bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Mortality among Severe Trauma Patients Treated in a Trauma Centre versus a Non-Trauma Centre
Authors: Lai CH , Lai CH , Chen KH , Wang CH , Hsiao CT , Hsiao KY
Published: December 2017

Introduction

In Taiwan, patients with major trauma are often sent to the closest non-trauma centre for initial resuscitation and transferred to distant trauma centres subsequently. This study aimed to evaluate the in-hospital mortality of severe trauma patients treated in a trauma centre versus in a non-trauma centre.

Methods

This prospective observational study reviewed 223 patients with major trauma (defined as Injury Severity Scale [ISS] score >15) who visited either a Level I trauma centre or a non-trauma centre from April 2013 to March 2014. Data of clinical status, trauma mechanisms, laboratory and radiology, interventions, and mortality/survival were evaluated. Logistic regression analysis was performed to assess effects of initial hospital treatment on mortality.

Results

A total of 158 major trauma patients were taken to the trauma centre hospital, and 65 patients were taken to the non-trauma centre. Age > 70 years (odds ratio [OR] 6.24, 95% confidence interval [CI] 1.01 to 38.62, compared to age ≤40 years), Glasgow Coma Scale [GCS] 3-8 (OR 19.00, 95% CI 2.30-157.01, compared to GCS 13-15), GCS 9-12 (OR 28.88, 95% CI 4.40-189.86, compared to GCS 13-15), ISS score >25 (OR 6.95, 95% CI 1.27-38.08) and taken to non-trauma centre initially (OR 30.90, 95% CI 5.00-191.27) were significantly associated with mortality.

Conclusion

Initial treatment of patients with major trauma in a non-trauma centre was associated with increased mortality compared to initial treatment in a trauma centre.
An Unusual Case of a Large Subglottic Granuloma due to Foreign Body Aspiration in an 11-Year-Old Boy
Authors: Yang X , Guo Y , Ni X , Zhang J
Published: December 2017

Foreign bodies in subglottis are rarely seen in children. Delayed or missed diagnosis could result in serious complications. We reported a case of an 11-year-old boy, who was found to have a large subglottic granuloma due to foreign body aspiration, presented with persistent wheezing. The combined use of flexible and rigid bronchoscopy were vital to the diagnosis and treatment in this case.
An Evaluation of the ACEP Guideline for Mild Head Injuries in Taiwan
Authors: Hsiao KY , Li WC , Chang CH , Lin MHC , Yang JT , Wang PC , Chen KH
Published: December 2017

Introduction

Traumatic brain injury (TBI) is an important issue in the emergency department. In the United States, the American College of Emergency Physicians (ACEP) published clinical guideline to select patients with mild head injuries for head computed tomography (CT) scans in 2008. The aim of this study was to identify the possible benefits of compliance with these guidelines for mild head injury patients in Taiwan.

Method

This was a secondary analysis on our previous study published for association of hypertension and head injuries. In our previous study, we collected data about 1290 patients with head injuries who received brain CT scans in the emergency department from September 2012 to August 2013 for a study regarding the association between head injury and hypertension. In present study, we subjected this data to further analysis to try to validate the ACEP clinical policy for mild head injuries.

Results

Of these 1,290 patients, 154 were found to have brain haemorrhage on the initial brain CT scan, and 5 were in need of neurosurgical intervention. A total of 859 patients met the ACEP guideline criteria, and 117 of these had brain haemorrhages. The sensitivity and specificity of the ACEP guideline to predict brain haemorrhage were 75.97% (95% confidence interval [CI], 68.44% to 82.48%) and 34.68% (95% CI, 31.91% to 37.53%), respectively. In predicting neurosurgical intervention, the sensitivity and specificity of the guideline were 100% (95% CI, 47.82% to 100%) and 33.54% (95% CI, 30.96% to 36.2%), respectively.

Conclusion

Although adoption of the ACEP clinical policy may reduce the number of brain CT scans in mild head injury patients who may need neurosurgical interventions, it is not a good selection tool in Taiwan.
Blast Lung Injury: Our Experience
Authors: Sreekanth C , Bai R
Published: December 2017

Blast lung injury (BLI) is a relatively uncommon feature of victims involved in bomb blasts. Patients may present with clinical features of different proportions; and clinical imaging forms an important tool in managing these patients. BLI is very uncommon and therefore offers a challenge to the emergency room personnel. A complete patient assessment with a holistic approach should be kept in mind. We present a case of suspected lung injury of a young female who was an innocent victim of BLI and who was managed conservatively.
Perforation of Meckel's Diverticulum by a Fish Bone Presenting as Acute Appendicitis: A Case Report
Authors: Lai ATY
Published: December 2017

Meckel's diverticulum can present with unusual symptoms and signs leading to delay diagnosis. Herein, we report a case of a 48-year-old Chinese man who presented to us for symptom of acute appendicitis. Further investigation by computed tomography scan pelvis showed acutely inflamed medium sized diverticulum at the distal ileum with focal perforation and peritonitis. Laparoscopy showed perforated meckel's diverticulitis with a fish bone half perforated out and localised abscess formation. He had unremarkable post-operative course. We review the literature about complication of Meckel's diverticulum and the necesssity of surgical removal.
Occult Perforation with Circumferential Ischaemic Injury of the Sigmoid Colon following Seat-Belt Trauma: A Case Report
Authors: Ho TH , Chang SW , Yeh HW , Yeh CB
Published: December 2017

Seat-belt syndrome is defined as the presence of a seat-belt sign predominantly involving thoracolumbar vertebral fractures and intra-abdominal organ injury following the use of a seat belt during a traffic collision. Isolated sigmoid colon perforation occurring as part of seat-belt syndrome is rare. We report a 34-year-old patient who presented seat-belt sign after his car collided with a guardrail. The patient was initially haemodynamically stable and complained lower abdomen pain. Serial clinical examination with abdominal computed tomography (CT) scans illustrated sigmoid colon with ischaemic change without perforation. Exploratory laparotomy was performed and isolated sigmoid colon perforation was diagnosed. Therefore, in cases of persistent abdominal pain or tenderness despite an initially negative CT scan, repeated examinations of the abdomen with following abdominal CT are recommended because of the high risk of seat-belt sign and the possibility that the peritoneal symptoms can be hidden, such as in the retroperitoneal duodenum or sigmoid colon. Thus, we recommend using repeat abdominal CT as an adjunct to secondary survey for clarifying the haemodynamic status of patients with seat-belt trauma.
Outpatient Treatment of Pulmonary Embolism: sPESI Score and Highly Sensitive Troponin may Prove Helpful
Authors: Kartal M , Unal A , Goksu E , Yilmaz D , Gungor F
Published: December 2017

Introduction

Despite advances in therapeutic and diagnostic options, acute pulmonary embolism (PE) is associated with high morbidity and mortality. Risk classification is important in deciding how and where to treat patients This study aimed to investigate simplified pulmonary embolism severity index (sPESI) scores and highly sensitive troponin levels to predict 30‐day clinical outcomes.

Methods

Patients with the symptoms of dyspnoea, chest pain, and haemoptysis were included in the study. Multiple detector computed tomography (CT) examinations were performed. If the patients' glomerular filtration rate levels were less than 60 ml/min/1.73 m2, then the ventilation/perfusion (V/Q) scan was the preferred imaging modality. Venous blood samples were collected to test for highly sensitive troponin T levels (Elecsys troponin T high sensitive, Roche diagnostics). All patients were examined by two‐dimensional bedside echocardiography for detection of right ventricular dilatation. Patients' baseline characteristics (sex, ages, etc.) were recorded along with co‐morbidities, symptoms, haemodynamic conditions, all‐cause mortality rates during hospitalisation, the duration of hospital stay, radiographic test results, and laboratory findings, and electrocardiography were also obtained during emergency department admission. Primary outcome measure was defined as death in a month. Logistic regression model was created to reveal the associated parameters related to mortality within a month of the emergency department visit.

Results

One hundred and seventy patients suspected of PE underwent either a CT angiogram or pulmonary V/Q scan. In total 70 patients were diagnosed with PE and included in the study. The logistic regression model was created in order to assess poor prognosis markers. In addition to the troponin levels and sPESI scores commonly used for pulmonary embolism prognosis, right ventricular dilatation, heart rate, systolic blood pressure and oxygen saturation using logistic regression models were created. Positive troponin level (odds ratio: 5.23 and 95% confidence interval [CI] 1.03 to 26.51) and negative sPESI score (odds ratio 2.14 and 95% CI 1.00 to 4.60) were found to be significant.

Conclusions

Some scoring systems, including PESI and sPESI score, can be used for predicting mortality in patients with pulmonary embolism. If sPESI score is zero, and troponin levels are negative, the patient can be discharged safely.
Association between Systolic Blood Pressure after Thrombolysis and Early Neurological Improvement in Ischaemic Stroke Patients
Authors: Seok J , Lee JS , Jeong KY , Lee CM
Published: December 2017

Introduction

This study aimed to evaluate the relationship between systolic blood pressures (SBPs) within 12 hours after intravenous recombinant tissue plasminogen activator (rtPA) treatment and early neurological outcomes.

Methods

This was a retrospective observational study of acute ischaemic stroke (AIS) patients who received intravenous rtPA administration. SBPs at the time of rtPA bolus and thereafter every hour were collected. The mean, standard deviation, and coefficient of variation values of SBP during the periods of 0‐2 h, 2‐6 h, and 6‐12 h were calculated. The primary outcome was major neurologic improvement (MNI) at 24 hours after thrombolysis.

Results

Serial measures of SBPs revealed different 12‐hour courses between the patients with and without MNI. The difference of SBP tendency was statistically significant (p=0.013). In univariate analysis, patients with MNI showed lower levels of mean SBPs during the periods of 2‐6 h and 6‐12 h (p=0.030 and p=0.005, respectively), and higher frequency of very early neurologic improvement (VENI) at the end of rtPA infusion (p<0.001). In logistic regression analysis, VENI at 1 h, mean SBP value during 6‐12 h, and atrial fibrillation were independently related to MNI at 24 h.

Conclusions

SBP level during the first 12 hours after intravenous rtPA treatment may be an important clinical factor that is associated with early neurological improvement of AIS patients.
A Case of Penetrating Neck Injury with Retained Foreign Body in the Cervical Vertebral Body and Vertebral Artery Dissection
Authors: Tong TMC , Wong OF , Kwan GWM , Chan KKC
Published: December 2017

Vertebral artery injury is an uncommon but life‐threatening condition. We report a young lady with penetrating neck injury, after stabbed by her husband with a ceramic knife, resulting in right C5 nerve root injury and vertebral artery dissection. The tip of the knife was retained in the cervical vertebral body. Embolisation of the proximal vertebral artery was performed before the removal of the retained knife tip. The nerve root injury was successfully repaired and the patient had only minimal proximal weakness after the operation. The management of penetrating neck trauma with vertebral artery injury is discussed.
Historicist interpretation of the Olivet Discourse and the sixth seal: 2. Corrective, reinterpretation, and saving the historical Jesus
Authors: Charlesworth Scott D.
Published: December 2017

The reference in the sixth seal to signs in the heavens that accompany the parousia (Rev 6:12–17) corrects the flawed interpretation of Daniel found in Mark 13 par. Because the heavenly signs occur in the sixth of seven seals, the consecutive openings imply a sequencing of events and, therefore, a delayed parousia. Similarly, the greatest tribulation of all time did not occur in connection with the fall of Jerusalem as Matthew has it (24:21). John is shown a ‘great multitude’ of people coming out of a ‘great tribulation’ subsequent to his day (Rev 7:14). This great tribulation, with its primary point of reference in the ‘time, times, and half a time’ of Daniel (7:25; 12:7–10; 11:32–35) and its counterparts in Revelation (13:1–8; cf. 11:2–3; 12:6, 14), is to be followed by an even greater tribulation involving the whole earth (13:11–17). Further, since the first plague falls on those with the mark of the beast (16:2), the seven last plagues are associated with this second, unprecedented tribulation. As for the timing of the parousia, the parallels between the sixth seal and the seventh plague imply that the second coming is to accompany the opening of the sixth seal and outpouring of the seventh bowl (16:17–20). Thus, the Apocalypse corrects the Olivet Discourse in an implicit admission that the historical Jesus had misunderstood Daniel. In doing so it reinterprets Daniel and provides a foundation for historicist interpretation of that apocalyptic book and, possibly, of the Apocalypse itself.
ARCIC III in the light of ARCIC II: A critical response to Life in Christ, Morals, Communion and the Church
Authors: Baker Frances
Published: December 2017

The Mandate of ARCIC II was to examine the differences which separate the Anglican and Roman Catholic communions. In the development of the Statement Life in Christ: Morals, Communion and the Church, this Mandate worked against the possibility of an outcome which would lead to a shared understanding of Christian moral life. The major focus of the Statement, the two issues on which there were formal statements of disagreement between the two communions, led to a very narrow focus for Christian life in the light of the gospel and a sense that the differences were too great to allow for resolution. Further exploration of the implications of our shared baptismal call in Christ and its implication for Christian living could have provided a much stronger basis for the consideration of particular moral issues and ethical reasoning that is an expression of “Life in Christ”. The process of ARCIC III may facilitate a broader understanding of Christian moral life and a more nuanced articulation of ethical reasoning and moral culpability within the Roman Catholic moral tradition. These in turn may provide a more hopeful path towards communion with regard to the discernment of right ethical teaching.
Partners in crime? The partnership of the woman and man in the Garden of Eden narrative
Authors: Deutschmann Barbara
Published: December 2017

The Garden of Eden narrative of Genesis 2:4b–3:24 is more than an account of a fall from grace. The author is interested in the dynamics of human partnership and has made it the centrepiece of the narrative that situates humanity within the vocation of serving and keeping the earth. This partnership has traditionally been under-explored. Scholars interested in gender have focused on the depiction of the woman with less attention to wider gender significations and the intricate partnership narrated between the pair. This article shows how a particular vocabulary of partnership, namely, the word-pair, ʾ îš and ʾiššâ, are used to highlight key points in the development of the relationship. It argues that notions of sex/gender are subsumed within the vocation of serving and keeping the earth, and fundamentally formulated as a work of partnership of sexed human beings.
Richard Hooker, John Henry Newman: A Via Media theology of the Eucharist
Authors: Curnow Kelvin Fraser
Published: December 2017

The orthodox position that the Church of England represented a theological and ecclesiological Via Media between Roman Catholicism and Protestantism has been challenged in recent decades. Revisionist historians have disputed the view that the 16th-century apologist for the Church of England Richard Hooker presented the paradigm of an Anglican Via Media in his foundational works, Of the Lawes of Ecclesiastical Polity and Discourse on Justification. The disputes have centred on Hooker’s doctrine of justification and theology of the Eucharist. Criticism has consequently been directed toward members of the 19th-century Oxford Movement who formulated their own contemporary religious Via Media based on the rediscovered works of Richard Hooker and 17th-century Anglican divines. Some historians also contend that no such Via Media existed and was fabricated by the Tractarians, particularly John Henry Newman, to suit their own theological ends. This article surveys the evidence which supports the case for the Via Media by examining Hooker’s works for confirmation of the principle, and determining if Newman both identified and made use of the evidence accurately. The focus of this study will be comparing Eucharistic theology in the works of Hooker and Newman.
IFRS adoption in Australia: A strong structuration perspective
Authors: Chapple Sandra
Published: December 2017

This article provides an historical account of conditions and actions which gave rise to the decision to adopt International Financial Reporting Standards in Australia. This decision is seen as a ‘moment’ within a much broader movement of history, namely, the emergence of a transnational neoliberal global order comprising networks of multilateral arrangements and strategic alliances, as well as ambiguous but powerful social, political and cultural forces. Those phenomena and their force in the context of accounting standard setting are examined here through a conflation of Castells’ work on globalisation with the strong structuration model of Stones. This article demonstrates the potential of the Stones/Castells theoretical nexus to contribute to future accounting research, not only within the narrow realm of rule-making but more broadly in our attempts to understand and critique the manner in which global neoliberal processes have come to impact contemporary experience.
Polishing the Apple: A Holistic Approach to Developing Public Health Law Educators as Leaders of Change
Authors: Gerardi Debra
Published: December 2017

The RWJF public health law faculty fellowship provided an opportunity for legal and public health scholars to come together to develop innovative approaches for teaching public health law in schools of law, public health, medicine, and social work nationally. The fellowship program emphasized the importance of integrating individual change (personal and professional development) with organizational change as twin pillars of the core competencies necessary for advancing public health law education. This article describes the curriculum and learning formats used throughout the fellowship to guide the fellows' development in the areas of leading change, managing conflict, building collaborative partnerships, and maintaining personal resilience.
It's the Prices, Advanced Capitalism, and the Need for Rate Setting — Stupid
Authors: Frankford David M.
Published: December 2017

Competition cannot stem the rise of health care expenditures because it leaves agency diffuse and transferred in part to the institutions of advanced capitalism, which excel in generating demand for their services. The United States should turn to state rate setting to concentrate purchasing power.
The Affordable Care Act's Day(s) in Court
Authors: Hall Mark A.
Published: December 2017

This article reviews the primary avenues of judicial challenge to the ACA, focusing on those that have reached, or have the potential to reach, the Supreme Court. The review demonstrates how deep-seated public policy opposition can be expressed through litigation.
Medicaid's Role in Health Reform and Closing the Coverage Gap
Authors: Rowland Diane , Lyons Barbara
Published: December 2017

Medicaid coverage matters for millions of low-income Americans, and especially for those with ongoing and serious health challenges. A source of comprehensive and affordable coverage, Medicaid has long been a cornerstone of federal and state efforts to improve access and health outcomes for very poor and medically vulnerable populations. The Affordable Care Act (ACA) leveraged Medicaid's role in serving the poor to broaden the program's reach to millions of low-income uninsured adults, and positioned the program as a fundamental component of the newly established continuum of public and private coverage. Looking ahead, if more states embrace the Medicaid expansion, there is the potential to build on this progress to significantly reduce the number of uninsured Americans.
Struggles in Defining and Addressing Requests for “Family Balancing”: Ethical Issues Faced by Providers and Patients
Authors: Klitzman Robert
Published: December 2017

This study – the first to explore how infertility providers confront several critical dilemmas concerning sex selection of embryos for nonmedical, social reasons – highlights key challenges and questions. Clinicians struggle, for instance, with how to define “family balalancing”, when to offer it, and how to decide.
HIPAA Compliance and Training: A Perfect Storm for Professionalism Education?
Authors: Agris Julie L. , Spandorfer John M.
Published: December 2017

The HIPAA Rules continue to support and bolster the importance of protecting the privacy and security of patients' protected health information. The HIPAA training requirements are at the cornerstone of meaningful implementation and provide a ripe opportunity for critical education.
Exploring the theoretical foundations of visual art programmes for people living with dementia
Authors: Windle Gill , Gregory Samantha , Howson-Griffiths Teri , Newman Andrew , O’Brien Dave , Goulding Anna
Published: December 2017

Despite the growing international innovations for visual arts interventions in dementia care, limited attention has been paid to their theoretical basis. In response, this paper explores how and why visual art interventions in dementia care influence changes in outcomes. The theory building process consists of a realist review of primary research on visual art programmes. This aims to uncover what works, for whom, how, why and in what circumstances. We undertook a qualitative exploration of stakeholder perspectives of art programmes, and then synthesised these two pieces of work alongside broader theory to produce a conceptual framework for intervention development, further research and practice. This suggests effective programmes are realised through essential attributes of two key conditions (provocative and stimulating aesthetic experience; dynamic and responsive artistic practice). These conditions are important for cognitive, social and individual responses, leading to benefits for people with early to more advanced dementia. This work represents a starting point at identifying theories of change for arts interventions, and for further research to critically examine, refine and strengthen the evidence base for the arts in dementia care. Understanding the theoretical basis of interventions is important for service development, evaluation and implementation.
The Effect of Religious Involvement on Life Satisfaction among Korean Christians: Focused on the Mediating Effect of Spiritual Well-Being and Self-Esteem
Authors: Yoo Jieun
Published: December 2017

The present study examined the relationship between two categories of religious involvement, namely religious belief and religious behavior, and life satisfaction among Korean Christians (N = 278) with spiritual well-being and self-esteem as potential mediators in this relationship by using structural equation modeling (SEM). The results supported the full mediated structural model and indicated that religious belief had a significant indirect effect on life satisfaction through the mediators, spiritual well-being and self-esteem. Religious behavior did not have an indirect or direct effect on life satisfaction among Korean Christians. The significance, implications, and limitations of the study were discussed.
What Can IRBs Learn From CABs? A Qualitative Analysis of the Experiences of Recruitment and Training of Nonscientist Members on Research Review Boards
Authors: Solomon Cargill Stephanie
Published: December 2017

Governments, funders, and institutional policies increasingly encourage and even mandate the involvement of nonscientists in the ethical review of research, most famously in institutional review boards (IRBs), but also on community advisory boards (CABs) and other committees that contribute to research governance. In spite of these requirements, few have examined how different factors such as recruitment strategies, training, and different qualifications shape the contributions of nonscientists to the research enterprise. This pilot study begins to fill in this lacuna by interviewing nonscientist members of IRBs and community members of CABs. Results suggest patterned differences in demographics, recruitment strategies, training, and perceived qualifications between community members on these two types of boards with potential implications for how we perceive the scope of contributions that nonscientists can provide to the ethical review of research and the strategic ways these contributions can be elicited.
Aerial Herbicide Spray to Control Invasive Water Hyacinth (Eichhornia crassipes): Water Quality Concerns Fronting Fish Occupying a Tropical Floodplain Wetland
Authors: Waltham N. J. , Fixler S.
Published: December 2017

Water hyacinth ( Eichhornia crassipes) is an aquatic weed degrading tropical floodplains everywhere. On the Burdekin floodplain, northern Australia, it is widespread and contributes to poor water quality, specifically hypoxia which contributes to voluminous wetland fish kills each summer. Removing weeds have focused on applying herbicides using aerial spraying, though restoration success is not monitored. Here, we investigated four aerial spray applications scheduled between November 2013 (Year 1, November 2013 to November 2014) and November 2015 (Year 2, November 2014 to November 2015) in Lochinvah wetland (35 ha wetland, Burdekin floodplain). Using high-frequency (20 min) loggers, dissolved oxygen (DO%) was tracked, which revealed that concentrations were similar before and several weeks after a spray application (independent t test, p > 0.01, except spray application 2, p = 0.06). More interestingly, aquatic weed coverage was low (5% of wetland) during Year 1 and DO had a typical diurnal cycle (20% to 130%). In contrast, low wetland flushing in Year 2 and high weed coverage (80% coverage) combined to increase DO hypoxia exposure risks for fish, with nearly 100% of the logging time failing acute and chronic values known for local fish. The Year 2 weed cover also increased water temperature exposure risk (twofold increase), which was unexpected and which means that fish probably could access cool, deeper, water refugia more frequently compared with Year 1. Controlling aquatic weeds using aerial spraying seems to have minimal risk for fish when cover is low; however, the proliferation of aquatic weeds and spraying has deleterious impact on available oxygen for fish.
Age Stratification of 30-Day Postoperative Outcomes Following Excisional Laminectomy for Extradural Cervical and Thoracic Tumors
Authors: Phan Kevin , Cheung Zoe B. , Vig Khushdeep S. , Hussain Awais K. , Lima Mauricio C. , Kim Jun S. , Di Capua John , Cho Samuel K.
Published: December 2017

Study Design:

Retrospective cohort study.

Objectives:

To evaluate age as an independent predictive factor for perioperative morbidity and mortality in patients undergoing surgical decompression for metastatic cervical and thoracic spinal tumors using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2011 to 2014.

Methods:

We identified 1673 adult patients undergoing excisional laminectomy of cervical and thoracic extradural tumors. Patients were stratified into quartiles based on age, with Q1 including patients aged 18 to 49 years, Q2 including patients aged 50 to 60 years, Q3 including patients aged 61 to 69 years, and Q4 including patients ≥70 years. Univariate and multivariate regression analyses were performed to examine the association between age and 30-day perioperative morbidity and mortality.

Results:

Age was an independent risk factor for 30-day venous thromboembolism (VTE) and reoperation. Patients in Q3 for age had nearly a 4 times increased risk of VTE than patients in Q1 (odds ratio [OR] 3.97; 95% CI 1.91-8.25; P < .001). However, there was no significant difference in VTE between patients in Q4 and Q1 ( P = .069). Patients in Q2 (OR 1.99; 95% CI 1.06-3.74; P = .032) and Q4 (OR 2.18; 95% CI 1.06-4.52; P = .036) for age had a 2 times increased risk of reoperation compared with patients in Q1.

Conclusions:

Age was an independent predictive factor for perioperative VTE and reoperation, but there was no clear age-dependent relationship between increasing age and the risk of these perioperative complications.
Migration, sons of the soil conflict, and international relations
Authors: Mitchell Matthew I.
Published: December 2017

For most of the 20th century, the discipline of international relations largely ignored migration. Although recent work has made important contributions, a number of gaps remain, as the emerging literature tends to examine national security, international migration, forced migration, and developed countries, without exploring internal conflict, internal migration, voluntary migration, and developing countries. This article examines the enduring gaps in the literature on migration in international relations. It uses the concept of “sons of the soil” conflicts and the illustrative example of Côte d’Ivoire to highlight these overlooked dimensions. This serves to underscore the need for a new research agenda on migration in international relations.
Effects of a multi-strain probiotic supplement for 12 weeks in circulating endotoxin levels and cardiometabolic profiles of medication naïve T2DM patients: a randomized clinical trial
Authors: Sabico Shaun , Al-Mashharawi Ayah , Al-Daghri Nasser M. , Yakout Sobhy , Alnaami Abdullah M. , Alokail Majed S. , McTernan Philip G.
Published: December 2017

Background

The present randomized clinical trial characterized the beneficial effects of a multi-strain probiotics supplementation on improving circulating endotoxin levels (primary endpoint) and other cardiometabolic biomarkers (secondary endpoint) in patients with T2DM.

Methods

A total of 78 adult Saudi T2DM patients (naïve and without co-morbidities) participated in this clinical trial and were randomized to receive twice daily placebo or probiotics [(2.5 × 109 cfu/g) containing the following bacterial strains: Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Lactobacillus acidophilus W37, Lactobacillus brevis W63, Lactobacillus casei W56, Lactobacillus salivarius W24, Lactococcus lactis W19 and Lactococcus lactis W58 (Ecologic®Barrier)] in a double-blind manner for 12 weeks. Anthropometrics and cardiometabolic profiles were obtained at baseline and after 12/13 weeks of treatment.

Results

After 12/13 weeks of intervention and using intention-to-treat analysis, no difference was noted in endotoxin levels between groups [Placebo − 9.5% vs. Probiotics − 52.2%; (CI − 0.05 to 0.36; p = 0.15)]. Compared with the placebo group however, participants in the probiotics groups had a significant but modest improvement in WHR [Placebo 0.0% vs. Probiotics 1.11%; (CI − 0.12 to − 0.01; p = 0.02)] as well as a clinically significant improvement in HOMA-IR [Placebo − 12.2% vs. Probiotics − 60.4%; (CI − 0.34 to − 0.01; p = 0.04)].

Conclusion

Using a multi-strain probiotic supplement daily for 12/13 weeks significantly improved HOMA-IR and modestly reduced abdominal adiposity among medication naïve T2DM patients.

Trial Registration: ClinicalTrials.gov Identifier: NCT01765517, Registered January 10, 2013
Management and investigation of a Serratia marcescens outbreak in a neonatal unit in Switzerland – the role of hand hygiene and whole genome sequencing
Authors: Zingg Walter , Soulake Isabelle , Baud Damien , Huttner Benedikt , Pfister Riccardo , Renzi Gesuele , Pittet Didier , Schrenzel Jacques , Francois Patrice
Published: December 2017

Background

Many outbreaks due to Serratia marcescens among neonates have been described in the literature but little is known about the role of whole genome sequencing in outbreak analysis and management.

Methods

Between February and March 2013, 2 neonates and 2 infants previously hospitalised in the neonatal unit of a tertiary care centre in Switzerland, were found to be colonised with S. marcescens. An investigation was launched with extensive environmental sampling and neonatal screening in four consecutive point prevalence surveys between April and May 2013. All identified isolates were first investigated by fingerprinting and later by whole genome sequencing. Audits of best practices were performed and a hand hygiene promotion programme was implemented.

Results

Twenty neonates were colonised with S. marcescens. No invasive infection due to S. marcescens occurred. All 231 environmental samples were negative. Hand hygiene compliance improved from 51% in April 2013 to 79% in May 2013 and remained high thereafter. No S. marcescens was identified in point prevalence surveys in June and October 2013. All strains were identical in the fingerprinting analysis and closely related according to whole genome sequencing.

Conclusions

Improving best practices and particularly hand hygiene proved effective in terminating the outbreak. Whole genome sequencing is a helpful tool for genotyping because it allows both sufficient discrimination of strains and comparison to other outbreaks through the use of an emerging international database.
Mannitol and the blood-labyrinth barrier
Authors: Le Trung N. , Blakley Brian W.
Published: December 2017

Background

Characterization of the blood labyrinth barrier (BLB) is extremely important to determine whether the BLB can be manipulated pharmacologically. However, experiments to investigate the BLB are technically difficult to perform. In this report, we demonstrated a unique method of controlling the BLB, and established the pharmacokinetics of gentamicin in perilymph, cerebrospinal fluid (CSF) and blood with and without mannitol.

Study design

Controlled animal research project.

Methods

Permeability of the BLB and the blood brain barrier (BBB) to gentamicin with and without mannitol was studied by collecting 175 samples from 44 guinea pigs using concentrations relevant to human clinical situations. Samples were taken from two groups of 22 animals, with each animal undergoing sampling at a different time after administration of either 10 mg/ml gentamicin (4 mg/kg) (Gardena, CA) alone or gentamicin with 20% mannitol (250 mg/kg) (Mallinckrodt Inc., KY). The sample times varied from 0.5 to 17.5 h post-infusion. Samples were also taken from 4 animals as negative controls after administration of normal saline. Our goal was to simultaneously assess the pharmacokinetics of gentamicin in each of three different fluid samples in the same animal. Thus at the pre-determined post-infusion sampling time, each animal was sampled once for perilymph, CSF, and blood before being euthanized. Each animal contributed to a single time point on the subsequent pharmacokinetic curves with more than one animal per time point.

Results

Mannitol increased the rate of entry and egress of gentamicin through BLB significantly ( p = 0.0044) but the effects on the BBB did not reach statistical significance ( p = 0.581). Mannitol did not alter renal clearance of gentamicin from the blood ( p = 0.433). The concentration of gentamicin in perilymph and CSF was always significantly lower than in blood.

Conclusions

Mannitol administration transiently increases the permeability of the BLB. Potential clinical benefits may accrue from selected timing of administration of osmotic agents such as mannitol augmenting the rate of entry and egress of compounds such as gentamicin into and out of perilymph.
A New Photo-Control Method for Organic–Inorganic Interface Dipoles and Its Application to Photo-Controllable Molecular Devices
Authors: Suda Masayuki
Published: December 2017

The ability to manipulate the behavior of electrons at organic–inorganic interfaces is of crucial importance in the development of future molecular devices. It has been shown that interface dipoles, created by the chemisorption of a self-assembled organic monolayer (SAM) on a solid surface, induce carrier injection effects. This means that the interface electronic properties can be manipulated by designing the molecular dipoles and arrangements in the SAMs. In this study, a novel strategy to photo-control molecular dipoles through the use of photochromic SAMs is proposed, and a number of photo-controllable molecular devices have been developed based on this strategy. This account provides a review of the basic concept of the photo-control of interface dipoles and the recent advances in the development of photo-controllable molecular devices.
Structural abnormalities and altered regional brain activity in multiple sclerosis with simple spinal cord involvement
Authors: Yin Ping , Liu Yi , Xiong Hua , Han Yongliang , Sah Shambhu Kumar , Zeng Chun , Wang Jingjie , Li Yongmei
Published: December 2017

Objective:

To assess the changes of the structural and functional abnormalities in multiple sclerosis with simple spinal cord involvement (MS-SSCI) by using resting-state functional MRI (RS-fMRI), voxel based morphology (VBM) and diffusion tensor tractography.

Methods:

The amplitude of low-frequency fluctuation (ALFF) of 22 patients with MS-SSCI and 22 healthy controls (HCs) matched for age, gender and education were compared by using RS-fMRI. We also compared the volume, fractional anisotropy (FA) and apparent diffusion coefficient of the brain regions in baseline brain activity by using VBM and diffusion tensor imaging. The relationships between the expanded disability states scale (EDSS) scores, changed parameters of structure and function were further explored.

Results:

(1) Compared with HCs, the ALFF of the bilateral hippocampus and right middle temporal gyrus in MS-SSCI decreased significantly. However, patients exhibited increased ALFF in the left middle frontal gyrus, left posterior cingulate gyrus and right middle occipital gyrus ( two-sample t-test, after AlphaSim correction, p < 0.01, voxel size > 40). The volume of right middle frontal gyrus reduced significantly (p < 0.01). The FA and ADC of right hippocampus, the FA of left hippocampus and right middle temporal gyrus were significantly different. (2) A significant correlation between EDSS scores and ALFF was noted only in the left posterior cingulate gyrus.

Conclusion:

Our results detected structural and functional abnormalities in MS-SSCI and functional parameters were associated with clinical abnormalities. Multimodal imaging plays an important role in detecting structural and functional abnormalities in MS-SSCI.

Advances in knowledge:

This is the first time to apply RS-fMRI, VBM and diffusion tensor tractography to study the structural and functional abnormalities in MS-SSCI, and to explore its correlation with EDSS score.
Senescence and tumor suppression
Authors: Hinds Philip , Pietruska Jodie
Published: December 2017

Cellular senescence has emerged as a potent tumor suppression mechanism that restrains proliferation of cells at risk for malignant transformation. Although senescent cells have permanently exited the cell cycle, their presence can have detrimental effects on the surrounding tissue, largely due to the development of the senescence-associated secretory phenotype (SASP). Here, we review the tumor-suppressive and tumor-promoting consequences of the senescence response, focusing on the SASP as a key mediator of this dichotomy. Accumulating evidence suggests that the persistence of senescent cells can exacerbate the development of a pro-inflammatory, immunosuppressive microenvironment that can favor tumorigenesis. Given that senescence of tumor and stromal cells is a frequent outcome of anti-cancer therapy, approaches that harness the growth inhibitory effects of senescence while limiting its detrimental effects are likely to have great clinical potential.
Crystallization and preliminary X-ray diffraction analysis of YejM from Salmonella typhimurium: an essential inner membrane protein involved in outer membrane directed cardiolipin transport
Authors: Gabale Uma , Qian Gene , Roach Elaina , Ressl Susanne
Published: December 2017

Salmonella  typhimurium is responsible for over 35% of all foodborne illness related hospitalizations in the United States. This Gram-negative bacterium possesses an inner and an outer membrane (OM), the latter allowing its survival and replication within host tissues. During infection, OM is remodeled by transport of glycerophospholipids across the periplasm and into the OM. Increased levels of cardiolipin in the OM were observed upon PhoPQ activation and led to the discovery of YejM; an inner membrane protein essential for cell growth involved in cardiolipin binding and transport to the OM. Here we report how YejM was engineered to facilitate crystal growth and X-ray diffraction analysis. Successful structure determination of YejM will help us understand how they interact and how YejM facilitates cardiolipin transport to the OM. Ultimately, yejm, being an essential gene, may lead to new drug targets inhibiting the pathogenic properties of S. typhimurium.
MODELING OF KREDITING PROCESSES IN COMMERCIAL BANK ACCORDING TO CURRENT PROBLEMS
Authors: Иремадзе Элисо , Iremadze Eliso , Антонова Наталия , Antonova Natalia , Нигматуллин Артур , Nigmatullin Artur
Published: December 2017

The purpose of the study is to work out practical recommendations for the formation of bank liabilities, optimization of their structure and the use of credit resources in the commercial bank «Russian Standard».

Practical recommendations, given for optimizing the formation and the use of credit resources in the commercial bank "Russian Standard" can be used in different bank organizations
Professional Identity of the Student As a Reality
Authors: Бикбулатова Валентина , Bikbulatova Valentina , Рабаданова Разият , Rabadanova Raziyat , Юлина Галина , Yulina Galina
Published: December 2017

This article considers the problem of professional readiness and professional identity of students, the essence and method of development. The subject of research is the self-actualization of the individual of a student. The object of the research are students of psychological and pedagogical education, psychology of Moscow State University of Technologies and Managementnamed after K.G. Razumovskiy
Features of Application of Information Test Technologies in the Teaching of Technical Disciplines
Authors: Курочкин Анатолий , Kurochkin Anatoliy , Фролов Дмитрий , Frolov Dmitriy
Published: December 2017

Among the new technologies for teaching and controlling students' knowledge, test technologies, whose development is based on the computerization of the educational process, are of greatest interest. A very common shortcoming of some testing programs is to ensure the performance of only one function - knowledge control. While this process is a component of the learning process and should be integrated with it as much as possible. This task can be solved on the basis of the use of educational technologies with the use of all kinds of information technologies for teaching and new teaching methods, as well as computer technologies for organizing independent work while testing knowledge and teaching technical disciplines. The practical implementation of these directions involves the development of test tasks that perform both monitoring and training functions. The relevance of the chosen topic determined the purpose of the work - identifying the features of the training and controlling complex for technical disciplines in the training of bachelors. As a result of the research, we offer a test technology in which several functions of the teacher are given to the training and controlling complex, which represents the software product. The developed technique and the accounted features of the use of the training and controlling complex for technical disciplines made it possible to increase the effectiveness of training by test methods, which was confirmed by the students' questioning.
A Discrete Event Model of Viability Building in a Public University Organization
Authors: Oltean Virginia Ecaterina , Borangiu Theodor , Drăgoicea Monica
Published: December 2017

In the context of today’s interconnected world, public higher education is confronted with a shift of its role from public good to public service, which is accompanied by new challenges in building and maintaining the viability of public universities. There is a vast literature on this topic, but there is not yet reported a systematic approach in modeling the basic steps of decision making and problem solving to be completed by a public university to remain viable. Starting from the concepts of service system, and consonance and resonance as key viability conditions, this paper proposes a discrete event model of the viability building and maintaining process in a generic public university organization. The model evolution is driven by events conditioned by internal, external, or mixed causes. Some of the uncontrollable events occurring in the process may drive the discrete evolution to disturbance rejection states, where specific recovery strategies are applied. If recovery is successful, disturbances may become sources of innovation. The discrete event model can be used as a theoretical and conceptual tool for building and testing instances of the viability building and maintaining processes in public universities, and also for refining academic evaluation criteria by the authorities.
Enhancing the Design and Management of the Product-Service System Supply Chain: An Application to the Automotive Sector
Authors: Resta Barbara , Gaiardelli Paolo , Cavalieri Sergio , Dotti Stefano
Published: December 2017

The proper design and management of product-service system (PSS) supply chains is a prerequisite for the successful implementation of servitised business models. As underlined by empirical evidence, research on how different types of PSS offerings affect the design and management of the upstream supply chain of PSS providers still appears to be lagging. Therefore, this paper introduces a theoretical explanatory conceptual framework derived from a literature analysis and further developed by four case studies from the automotive sector, which highlight the linkages between the value proposition and supply chain of PSS providers. The results are summarised into 11 propositions that underline the key roles and capabilities that bridge PSS offering features with distinctive characteristics of the PSS supply chain. They also show specific patterns of partners’ relationships and organisational configurations that can be identified during the servitisation transformation.