bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of Echocardiography in Low Birth Weight Infants With Congenital Heart Disease
Authors: Dorfman Adam L. , Levine Jami C. , Colan Steven D. , Geva Tal 
Published: January 2017

Objective. Echocardiography has been shown to be highly accurate in infants and children, but its accuracy has not been studied in detail in low birth weight (LBW) infants with structural congenital heart disease (CHD). This study was undertaken to examine the diagnostic accuracy of echocardiography in the evaluation of CHD in these infants.
Methods. All echocardiograms performed between 1995 and 2000 on infants who had structural CHD and weighed ≤2.5 kg were reviewed (n = 251). Infants who weighed &gt;2.5 kg, matched for type of CHD, were control subjects (n = 319). The results of initial echocardiograms were compared for diagnostic accuracy with consensus diagnoses on the basis of all confirmatory data available. An observer who was blinded to patient group graded a sample of randomly selected echocardiograms (n = 100) for technical quality.
Results. There were 13 major diagnostic errors in the LBW infants (5.2%) and 6 in the control subjects (1.9%). There were 20 minor errors in the LBW group (8.0%) and 21 in the control subjects (6.6%). The technical quality scores of the 2 groups were not significantly different, but a higher proportion of the LBW studies were graded as “poor” or “borderline” quality, compared with the control subjects (40% vs 28%). The majority (54%) of major errors in the LBW infants could potentially be explained by alterations in blood flow secondary to pulmonary hypertension.
Conclusions. Although echocardiography is an accurate imaging modality in premature and LBW infants with structural CHD, the incidence of clinically important diagnostic errors is higher than in infants who weigh &gt;2.5 kg. As surgical and transcatheter interventions are extended to this population, heightened awareness of clinicians to pitfalls of echocardiography in this group of patients is warranted.
Pediatric Residency Education: Is Sports Medicine Getting Its Fair Share?
Authors: Demorest Rebecca A. , Bernhardt David T. , Best Thomas M. , Landry Gregory L. 
Published: January 2017

Introduction. Sports are the leading injury-related cause for pediatric primary care visits. Pediatric residency education guidelines suggest incorporating sports medicine (SM) education into curricula; however, research is lacking regarding effective teaching methods.
Objective. To assess reported US pediatric residency SM curricula, teaching methods, and resident evaluation of SM education.
Design/Methods. Chief residents (CRs) and third-year residents (PL3s) from 100 randomly selected US Accreditation Council for Graduate Medical Education–accredited residency programs, stratified by size and geographic location, received surveys regarding programs' SM curriculum and teaching methods and individuals' methods for learning SM.
Results. Response rates were 63% and 39% for CRs and PL3s, respectively. According to CRs, 34% of programs had no one in charge of their SM curriculum. Lecture (77%) was the primary method used for teaching SM. Hands-on teaching (37%) was used less frequently. CRs stated that 29% of programs did not include musculoskeletal examination teaching in their curriculums; 24% did not include formal teaching of concussion management, and 29% did not include reasons for medical disqualification. PL3s rated teaching of joint examinations and the preparticipation physical as the most poorly taught components of the physical examination. PL3s rated hands-on teaching and patient experience as the best methods for improving SM education. CRs reported that only 36% of programs have discussed incorporating more SM into their curriculum.
Conclusions. SM education is deficient in US pediatric residency programs. Standardized curricula should be developed with a focus on hands-on training as a means for teaching SM to pediatric residents.
Emergency Department Allies: A Web-Based Multihospital Pediatric Asthma Tracking System
Authors: Kelly Kevin J. , Walsh-Kelly Christine M. , Christenson Peter , Rogalinski Steven , Gorelick Marc H. , Barthell Edward N. , Grabowski Laura 
Published: January 2017

OBJECTIVE. To describe the development of a Web-based multihospital pediatric asthma tracking system and present results from the initial 18-month implementation of patient tracking experience.
DESIGN. The Emergency Department (ED) Allies tracking system is a secure, password-protected data repository. Use-case methodology served as the foundation for technical development, testing, and implementation. Seventy-seven data elements addressing sociodemographics, wheezing history, quality of life, triggers, and ED managment were included for each subject visit.
SETTING. The ED Allies partners comprised 1 academic pediatric ED and 5 community EDs.
POPULATION. Subjects with a physician diagnosis of asthma who presented to the ED for acute respiratory complaints composed the asthma group; subjects lacking a physician diagnosis of asthma but presenting with wheezing composed the wheezing group.
RESULTS. The tracking-system development and implementation process included identification of data elements, system database and use case development, and delineation of screen features, system users, reporting functions, and help screens. For the asthma group, 2005 subjects with physician-diagnosed asthma were enrolled between July 15, 2002 and January 14, 2004. These subjects accounted for 2978 visits; 10.4% had ≥3 visits. Persistent asthma was noted in 68% of the subjects. During the same time period, 1297 wheezing subjects with a total of 1628 ED visits (wheezing group) were entered into the tracking system. After enrollment, 57% of the subjects with ≥1 subsequent ED visits received a physician diagnosis of asthma.
CONCLUSIONS. Our sophisticated tracking system facilitated data collection and identified key intervention opportunities for a diverse ED wheezing population. A significant asthma burden was identified with significant rates of hospitalization, acute care visits and persistent asthma in 68% of subjects. The surveillance component provided important insights into health care issues of both asthmatic subjects and wheezing subjects, many of whom subsequently were diagnosed with asthma.
Improving Pediatric Asthma Care Through Surveillance: The Illinois Emergency Department Asthma Collaborative
Authors: Lenhardt Richard O. , Catrambone Catherine D. , McDermott Michael F. , Walter James , Williams Seymour G. , Weiss Kevin B. 
Published: January 2017

OBJECTIVES. To better understand and improve the care of asthma patients who require emergency department (ED) care, the Illinois Emergency Department Asthma Collaborative (IEDAC) was created to develop, test, and disseminate an ED-based surveillance system. This report describes the development and testing of the pediatric IEDAC surveillance instruments and demonstrates how these instruments can be used to describe the health status, healthcare delivery, and outcome of children using ED services.
METHODS. A convenience sample of 128 children presenting to 5 EDs in Illinois for asthma care was the study base. Data were collected on monthly samples of children aged 2 through 17 years who presented to these EDs from May to November 2003. Three instruments were used to collect data regarding the children’s pre-ED, ED, and post-ED experience.
RESULTS. At the ED visit, 73.4% of children met national guideline criteria for persistent-level asthma symptoms. Among this group, 53.2% were using inhaled corticosteroid (ICS) medications. At 1 month follow-up, 66.6% of the children met the criteria for persistent-level asthma symptoms, which was statistically unchanged from the ED visit. Among the latter group, 64.2% were using ICS medications, again statistically unchanged compared with the ED visit. At follow-up, 24.5% of children were reported to have returned to an ED or were subsequently hospitalized. The majority of children were noted at follow-up to have limitation of at least some activity.
CONCLUSIONS. Children who presented to IEDAC EDs were found to have a high level of asthma burden that continued at follow-up despite treatment. Moreover, a substantial proportion of children had returned to an ED or were subsequently hospitalized. Encouraging trends in medication use were observed, although suboptimal medication use was also observed.
California's Experience Implementing a Pilot Newborn Supplemental Screening Program Using Tandem Mass Spectrometry
Authors: Feuchtbaum Lisa , Lorey Fred , Faulkner Lisa , Sherwin John , Currier Robert , Bhandal Ajit , Cunningham George 
Published: January 2017

OBJECTIVE. In response to a California legislative mandate, a pilot tandem mass spectrometry (MS/MS) screening program was undertaken by the Genetic Disease Branch of the California Department of Health Services between January 2002 and June 2003. This article outlines the Genetic Disease Branch approach to implementing the MS/MS pilot program and the program evaluation strategies used.
METHODS. Through the use of multiple data collection methods, we were able to describe hospital participation patterns, screening test uptake, screening test performance, follow-up services utilization, and provider and family satisfaction with the educational materials and follow-up services provided.
RESULTS. During the 18-month pilot program, just more than one half of California's 755698 newborns were offered MS/MS screening; among this group, 90% of parents chose to have their newborns screened. Fifty-one newborns were identified with MS/MS-detectable disorders, among 461 patients referred for follow-up testing (0.13% of the screened population). One disorder was diagnosed successfully for every 6939 newborns screened and for every 9 infants referred (excluding phenylketonuria). The overall California population prevalence of MS/MS-detectable disorders was 1 case per 6500 infants (excluding phenylketonuria). The positive predictive value for medium-chain acyl-CoA dehydrogenase deficiency was 86.7%, whereas the positive predictive value for short-chain acyl-CoA dehydrogenase deficiency was 21.6%. For a sample from Hawaii, 1 isovaleric aciduria case was detected among 6132 newborns.
CONCLUSIONS. Evaluation of the California MS/MS screening pilot program demonstrated that this technology was effective in identifying additional metabolic disorders. The positive predictive value of screening was particularly good for medium-chain acyl-CoA dehydrogenase deficiency. Overall, patient referral rates were very acceptable. The utility of the program was also demonstrated by positive reviews from patients and providers.
Children’s Hospital Characteristics and Readmission Metrics
Authors: Auger Katherine A. , Teufel Ronald J. , Harris J. Mitchell , Gay James C. , Del Beccaro Mark A. , Neuman Mark I. , Tejedor-Sojo Javier , Agrawal Rishi K. , Morse Rustin B. , Eghtesady Pirooz , Simon Harold K. , McClead Richard E. , Fieldston Evan S. , Shah Samir S. 
Published: January 2017

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

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

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

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

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

Este ensaio propõe atuar com as forças artísticas de um currículo a partir dos trabalhos de Sophie Calle e Georges Perec. De modo a embaralhar arte e vida, ambos os autores se prestam a um movimento de reduções, de subtrações a partir de um minimalismo brutal e de uma simplicidade crua. Nesta medida, tomada por ideias oulipianas e, em meio ao pensamento de Bachelard, busca-se um currículo poeticamente inventariado, suspendendo as definições, as verdades, os julgamentos, os quadros de referência, as atitudes pré-formatadas. Trata-se de um exercício que deseja portar um falar de coisas comuns do cotidiano, do trivial e por vezes evidente, mas que, no entanto, raramente recebe nossa atenção. Assim, mais do que qualquer outra coisa, pretende-se pensar em um currículo que se efetuaria no encontro com diferenças tornadas visíveis, produzidas a partir de impressões sensíveis que se repetem singularmente a cada experiência.Palavras-Chave: Diferença. Currículo. Bachelard. Sophie Calle. Georges Perec.POETIC CREATION AND CURRICULUM OF DIFFERENCEAbstract: This paper aims to propose an action with the artistic forces of a curriculum by considering artistic works by Sophie Calle and Georges Perec. By intertwining art and life, both authors lend themselves to a movement of reductions, subtractions through brutal minimalism and crude simplicity. In this sense, amidst Oulipian ideas and Bachelard’s thought, it attempts to act with a poetically inventoried curriculum, by suspending definitions, truths, judgments, reference frames, pre-formed attitudes. It is an exercise intended to trigger the talk about ordinary, trivial, sometimes evident daily things that seldom draw our attention. Thus, more than anything, it aims to think about a curriculum that would be real in the encounter with differences that have become visible, produced from sensitive impressions that have been singularly repeated in every experience.Keywords: Difference. Curriculum.Bachelard. Sophie Calle. Georges Perec.CREACIÓN POÉTICA Y CURRÍCULO DE LA DIFERENCIAResumen: Este ensayo propone actuar con las fuerzas artísticas de un currículo a partir de los trabajos de Sophie Calle y Georges Perec. De manera a confundir arte y vida ambos los autores se prestan a un movimiento de reducciones, de sustracciones a partir de un minimalismo brutal y de una cruda simplicidad. En esta medida, tomada por ideas oulipianas y por el pensamiento de Bachelard, se busca un currículo poéticamente inventariado, que suspende definiciones, verdades, juzgamientos, los cuadros de referencia, las actitudes preformateadas. Se trata de un ejercicio que desea portar el hablar de las cosas comunes de lo cotidiano, de lo trivial y a veces evidente, pero, aún, raramente recibe nuestra atención. Así, más que otra cosa, se pretende pensar en un currículo que se efectuaría en los encuentros con diferencias tornadas visibles, producidas a partir de impresiones sensibles que se repiten singularmente a cada experiencia.Palabras-Clave: Diferencia. Currículo. Bachelard. Sophie Calle. Georges Perec.
Traffic model for the interconnection of networks and operators using MPLS-TE
Authors: Restrepo Carlos Mario , Salcedo-Parra Octavio José , Sánchez-Céspedes Juan Manuel 
Published: January 2017

In this paper, the main features of MPLS Traffic Engineering are presented to illustrate how telecommunication service providers use them to create interconnections between each other in order to offer telecom services satisfying QoS commitments. Based on previous traffic models, a new model, which deals with traffic queue balancing for different Classes of Service, and for a provider using another provider´s network is presented. The model output shows that carrying another operator’s traffic may increase delays in an undesirable manner, forcing the carrier to increase the serving rate of LSRs until Utilization is below 60 %. In order to validate the model, a number of network scenarios are implemented in the Wolfram Mathematica 10.1 Study Version, based on study case configurations of an MPLS network. The total global model is useful for future implementation of test-beds of interconnected providers under an MPLS environment.
Computational simulation of concentration by osmotic evaporation of passion fruit juice (Passiflora edullis)
Authors: Forero-Longas Freddy , Pulido-Díaz Adriana Patricia , Pedroza-Berrio Kelly Johana 
Published: January 2017

This study aimed at implementing a comprehensive strategy for the multiphysics simulation of the osmotic evaporation process applied in the concentration of passion fruit juice. The phenomena of mass and momentum transfer were analyzed in Comsol® and Matlab®, using a two-dimensional axial geometry as a simplification of the membrane module. Computer simulations were validated through comparisons with experimental data obtained from osmotic evaporation of passion fruit juice previously ultrafiltrated. The juice was concentrated to 52.25 ± 0.36 (°Brix) of soluble solids, reaching a final flux of 0.63 (kg/m2h) after 6 hours. The concentrate retained the organoleptic and physicochemical quality characteristics of the original juice when it was reconstituted in water. The models and simulations developed can be used to describe, analyze, and efficiently improve the osmotic evaporation process applied to the concentration of juices.
A memetic algorithm for minimizing the makespan in the Job Shop Scheduling problem
Authors: Lamos-Díaz Henry , Aguilar-Imitola Karin , Pérez-Díaz Yuleiny Tatiana , Galván-Núñez Silvia 
Published: January 2017

The Job Shop Scheduling Problem (JSP) is a combinatorial optimization problem cataloged as type NP-Hard. To solve this problem, several heuristics and metaheuristics have been used. In order to minimize the makespan, we propose a Memetic Algorithm (MA), which combines the exploration of the search space by a Genetic Algorithm (GA), and the exploitation of the solutions using a local search based on the neighborhood structure of Nowicki and Smutnicki. The genetic strategy uses an operation-based representation that allows generating feasible schedules, and a selection probability of the best individuals that are crossed using the JOX operator. The results of the implementation show that the algorithm is competitive with other approaches proposed in the literature.
A software pilot application to calculate the parameters involved in subsidiaries interconnection based on FSO technology
Authors: Salamanca Jorge Enrique , López-Sarmiento Danilo Alfonso , Gallego-Torres Adriana Patricia 
Published: January 2017

Free Space Optics (FSO) technology transmits information using free space optical signals similar to those that travel through optical fibers. The capacity of FSO to connect buildings close together is covered in this paper. Four optical wireless links between three buildings of a fictitious company, considering a building that obstructs the sight line between two of them, are designed here. As part of the design process, several issues such as distance between the equipment, weather conditions, some features of the FSO equipment, and system losses were addressed; moreover, an application that performs the calculations and displays the results of the most important aspects in the design was implemented. The importance of such links is given by their flexibility, low implementation costs, mobility, rapid deployment, high throughput, great bandwidth, reliability, and high security level due to their operating principles, among others; therefore, this type of links are an ideal option to implement a backbone for the proposed network.