftunterschieden steht jedoch im Konflikt mit wirksamen Anreizen zur Teilnahme am Steuerwettbewerb. Patrick Leisibach und Christoph A. Schaltegger quantifizieren in diesem Beitrag die systemimmanenten Anreizeffekte im Schweizer Finanzausgleichssystem mittels einer Berechnung der Grenzabschöpfungsquoten. Insbesondere finanzschwache Kantone haben im bestehenden System nur geringe Anreize, die eigenen Steuereinnahmen mittels attraktiver (Steuer-)Politik zu steigern. Die Steuermehreinnahmen infolge von neuen Unternehmensgewinnen vermögen bei zwei von drei Kantonen die Abschöpfung durch den Finanzausgleich nicht zu kompensieren. Deshalb ist es mehr als fraglich, ob das Ziel, die Disparitäten zwischen den Kantonen abzubauen, langfristig erreicht werden kann. Wie Simulationsrechnungen zeigen, können aktuelle Reformen das Problem mildern. Für eine weiterreichende Problemlösung wäre der aktuell progressive Ausgleichstarif durch einen linearen Tarif bei gleichzeitiger Absenkung der Mindestausstattung zu ersetzen. Da letzteres politisch wenig Sympathien genießt, erörtern die Autoren abschließend einen Alternativvorschlag.
GABAAReceptors Are Well Preserved in the Hippocampus of Aged Mice
Authors: Palpagama Thulani H. , Sagniez Mélanie , Kim SooHyun , Waldvogel Henry J. , Faull Richard L. , Kwakowsky Andrea 
Published: July 2019

AbstractGABA is the primary inhibitory neurotransmitter in the nervous system. GABAAreceptors (GABAARs) are pentameric ionotropic channels. Subunit composition of the receptors is associated with the affinity of GABA binding and its downstream inhibitory actions. Fluctuations in subunit expression levels with increasing age have been demonstrated in animal and human studies. However, our knowledge regarding the age-related hippocampal GABAAR expression changes is limited and based on rat studies. This study is the first analysis of the aging-related changes of the GABAAR subunit expression in the CA1, CA2/3, and dentate gyrus regions of the mouse hippocampus. Using Western blotting and immunohistochemistry we found that the GABAergic system is robust, with no significant age-related differences in GABAAR α1, α2, α3, α5, β3, and γ2 subunit expression level differences found between the young (6 months) and old (21 months) age groups in any of the hippocampal regions examined. However, we detected a localized decrease of α2 subunit expression around the soma, proximal dendrites, and in the axon initial segment of pyramidal cells in the CA1 and CA3 regions that is accompanied by a pronounced upregulation of the α2 subunit immunoreactivity in the neuropil of aged mice. In summary, GABAARs are well preserved in the mouse hippocampus during normal aging although GABAARs in the hippocampus are severely affected in age-related neurological disorders, including Alzheimer’s disease.
Clima organizacional y satisfacción del usuario externo en los servicios de hospitalización del Instituto Nacional de Salud del Niño, 2017
Authors: Fernández-Oliva Danitza , Revilla-Velásquez María E. , Kolevic-Roca Lenka A. , Cabrejos-Castilla Irma , Muchaypiña-Gallegos Isabel , Sayas-Avilés Iris , Chávez-Conde Lizeth , Mamani-Urrutia Víctor A. 
Published: July 2019

Introducción. El clima organizacional dentro de las instituciones de salud y la satisfacción del paciente se utilizan para evaluar y mejorar la calidad de los servicios de salud. Objetivo. Determinar el clima organizacional y la satisfacción del usuario externo sobre la atención medica recibida en los servicios de hospitalización del Instituto Nacional Salud del Niño (INSN). Métodos. En el año 2017 se aplicó una encuesta para calificar el clima organizacional a los trabajadores de los servicios de hospitalización del Departamento de Medicina del INSN. La satisfacción del usuario externo se midió mediante la encuesta SERVQUAL aplicada a los usuarios externos. Resultados. La calificación del clima organizacional fue de 76,3%, considerada como mejorable; y la satisfacción global del usuario externo fue de 64,4%. El clima organizacional en las dimensiones de identidad, comunicación organizacional y estructura lograron el calificativo de saludable y la dimensión remuneración obtuvo el calificativo de no saludable. La dimensión mejor valorada por los usuarios externos fue: ¿durante su hospitalización recibió visita médica todos los días?; y la menos valorada: ¿los trámites para el alta fueron rápidos?. Conclusión. La calificación global del clima organizacional fue de 76,3% y la satisfacción global del usuario externo fue de 64,4% en el INSN.
Entrenamiento muscular respiratorio en un paciente neurocrítico con ventilacion mecanica prolongada
Authors: Garcìa Adriana Monsalve , Astudillo Arias Lesly Yojana , Cruz Mosquera Freiser Eceomo 
Published: July 2019

La ventilación mecánica se instaura con frecuencia en los pacientes que ingresan a unidades de cuidados intensivos. A pesar de que su uso en la mayoría de los casos es transitorio, del 32% al 41% de los pacientes neurocríticos la requieren por periodos prologandos debido a diversas condiciones que dificultan el destete. En circunstancias en las que la causa de su prolongación es la debilidad muscular, tiene importancia el entrenamiento muscular inspiratorio, el cual puede contribuir al incremento de la fuerza muscular y facilitar el destete. El objetivo del presente reporte es describir el caso de un paciente de 65 años con hemorragia subaracnoidea Fisher III, ventilación mecánica prolongada, y dificultad para el destete en quien se implementó una estrategia de entrenamiento muscular respiratorio.
Adolescente con esclerosis múltiple de alta actividad
Authors: Huamaní Charles , Rojas Edgard 
Published: July 2019

La esclerosis múltiple (EM) es una enfermedad autoinmune del sistema nervioso central (SNC) que se puede presentar de formas muy variadas y progresa generando discapacidad. Menos del 5% de los casos son pediátricos, y aún menos frecuentes son los casos de EM de formas agresivas o de alta actividad. Presentamos el caso de un adolescente de 13 años que en seis meses tuvo tres brotes, cada vez más agresivos, con una alta carga de lesión evidenciada en la resonancia magnética y rápida progresión de su discapacidad. Discutimos la aproximación diagnóstica de la EM en la edad pediátrica, su forma de presentación y la valoración de formas de EM con alta actividad.
Migración intracraneal de aceite de silicona a través del nervio óptico post-vitrectomía
Authors: Quispe Huachaca Jhonathan Percy , Victorio Avila Cesar Antonio , Padilla Flores Juan Roberto 
Published: July 2019

La migración intracraneal del aceite de silicona intraocular es una complicación rara en el tratamiento de las complicaciones de la retinopatía diabética. Se han postulado varios posibles mecanismos etiopatogénicos para explicar este fenómeno de migración. El aceite de silicona se presenta hiperdenso en la tomografía, siendo un desafío distinguirlo de la hemorragia subaracnoidea, resaltando la utilidad de la resonancia magnética. En pacientes con evidencia de retinopexia de silicona previa, la visualización de una lesión intraventricular con un artefacto de desplazamiento químico asociado aumenta la posibilidad de que se trate de una migración del aceite de silicona. Presentamos el caso de un paciente con antecedente de retinopexia con aceite de silicona y cefalea intensa, identificándose migración del aceite de silicona al sistema ventricular con estudios de tomografía y resonancia.