bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-effectiveness of Outpatient Management for Febrile Neutropenia in Children With Cancer
Authors: Teuffel Oliver , Amir Eitan , Alibhai Shabbir M. H. , Beyene Joseph , Sung Lillian 
Published: January 2011

OBJECTIVE:Inpatient management remains the standard of care for treatment of febrile neutropenia (FN) in children with cancer. Clinical data suggest, however, that outpatient management might be a safe and efficacious alternative for patients with low-risk FN episodes.METHODS:A cost-utility model was created to compare 4 treatment strategies for low-risk FN. The base case considered pediatric cancer patients with low-risk FN. The model used a health care payer's perspective and a time horizon of 1 FN episode. Four treatment strategies were evaluated: (1) entire treatment in hospital with intravenous antibiotics (HospIV); (2) early discharge consisting of 48 hours of inpatient observation with intravenous antibiotics followed by oral outpatient treatment (EarlyDC); (3) entirely outpatient management with intravenous antibiotics (HomeIV); and (4) entirely outpatient management with oral antibiotics (HomePO). Outcome measures were quality-adjusted FN episodes (QAFNEs), costs (Canadian dollars), and incremental cost-effectiveness ratios. Parameter uncertainty was assessed with probabilistic sensitivity analyses.RESULTS:The most cost-effective strategy was HomeIV. It was cost-saving ($2732 vs $2757) and more effective (0.66 vs 0.55 QAFNE) as compared with HomePO. EarlyDC was slightly more effective (0.68 QAFNE) but significantly more expensive ($5579) than HomeIV, which resulted in an unacceptably high incremental cost-effectiveness ratio of more than $130 000 per QAFNE. HospIV was the least cost-effective strategy because it was more expensive ($14 493) and less effective (0.65 QAFNE) than EarlyDC.CONCLUSION:The findings of this decision-analytic model indicate that the substantially higher costs of inpatient management cannot be justified on the basis of safety and efficacy considerations or patient/parent preferences.
Treatment of Variable Water Sources: Adaptations for a Flexible Desalination System
Authors: Chapman Michelle , Leitz Frank 
Published: January 2011

There are a number of locations where a utility would want to be able to treat multiple sources of water with one treatment system. Those that the Bureau of Reclamation (Reclamation) has come across recently are:The Texas Gulf Coast where brackish surface or groundwater is available for much of the year but only seawater is available during dry seasons;South central California where the character of the irrigation drainage water changes with the intensity of irrigation;Inland desert areas where the composition of brackish surface and groundwater is significantly different when augmented with storm water.
Reclamation assisted the US Office of Naval Research in development and demonstration of the Expeditionary Unit Water Purifier system which can produce 378 m3/day (100,000 gal/day) of potable water from any liquid source water up to 60 g/L TDS under 35°C. The system was tested under the Environmental Technology Validation (ETV) program overseen by NSF International for the US Environmental Protection Agency (EPA). Test water sources were seawater, turbid surface water, and tertiary wastewater. As a complete system, it performed well with each source. It was only capable of 50% recovery of water however. Because of this, the system has been turned down for potential emergency applications due to the excessive loss of water. This issue occurring at the same time as the three situations mentioned above prompted a proposal to design a flexible system that could be adapted to achieve high water recovery when the feed source allows while still maintaining the capability of recovering energy when the remaining concentrate pressure allows.
Septic Tank Effluent Treatment by Subsurface Horizontal Flow Wetland
Authors: Pandebesie Ellina S. , Arie Ni Wayan Budi 
Published: January 2011

Domestic wastewater treatment in Indonesia, mostly treat by using septic tanks. The use of septic tanks preferred by the public because of the design, construction, and maintenance are easy and more economical for the system of domestic wastewater disposal. Effluent from the septic tank still contains BOD about 100 mg /l, COD about 250 mg/l and TSS about 100 mg /l. This effluent is still dangerous to public health and is not fulfill wastewater effluent standards yet. If there is open space available, extended treatment of septic tank effluent can be done by field infiltration. This open space must suitable for infiltration without contaminating the ground water or well water. In urban areas with ground water level is high such as Surabaya, water infiltrate into the ground causing the problem. Problems that arise are due to pollution of ground water and surface water contaminated by effluent from the septic tank. Because of these problems, it would require an alternative treatment of septic tank effluent. Appropriate technology would be a simple, economical, easy in operation and maintenance. One of wastewater processing that can be applied to the septic tank effluent is a constructed wetland system.
Previous research carried out by using Cyperus papyrus plant with sand media in batch experiments showed satisfactory results. In this study, experiments conducted by using Cyperus papyrus plant with sand media with continuous flow in a horizontal subsurface flow wetland method. Wastewater flows with varying flow 90 ml /min and 180 ml /min. The objective of this research is to determine the ability of a horizontal subsurface flow wetland for treating septic tank effluent. The parameters analyzed were BOD and TSS. The results show the relation of organic loading rate with BOD removal efficiency. The highest organic loading rate of 0.051 kg BOD/m2.d on first day observations has BOD removal efficiency of 73.63% and the lowest organic loading rate of 0.029 kg BOD/m2.d with an efficiency of 70.82%. This shows that BOD removal efficiency is affected by organic loading rate. If BOD loading rate increase, it will decrease BOD removal efficiency. Organic loading rate recommended for domestic wastewater is 0.037-0.4 kg BOD5 /m2.d. Although in this study the organic loading rate exceeds the above recommendations, but efficiency is still good, above 70%.
Gender- and Poor-inclusive Community-managed Sanitation and Hygiene in Urban Indonesia
Authors: Mozar R. , Sijbesma C. 
Published: January 2011

The Government of Indonesia executed the Indonesia Sanitation Sector Development Program (ISSDP, April 2006 - January 2010), with financial support from the Governments of the Netherlands and Sweden, as well as management support from the World Bank's Water and Sanitation Program (WSP). The program assisted a dozen cities to improve sanitation in a wider sense. It covered safe disposal of human excreta and waste water, local drainage, solid waste management and promotion of hygienic practices. The program was demand-based: the cities brought in their own human and financial resources, but got technical assistance for sanitation situation assessments and mapping, sanitation strategy and program development, and finding additional resources for increased implementation.
The program had three major thrusts: (1) develop an enabling sanitation environment, (2) raise sanitation awareness and promote good hygiene, and (3) build city sanitation planning capacities and develop city sanitation strategies. The promotion component included development of poor-inclusive sanitation intervention, assisting men, women and children in the poorest neighborhoods to strengthen good and improve bad sanitation and hygiene conditions and practices.
Community empowerment is important in urban sanitation development, but at the same time, requires that the social and technical institutions in charge of empowerment and sanitation adopt new skills and techniques for working with communities. Without the right skills to assist the communities, build their skills, and provide some minimal monitoring of performance afterwards, there is a risk of over-expecting what a community can manage. Community empowerment with gender- and poor-inclusive approaches must be integrated into all stages of urban sanitation development, i.e. (1) the organizational development, (2) review of related existing projects and services, (3) formulation of an overall city sanitation strategy and program, and (4) local project planning. Equitably attention for gender and poor is part of the overall organization, strategy formulation, local action planning, program and projects development and implementation, and monitoring and evaluation of outputs, outcomes and impacts.
Sustainable Sanitation as a Part of an IWRM in the Karst Area of Gunung Kidul: Community Acceptance and Opinion
Authors: Nayono S. , Singer M. , Lehn H. , Kopfmüller J. 
Published: January 2011

To overcome the problem of water scarcity in a rural karst area located in Gunung Sewu, Yogyakarta, Indonesia, water from an underground cave (Bribin Cave) is pumped and distributed to the people. Since karst aquifers are often considered as highly vulnerable to contamination from human activities, potential problems caused by current sanitation and hygiene practices in the recharge region must be anticipated. About 90% of the people in the recharge area use pour flush syphon toilets with poorly designed septic tanks and the rest have simple pit latrines. However, the existing septic tanks are very poorly designed and are actually only improved infiltration pits.
One possible option to reduce the risk of aquifer contamination is to promote sustainable sanitation, which combines hygienic aspects with recycling of nutrients from human feces and urine. Sustainable sanitation comprises different technologies including low cost technology, which can be afforded by the community and provide economic benefit to the low income inhabitants in Gunung Sewu. The technology proposed is urine diverting and composting toilets. This paper presents the existing condition of rural domestic wastewater treatment and the opinion/ acceptance of the community in karst area of Gunung Sewu towards urine diverting and composting toilets. The results of the survey shows that although the acceptance of using the composting toilet is not high (25% to 43%), the interest of the community in using the end product is relatively high. While the acceptance of composting fertilizer from feces (humanure) ranges from 37% to 57%, urine fertilizer attracts 42%-71% respondents' interest.
Empowering the Urban Poor to Solve their Sanitation Problem
Authors: Ismawati Yuyun, 
Published: January 2011

SANIMAS (Sanitasi oleh Masyarakat) or Sanitation by Community is a nation-wide sanitation program for urban poor settlements in Indonesia and has already been implemented since 2003. Population density in urban settlement range between 600 to more than 1000 people per square km, which provides no room for proper sanitation infrastructures. The decentralized, communal, community-managed and cluster wise approach to solve sanitation problems in such high density has many types of challenges: technical, environmental, social and financial. Therefore there is the need to have concerted efforts for a careful yet reliable, high quality standard design, good supervision, sustainable operation and maintenance, as well as for continual monitoring and improvements.
In the past, water and sanitation facilities in urban poor settlements were built for quantity and appearance not for quality and performance. As a result most of the infrastructures collapse and disfunction only a couple of months after the construction has been handed over to the community. Leaking or bottomless septic tanks are usually the reality and lack of maintenance is a common problem as no community committee is assigned to oversee or monitor the facilities.
As a national program, SANIMAS is implemented in more than 70 urban poor community clusters or approximately 8,000-10,000 people every year which previously identified as unserved population. It is implemented in sequences of activities and accomplished only by good team work, guided by standardized steps. All team members, coordinators, field facilitators, technical team, relevant government officers and community committees must build and maintain good coordination and communication.
Several capacity building packages are designed for and delivered to different groups to ensure that implementation steps are understood by the relevant team members. Various training modules are developed and delivered to technical teams, senior facilitators, field facilitators and community committees. Each training aims at communicating the minimum standard activities required to accomplish the program.
To ensure that facilities serve their function in a sustainable way, a monthly community participatory monitoring has been designed. That way technical, environmental, financial and institutional aspect is mainly monitored by the community in assistance of team members. The monitoring results are used as inputs for improvement, local policy development and strategy. This paper shows that through the decentralised sanitation approach, a sustainable sanitation service for the poor is possible.
Mainstreaming DEWATS and the Subsequent Need to Introduce a Quality Management System
Authors: Fladerer Frank 
Published: January 2011

Numerous pilot- and demonstration projects for appropriate waste water management solutions for the urban poor in developing countries have been conducted and can be considered as good practices. In order to have a chance to achieve the MDGs it is urgently necessary to scale those pilot implementations up and reach a mass dissemination.
However, the task to multiply those pilots and mainstream the “good practice” to become mass dissemination is a challenge where most approaches have failed so far.
The paper reflects on the experiences gained in Indonesia during the up-scaling of DEWATS implementation by a community of practitioners. It shows the process of the development of “good practices” from a small number of applications to a “Quality Management System with internal certification” for large numbers of implementation packages.
The main components of the system are:The Quality Management System for technical aspects of DEWATS planning and implementationThe Certification system for Human resources who occupy key positions in the implementation process of DEWATSThe Certification system for the implemented DEWATS service packagesThe organizational setup to maintain such a system.
The paper describes each of those components as well as the challenges and lessons learned during its application.
City-wide Planning for Decentralized Basic Needs Services (DBNS)
Authors: Kraemer P. , Balachandran B.R. , Haran S. , Pai R. , Prochaska C.F. , Sachdeva R. 
Published: January 2011

The speed of urbanization is putting enormous pressure on the cities in developing countries to keep up with the provision of basic services like housing, energy and water supply, solid and liquid waste management, social, educational and cultural institutions etc. Decentralized basic needs services (DBNS) are proven supplements to existing (centralized) systems to improve cities service performance. However, a successful integration of DBNS options in the traditional domain of centralized services requires its inclusion in cities' development plans.
From a city manager perspective to opt for DBNS, a detailed assessment on the extent of the services that could be provided through DBNS, their price as well as other possible implications is required. Such assessment will need to include also details of policy and institutional changes/adaptations requirements, information/awareness needs, possible fiscal incentive, etc.
The presented city-wide DBNS planning methodology aims at providing a first guide on how to conduct such assessment, focusing on some of the most pressing basic services. The resulting City-wide DBNS plan targets to be a work document for city managers. It provides a clear overview of the ground situation of the selected DBNS and provides prioritized intervention plans for key DBNS related stress areas of the city.
Capacity Building - A tool for Up-scaling Decentralised Sanitation Infrastructure Provision
Authors: Kraemer P. , Sinha S. 
Published: January 2011

India is home to almost one-third of the world's population that survive without adequate sanitation facilities. Bremen Overseas Research and Development Association (BORDA) in collaboration with the Consortium for DEWATS Dissemination (CDD) Society, has developed for the last 10 years, integrated solution packages for the provision of basic urban sanitation facilities. The customised packages include all or part of key sanitation elements like: toilets, decentralised wastewater treatment systems (DEWATS), health and hygiene education, solid waste management, drainage system, stakeholder participation measures.
Over the last decade, with the support of its network partners CDD Society has been successful in delivering around 400 sanitation systems in South Asia. Due to the rapid growth of its population, India may require 1.3 million sanitation systems alone in the coming years. One of the key issues in meeting this huge target is the lack of trained professionals and implementing agencies.
To upscale the efforts in delivering basic needs services in the sanitation sector, the Basic Needs Services (BNS) Network has started the establishment of a capacity building institution for decentralised sanitation solutions called Centre for Advanced Sanitation Solutions (CASS). CASS aims at providing the entire range of knowledge and skills required for the implementation of integrated sanitation solutions such as technical know-how for designing toilets, decentralised wastewater treatment systems (DEWATS), drainage systems, solid waste management and drinking water source protection; social support measures include health and hygiene education, community-based participatory planning tools as well as project management related aspects. For town and city managers, CASS will offer planning support for city and town-wide sanitation programmes. Furthermore, sanitation related R&D activities, knowledge management and exhibition is offered under CASS's ‘One-Stop-Shop’ concept; all components of sanitation are provided under one roof.
This paper presents the basic components of the capacity building strategy developed by CDD/BORDA focusing on target groups, development of knowledge units (training module) and the didactical approach.
Distribution of Abdominal Visceral and Subcutaneous Adipose Tissue and Metabolic Syndrome in a Korean Population
Authors: Kim Soyeun , Cho Belong , Lee Hyejin , Choi Kyojoo , Hwang Seung Sik , Kim Donghee , Kim Kyoungwoo , Kwon Hyuktae 
Published: January 2011

OBJECTIVE
This study aimed to assess the correlation between abdominal subcutaneous adipose tissue (SAT) and metabolic syndrome (MetS) in Korean adults after adjusting for the effects of visceral adipose tissue (VAT).

RESEARCH DESIGN AND METHODS
The SAT/VAT ratio (SVR) was calculated using abdominal computed tomography in 2,655 subjects. We used regression analyses to assess whether the SVR predicted MetS.

RESULTS
For both sexes, the prevalence of elevated triglycerides, reduced HDL, and elevated fasting glucose significantly decreased with increasing quintiles of SVR (P for trend &lt; 0.05). The prevalence and odds ratios of MetS significantly decreased as the SVR increased (men: odds ratio 0.5 [95% CI 0.3–0.7]; women: 0.2 [0.1–0.5] for comparisons of lowest vs. highest quintile; P for trend &lt; 0.05).

CONCLUSIONS
After adjustment for VAT, abdominal SAT was inversely correlated with the occurrence of MetS.
Elevation of 1-Hour Plasma Glucose During Oral Glucose Tolerance Testing Is Associated With Worse Pulmonary Function in Cystic Fibrosis
Authors: Brodsky Jill , Dougherty Shayne , Makani Ramkrishna , Rubenstein Ronald C. , Kelly Andrea 
Published: January 2011

OBJECTIVE
Cystic fibrosis (CF)-related diabetes (CFRD) is associated with declining pulmonary function and increased mortality. During oral glucose tolerance testing (OGTT), CFRD is defined by 2-h plasma glucose (PG2). We hypothesized PG elevations during OGTT resolving by 2 h, not meeting CFRD criteria, influence pulmonary function in CF. Thus we investigated the frequency of elevated 1-h OGTT PG (PG1) and its relationship with pulmonary function.

RESEARCH DESIGN AND METHODS
Retrospective review of OGTTs was performed between August 2005 (annual screening initiation) and June 2008 at Children’s Hospital of Philadelphia CF Center. First-time, well state OGTTs (PG0, PG1, PG2) were analyzed. Additional data collected were: percent predicted forced expiratory volume in 1 s (FEV1), BMI percentile, lung bacterial colonization, age, and sex. OGTTs were categorized as normal (PG2 &lt;140 mg/dL), impaired glucose tolerance (IGT) (PG2 140–199 mg/dL), CFRD (PG2 ≥200 mg/dL), and indeterminate glycemia (INDET) (PG1 ≥200 mg/dL and PG2 &lt;140 mg/dL). Frequency of PG1 ≥140 but &lt;200 mg/dL was also noted. Multivariable linear regression was used to assess associations between percent predicted FEV1, BMI percentile, and OGTT PG.

RESULTS
OGTTs (101) were available (59 male/42 female; age 5.8–22 years, percent predicted FEV1 = 94.5 ± 18%, BMI percentile = 52 ± 25%). With the use of PG2, 91 OGTT were normal, eight were IGT, and two were CFRD. With the use of PG1 (n = 89), 39 OGTT were normal, 36 were PG1 ≥140 &lt;200 mg/dL, and 14 were PG1 ≥200 mg/dL. PG1 was negatively associated with percent predicted FEV1, adjusting for BMI percentile (P = 0.009, R2 0.13). Percent predicted FEV1 was not associated with PG0, PG2, age, sex, or lung bacterial colonization.

CONCLUSIONS
PG elevations at nontraditional OGTT times are common in CF. The association of increasing PG1 with worse pulmonary function suggests early PG abnormalities may be deleterious or an early marker for worsening disease and will be missed if CFRD diagnosis focuses on PG2.
Hydatidiform mole mimicking an enlarged uterine fibromyoma four months after ART
Authors: Terzic Milan , Dotlic Jelena , Maricic Sanja , Babovic Ivana 
Published: January 2011

AbstractHydatidiform mole is a pregnancy disorder, of a benign nature. We present a case of molar tissue within a uterine myoma, the first such entity reported in the literature. In May 2006, a thirty-eight year old infertility patient was admitted for myomectomy. She had anamnesis for chronic pelvic inflammatory disease and surgeries performed for tubal pregnancies. After the sixth intracytoplasmal spermatozoa injection procedure performed in January 2006, she conceived, but curettage was performed in March 2006 for a missed abortion. Following the routine preoperative evaluation in May 2006, four months after the last artificial reproductive technology procedure, myomectomy was performed as uneventful operation, but the histological report appeared unusual, showing degenerated chorionic villi within the uterine myoma. Molar tissue within uterine myoma might evolve even after artificial reproductive procedures. Furthermore, this finding might be misinterpreted as a fibromyoma degeneration. This is the first, and a unique case, of molar tissue within uterine myoma reported in the literature.