bluuebunny/crossref_metadata_2025_split huggingface dataset:
RSV Hospitalizations in Comparison With Regional RSV Activity and Inpatient Palivizumab Administration, 2010–2013
Authors: Glick Alexander F. , Kjelleren Stephanie , Hofstetter Annika M. , Subramony Anupama 
Published: May 2017

OBJECTIVES:
To compare pediatric respiratory syncytial virus (RSV) hospitalizations in the United States to regional RSV activity and inpatient palivizumab administration.

METHODS:
We characterized inpatients, excluding newborns, with RSV from the Pediatric Health Information System (July 2010–June 2013). RSV regional activity timing was defined by the National Respiratory and Enteric Virus Surveillance System. RSV hospitalization season (defined by at least 3 SDs more than the mean regional baseline number of RSV hospitalizations for 3 consecutive weeks) was compared with RSV regional activity season (2 consecutive weeks with ≥10% RSV-positive testing). Logistic regression was used to determine predictors of hospitalization timing (ie, during or outside of regional activity season). We also assessed the timing of inpatient palivizumab administration.

RESULTS:
There were 50 157 RSV hospitalizations. Mean RSV hospitalization season onset (early November) was 3.3 (SD 2.1) weeks before regional activity season onset (early December). Hospitalization season offset (early May) was 4.4 (SD 2.4) weeks after activity season offset (mid-April). RSV hospitalization and activity seasons lasted 18 to 32 and 13 to 23 weeks, respectively. Nearly 10% of hospitalizations occurred outside of regional activity season (regional ranges: 5.6%–22.4%). Children with chronic conditions were more likely to be hospitalized after regional activity season, whereas African American children were more likely to be hospitalized before. Inpatient palivizumab dosing was typically initiated before the start of RSV hospitalizations.

CONCLUSIONS:
There is regional variation in RSV hospitalization and activity patterns. Many RSV hospitalizations occur before regional activity season; high-risk infants may require RSV immunoprophylaxis sooner.
Hyponatremia and Hypotonic Intravenous Fluids Are Associated With Unfavorable Outcomes of Bronchiolitis Admissions
Authors: Shein Steven L. , Slain Katherine , Martinez Schlurmann Natalia , Speicher Richard , Rotta Alexandre T. 
Published: May 2017

OBJECTIVES:Hyponatremia has been associated with unfavorable outcomes when present at admission in children with bronchiolitis. Delayed hyponatremia may be a modifiable risk factor for severe disease that is influenced by intravenous fluid (IVF) tonicity. We hypothesized that both hyponatremia and prescription of severely hypotonic IVF are associated with unfavorable outcomes, and that prescription of severely hypotonic IVF is associated with subsequent hyponatremia.METHODS:Data were retrospectively extracted for 1557 pediatric inpatients with bronchiolitis. Any day on which a subject was prescribed IVF with sodium &lt;70 mEq/L was termed “IVF &lt;70.” All other days on which IVF was prescribed were termed “IVF ≥70.” Any blood sodium ≤135 mEq/L defined hyponatremia for that day. All other days with sodium available were labeled normonatremia. Variables were compared with Spearman correlation, Wilcoxon rank test, or χ2. Significant results had P &lt; .05.RESULTS:Blood sodium levels correlated negatively with hospital length of stay (r = −0.477, P &lt; .0001). On each of the first 4 days of hospitalization, significantly increased hospital length of stay was observed in patients with hyponatremia (n = 134 [25.7% of subjects with available sodium data]) versus patients with normonatremia (n = 387 [74.3%]), and in patients prescribed IVF &lt;70 (n = 348 [46.3% of subjects prescribed IVF]) versus patients prescribed IVF ≥70 (n = 403 [53.7%]). Patients prescribed IVF &lt;70 had increased rates of hyponatremia on the subsequent day versus patients prescribed IVF ≥70 (50.0% vs 26.9%, P &lt; .001).CONCLUSIONS:In children hospitalized with bronchiolitis, hyponatremia may be a modifiable risk factor for severe disease that may be mitigated by avoiding use of severely hypotonic IVF.
Mental Health Services Utilization and Expenditures Among Children Enrolled in Employer-Sponsored Health Plans
Authors: Walter Angela Wangari , Yuan Yiyang , Cabral Howard J. 
Published: May 2017

BACKGROUND AND OBJECTIVES:
Mental illness in children increases the risk of developing mental health disorders in adulthood, and reduces physical and emotional well-being across the life course. The Mental Health Parity and Addiction Equity Act (MHPAEA, 2008) aimed to improve access to mental health treatment by requiring employer-sponsored health plans to include insurance coverage for behavioral health services.

METHODS:
Investigators used IBM Watson/Truven Analytics MarketScan claims data (2007–2013) to examine: (1) the distribution of mental illness; (2) trends in utilization and out-of-pocket expenditures; and (3) the overall effect of the MHPAEA on mental health services utilization and out-of-pocket expenditures among privately-insured children aged 3 to 17 with mental health disorders. Multivariate Poisson regression and linear regression modeling techniques were used.

RESULTS:
Mental health services use for outpatient behavioral health therapy (BHT) was higher in the years after the implementation of the MHPAEA (2010–2013). Specifically, before the MHPAEA implementation, the annual total visits for BHT provided by mental health physicians were 17.1% lower and 2.5% lower for BHT by mental health professionals, compared to years when MHPAEA was in effect. Children covered by consumer-driven and high-deductible plans had significantly higher out-of-pocket expenditures for BHT compared to those enrolled PPOs.

CONCLUSIONS:
Our findings demonstrate increased mental health services use and higher out-of-pocket costs per outpatient visit after implementation of the MHPAEA. As consumer-driven and high-deductible health plans continue to grow, enrollees need to be cognizant of the impact of health insurance benefit designs on health services offered in these plans.
Refining Our Understanding of Value-Based Insurance Design and High Cost Sharing on Children
Authors: Ellis Randall P. , Bachman Sara S. , Tan Hui Ren 
Published: May 2017

BACKGROUND:There is significant concern about the financial burdens of new insurance plan designs on families, particularly families with children and youth with special health care needs (CYSHCN). With value-based insurance design (VBID) plans growing in popularity, this study examined the implications of selected VBID cost-sharing features on children.METHODS:We studied children’s health care spending patterns in 2 data sets that include high deductible and narrow network plans among others. Medical Expenditure Panel Survey data from 2007 to 2013 on 22 392 children were used to study out-of-pocket (OOP) costs according to CYSHCN, family income, and spending. MarketScan large employer insurance claims data from 2007 to 2014 (N = 4 263 452) were used to test for differences in mean total payments and OOP costs across various health plans.RESULTS:Across the data sets, we found that existing health plans place significant financial burdens on families, particularly lower income households and families with CYSHCN; individuals among the top 10% of OOP spending averaged more than $2000 per child. Although high deductible and consumer-driven plans impose substantial OOP costs on children, they do not significantly reduce spending, whereas health maintenance organizations that use network restrictions and tighter management do.CONCLUSIONS:Our results do not support the conclusion that high cost-sharing features that are common in VBID plans will significantly reduce health care spending on children.
Influence of salt level, starter culture, fermentable carbohydrates, and temperature on the behaviour of L. monocytogenes in sliced chouriço during storage
Authors: García-Díez J. , Patarata L. 
Published: April 2017

Sliced ready-to-eat traditional meat products presented in individual packaging with more convenience to the consumer is the way that food industry tries to adapt to the new consumer tendencies.
The current work assessed the survival of Listeria monocytogenes in a contaminated sliced vacuum packed chouriço with different sugar concentrations, two salt levels, and presence/absence of Lactobacillus sakei as starter culture along the storage period at two temperatures (8 °C and 22 °C). Neither the inoculation with L. sakei, nor the addition of carbohydrates influenced the survival of the pathogen. Higher amount of salt resulted in a significant reduction of L. monocytogenes, and storage at the higher temperature displayed a safer product. After 7 days, L. monocytogenes was not detected in any samples. The study of the association of the factors contributing for L. monocytogenes survival by logistic regression showed that increasing the level of salt addition from 1.5% to 3% reduces the odds of survival of L. monocytogenes to about one fifth (0.174). Worthy of attention is the significant reduction in the odds (OR=0.028) of finding viable L. monocytogenes when the samples are stored at room temperature (22 °C), when compared to low temperature (8 °C).
The general and indiscriminate use of refrigeration for meat products might increase the risk of presence of L. monocytogenes. The competitive advantage that L. monocytogenes has at low temperatures, as the potential inhibition of LAB activity, is probably the reason of the observed behaviour. The amount of salt was an important hurdle to control L. monocytogenes growth, so, manufacturing meat products with lower salt contents to meet the demands of healthy products might represent a risk for safety, since high levels of salt together with low aw are the keys for their conservation.
Efforts to Enhance the TVET Teachers Competencies through Apprenticeship Approach Pattern in Industry
Authors: Ratnata I Wayan 
Published: April 2017

Facing ACFTA (ASEAN - China Free Trade Area) in 2015 (ASEAN 2012), nations in the region must be ready with variety of challenges that will occur. In this paper will be focusing how to prepare vocational teachers who will teach in vocational education in order to produce skilled graduates are ready for work and appropriate to the demands of the world of company or industry. Up to now, the existence of vocational teacher education in the region ASEAN-China (RCP:2012) need to be improved, primarily in teaching learning process and need to have enough experience in company or industry. Indonesia is one of the member of the ASEAN’s Countries still experiences difficulty to improve vocational teachers’ education in order to be ready to teach. The most difficult in preparing of vocational teacher education is in terms of their skill. This study was using case study method, in which data collected through interview in depth to students in Department of Electrical Engineering Education, Faculty of Vocational and Technology Education, Universitas Pendidikan Indonesia. According to the questionnaire done to vocational teachers, students who are doing teaching practice in vocational school, can be concluded that enhancing the quality of vocational teacher education cannot just be provided through theory and should also be provided chance students doing apprenticeship in the world of industry or workplace. In this regard, seemingly it is necessary to have a breakthrough for increasing the students competencies in order fresh graduates are ready for work.
PENDEKATAN INKUIRI-KONTEKSTUAL BERBASIS TEKNOLOGI INFORMASI UNTUK MENINGKATKAN KETERAMPILAN BERFIKIR KRITIS MAHASISWA
Authors: Mahmudatusaadah Ai 
Published: April 2017

Food additive is one of the topics included in the food chemistry course. Despite its benefits which are directly related to everyday life applications, it is common knowledge that the chemistry is one of the subjects that are difficult to understand for its abstraction. Students’ average mastery of food chemistry is below 60%. The study found that information technology-based contextual inquiry approach to topic of food additives can improve students’ critical thinking skills. Increase in scores from pretest to posttest is experienced by all samples with different N-Gain values. The majority (59%) is in medium category, 20% in high category and a fraction (11%) is in low category. Information technology-based contextual inquiry approach to the topic of food additives makes students more active and increases learning enthusiasm
PENGARUH MOTIVASI BERPRESTASI TERHADAP KESIAPAN BELAJAR, PELAKSANAAN PRAKERIN DAN PENCAPAIAN KOMPETENSI MATA PELAJARAN PRODUKTIF
Authors: Fatchurrohman Rudy 
Published: April 2017

This study aims to define the factors that influence the achievement of productive subjects competence in TKR (Light Vehicle Engineering), describe the achievement motivation, learning readiness, and Prakerin or OJT (On Job Training) implementation in connection with the achievement of productive subjects, to determine the effect of achievement motivation on learning readiness and OJT implementation, and to determine the effect of learning readiness and OJT implementation on the competence achievement of productive TKR subjects. The calculation results of correlation and coefficient of determination show that achievement motivation correlates to learning readiness by 0,875, and to OJT implementation by 0,678. Learning readiness correlates to competence achievement of productive subjects by 0,392; OJT implementation correlates to the competence achievement of productive subjects by 0,381; while learning readiness and OJT implementation are correlated by 0,418. The study concludes that there is a significant correlation between achievement motivation, learning readiness and OJT implementation, and therefore there is a need to enhance students’ motivation, especially achievement motivation, so that students’ can have better level of learning readiness and OJT implementation
PENGGUNAAN METODE PECS (Picture Exchange Communication System) UNTUK MENINGKATKAN KEMAMPUAN KOMUNIKASI ANAK AUTIS
Authors: Heryati Euis , RA Riksma Nurahmi , Ratnengsih Een 
Published: April 2017

Qualitative disorders of communication are one of the characteristics possessed by children with autism. In children with autism occurred late speech development and the child is trying to communicate nonverbally. In this study tested method of Pecs (Picture Exchange Communication System) is an approach that can be used as an alternative to training communication autistic children. This method adjusts the communication characteristics and uniqueness of children with autism. This research aims to develop an approach to improve the communication skills of children with autism before and after the intervention and the extent of influence methods of Pecs in improving the communication skills of children with autism. The subjects were two autistic children who experience barriers to communication. The method used is an experimental method with the approach of Single Subject Research design A-B-A. The results showed that the mean level of capability to the subject 1 in the communication capabilities at baseline-A (A-1) of 4.7 in the intervention phase obtaining the mean level of 6.5, while the baseline phase-2 (A-2) after a given intervention get the mean level of 10. the early ability subject 2 in communication skills at baseline-A (A-1) of 5.7 in the intervention phase obtaining the mean level of 7.63, whereas the baseline phase-2 (A-2) after being given intervention to get the mean level of 11. the results of the study the two subjects above results in improved communication skills of children with autism in both subjects. Keywords : Communication Skills, Autistic, Pecs ( Picture Exchange Communication System)
Management of the ruptured sinus of valsalva aneurysmsa
Authors: Gupta Manju , Shoeb Mohd , Mishra Pankaj Kumar , Bathla Amit , Prasad Jagdish 
Published: May 2017

Background: RSOV is associated with a dramatic onset of symptoms to a state of biventricular failure due to sudden volume overload. Controversies exist about RSOV repairs among various centers are the surgical approach (chamber involved, transaortic or both) and the closure technique (primary/ patch closure). There have been no clinical trials to show that one technique is superior to other. In the present study, we reviewed our 16 years’ experience with repair of RSOV through exclusive transaortic approach.Methods: 40 patients underwent RSOV repair through transaortic approach from January 2000 to December 2016. The mean age was 30.2 years. The origin of RSOV was right coronary sinus in 75% of cases and non-coronary sinus in 22.5% of cases. There was one giant calcified unruptured aneurysm arising from right coronary sinus. Right ventricle was most common chamber of rupture comprising 96.67% cases. All patients underwent transaortic repair of RSOV using dacron patch. VSD repair was done in 25% cases. Aortic valve replacement was done in 62.5% cases for moderate to severe AR.Results: There were 7.5% in hospital deaths with no late deaths. Inotropic and ventilatory support required for 3±1.6 days and 1.8±1.2 days respectively. The mean ICU stay and hospital stay was 3.5±1.6 days and 7.5±2.5 days respectively. None of the patient required permanent pacemaker implantation. The 37 survivors were followed up for 6.4±3.6 years; all had an improvement in functional NYHA class with superior results in those with no aortic regurgitation. 7.5% patients developed mild AR during follow up which medical management was done.Conclusions: Surgical treatment of ruptured sinus of Valsalva aneurysm using the transaortic patch technique has an acceptably low operative risk, lesser distortion of aortic valve and good long-term symptom-freedom survival. An early aggressive approach is recommended to prevent worsening of symptoms and more extensive disease.
Diagnostic hysteroscopy in abnormal uterine bleeding: a five years study in Kathmandu university hospital
Authors: Shrestha Abha , Kayastha Bhagirathi , Makaju Ramesh 
Published: April 2017

<p class="abstract"><strong>Background:</strong> Abnormal uterine bleeding is the cause of concern, inconvenience and discomfort to many ladies, this affects millions of women in both developed and developing world. Until recent times, dilatation and curettage was the usual method of evaluation .This detects the cause of bleeding in less than 50% of the cases, but hysteroscopy is a better diagnostic modality and prompt treatment can be provided in the same setting.</p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A prospective study was carried out in the Department of Obstetrics and Gynecology at Dhulikhel hospital, Kathmandu University Hospital, Kavre, Nepal from January 2010 to January 2016. Two hundred and eighteen cases were enrolled in this study. Patients with abnormal uterine bleeding above the age of 18 years were enrolled. Hysteroscopic examination was done in all patients after the pregnancy was ruled out with urine pregnancy test and ultrasonology. The patients then underwent hysteroscopic guided endometrial sampling and endometrium was sent for histopathologic examination. The correlation between findings on hysteroscopy and histopathologic examination was tabulated. </span><span lang="EN-IN"> </span></p><p class="abstract"><strong>Results:</strong> Following were the findings on hysteroscopy: proliferative endometrium was in 59%, secretary endometrium was in 14%,endometrial hyperplasia in 12%, atrophic in 2 %, endometrial polyp in 7%, submucous myoma in 5% and carcinoma of endometrium in 1%.</p><p class="abstract"><strong>Conclusions:</strong> In patients with abnormal uterine bleeding, hysteroscopy provides more accurate diagnosis than dilatation and curettage<span lang="EN-IN">. </span></p>
Allergic contact stomatitis masquerading as apthous stomatitis: a case report
Authors: Sharma Shivani , N. Rakesh , Sharma Shweta 
Published: April 2017

<p class="abstract">Allergic contact stomatitis is a rare disorder, which most clinicians are not familiar with. These lesions may be indistinguishable clinically and histopathologically from various other lesions. We present a case of a young female who visited us with a complaint of painful ulcers over her tongue for the past 5 days. After a thorough history and clinical examination, a provisional diagnosis of apthous stomatitis was made and treated accordingly but with no relief. On carefully eliciting the history again, the patient confirmed using a new herbal toothpaste. The patient was advised topical corticosteriods and to avoid the new toothpaste. All the lesions healed completely in a week<span lang="EN-IN">. </span></p>
Aliskiren reduces albuminuria after kidney transplantation
Authors: Tylicki Leszek , Debska-Slizien Alicja M. , Lizakowski Slawomir , Przybylska Milena , Heleniak Zbigniew , Renke Marcin , Chamienia Andrzej L. , Biedunkiewicz Bogdan , Rutkowski Przemyslaw , Małgorzewicz Sylwia , Rutkowski Boleslaw 
Published: April 2017

Background: The renoprotective effects of agents inhibiting the renin-angiotensin system in renal transplant recipients have been supposed but not finally proven. We performed a double-blind, placebo and losartan controlled, cross-over study to evaluate the influence of aliskiren, direct renin inhibitor on albuminuria and other surrogate markers of kidney injury in patients after renal transplantation. The safety of this therapy was also evaluated. Method: 16 of 18 patients (12M, 4F), 48.3 ± 9.0 years, 57.7 ± 9.1 months after kidney transplantation, with hypertension and stable serum creatinine 1.4±0.08 without proteinuria, completed the protocol. Each patient underwent two 8-week treatment periods (one with aliskiren 150 mg and one with losartan 50 mg) in random order, allowing an 8-week placebo washout between them. Results: Aliskiren decreased 24h systolic and 24h diastolic blood pressure as compared to placebo (post hoc: p=0.009 and p=0.003). Aliskiren decreased albuminuria more effectively than placebo as well (post hoc: p=0.032). There were no differences between aliskiren and losartan in these regards. The influence of aliskiren on N-acetyl-β-D-glucosaminidase, transforming growth factor β-1 and 15-F2t-isoprostanes urine excretions was not significant. Serum potassium, creatinine, eGFR and trough blood cyclosporine or tacrolimus level were unaffected. A significant but not clinically relevant decrease in haemoglobin level after aliskiren was observed. Conclusion: Aliskiren decreases albuminuria in renal transplant recipients with clinically minimal side effects.
The Effects of Light Color on Seed Germination of Markhamia stipulata (Wall.) Seem
Authors: Rahmawati Sri Ulie , Rachmadiyanto Arief Noor 
Published: May 2017

<p class="Els-body-text"><em>Markhamia stipulata </em>(Wall.) Seem. (Bignoniaceae) is one of collections in Bogor Botanical Garden that potential as a medicine. Information about germination of these species were not known yet. This research was aimed to examine the effect of light color on germination process of <em>Markhamia stipulata</em> (Wall.) Seem. The research method used a Randomized Complete Block Design (RCBD) that consist of three treatments (red light, far red light, dark) and one control (open air) with four replications for each group. Each group consist of 10 seeds. Precentage of seed germination; seedling height; cotyledon width; length, width and number of leaves were measured. The result showed that seed germination start at third day after sowing. Germination rate and germination rate coefficcient showed there is no significant difference between all treatments even though far red light showed highest number (100 %; 0.755). However, light color influence on seedling growth. Far red light showed affect on internodes distance. Dark light showed affect on leaves and cotyledon size. Red light and control showed similarity.</p><p> </p><div><p class="Els-keywords"><strong>Keywords:</strong> dark; far red light<em>, </em><em>Markhamia stipulata</em> (Wall.) Seem; red light; seed germination</p></div>