bluuebunny/crossref_metadata_2025 huggingface dataset:
Academic Literacy and Cognitive Processing: Effects on the Examination Outcomes of Speech-Language Pathology Students at a South African University
Authors: Jordaan Heila , Moonsamy Sharon
Published: February 2015

This study was conducted in the South African context, where education is in a state of transition. One of the central issues in higher education is the development of academic literacy. However, as a result of an inadequate focus on educational linguistics and a lack of explicit instruction in academic literacy, many students do not achieve their full potential. This study focuses on aspects of academic literacy in the examination responses of a group of students studying in the discipline of speech-language pathology. The purpose of the study was to determine whether or not there is a relationship between the students’ academic literacy skills and their ability to answer examination questions. By means of an exploratory retrospective longitudinal record review, the examination scripts of 20 students were rated for evidence of various academic literacy skills. The ratings were highly correlated to the actual examination marks in both years of study, suggesting that there is a need to incorporate explicit instruction in academic literacy to develop students’ metacognitive processes while reading and writing for academic purposes.
Developing emergency department physician shift schedules optimized to meet patient demand
Authors: Savage David W. , Woolford Douglas G. , Weaver Bruce , Wood David
Published: February 2015

Objectives: 1) To assess temporal patterns in historical patient arrival rates in an emergency department (ED) to determine the appropriate number of shift schedules in an acute care area and a fast-track clinic and 2) to determine whether physician scheduling can be improved by aligning physician productivity with patient arrivals using an optimization planning model.

Methods: Historical data were statistically analyzed to determine whether the number of patients arriving at the ED varied by weekday, weekend, or holiday weekend. Poisson-based generalized additive models were used to develop models of patient arrival rate throughout the day. A mathematical programming model was used to produce an optimal ED shift schedule for the estimated patient arrival rates. We compared the current physician schedule to three other scheduling scenarios: 1) a revised schedule produced by the planning model, 2) the revised schedule with an additional acute care physician, and 3) the revised schedule with an additional fast-track clinic physician.

Results:Statistical modelling found that patient arrival rates were different for acute care versus fast-track clinics; the patterns in arrivals followed essentially the same daily pattern in the acute care area; and arrival patterns differed on weekdays versus weekends in the fast-track clinic. The planning model reduced the unmet patient demand (i.e., the average number of patients arriving at the ED beyond the average physician productivity) by 19%, 39%, and 69% for the three scenarios examined.

Conclusions: The planning model improved the shift schedules by aligning physician productivity with patient arrivals at the ED.
Impact of an in-house emergency radiologist on report turnaround time
Authors: Lamb Leslie , Kashani Paria , Ryan John , Hebert Guy , Sheikh Adnan , Thornhill Rebecca , Fasih Najla
Published: February 2015

Background

One of the many challenges facing emergency departments (EDs) across North America is timely access to emergency radiology services. Academic institutions, which are typically also regional referral centres, frequently require cross-sectional studies to be performed 24 hours a day with expedited final reports to accelerate patient care and ED flow.

Objective

The purpose of this study was to determine if the presence of an in-house radiologist, in addition to a radiology resident dedicated to the ED, had a significant impact on report turnaround time.

Methods

Preliminary and final report turnaround times, provided by the radiology resident and staff, respectively, for patients undergoing computed tomography or ultrasonography of their abdomen/pelvis in 2008 (before the implementation of emergency radiology in-house staff service) were compared to those performed during the same time frame in 2009 and 2010 (after staffing protocols were changed).

Results

A total of 1,624 reports were reviewed. Overall, there was no statistically significant decrease in the preliminary report turnaround times between 2008 and 2009 (p = 0.1102), 2009 and 2010 (p = 0.6232), or 2008 and 2010 (p = 0.0890), although times consistently decreased from a median of 2.40 hours to 2.08 hours to 2.05 hours (2008 to 2009 to 2010). There was a statistically significant decrease in final report turnaround times between 2008 and 2009 (p < 0.0001), 2009 and 2010 (p < 0.0011), and 2008 and 2010 (p < 0.0001). Median final report times decreased from 5.00 hours to 3.08 hours to 2.75 hours in 2008, 2009, and 2010, respectively. There was also a significant decrease in the time interval between preliminary and final reports between 2008 and 2009 (p < 0.0001) and 2008 and 2010 (p < 0.0001) but no significant change between 2009 and 2010 (p = 0.4144).

Conclusion

Our results indicate that the presence of a dedicated ED radiologist significantly reduces final report turnaround time and thus may positively impact the time to ED patient disposition. Patient care is improved when attending radiologists are immediately available to read complex films, both in terms of health care outcomes and regarding the need for repeat testing. Providing emergency physicians with accurate imaging findings as rapidly as possible facilitates effective and timely management and thus optimizes patient care.
Airway management of an open penetrating neck injury
Authors: Youssef Nayer , Raymer Karen E.
Published: February 2015

Although penetrating neck injuries (PNIs) represent a small subset of patients presenting to the emergency department (ED), they can result in significant morbidity and mortality. The approach to airway management in PNI varies widely according to clinical presentation and local practice, such that global management statements are lacking. Although rapid sequence intubation (RSI) may be safe in most patients with PNI, the high-risk subset (10%) of patients with laryngotracheal injury require particularly judicious airway management. It is not known if RSI is safe in such patients, nor has there been reported use of videolaryngoscopy in patients with open PNI. Established principles of airway management in patients with an open airway injury include the avoidance of both positive pressure bag-mask ventilation and blind tube passage and the early consideration of a surgical airway. Because this high-risk subset may not be clinically apparent on initial presentation in the ED, such guiding principles apply to all patients with PNI until the nature of the injury is more accurately defined. In this report, we present the case of a patient who presented to the ED with a zone II open PNI, which occurred as a result of a stab wound.
Randomized controlled trial of a nursing intervention to reduce emergency department revisits
Authors: Cossette Sylvie , Vadeboncoeur Alain , Frasure-Smith Nancy , McCusker Jane , Perreault Danielle , Guertin Marie-Claude
Published: February 2015

Objective

To determine whether a nursing intervention delivered at emergency department (ED) discharge would reduce ED revisits.

Method

A randomized study was conducted in the ED of a tertiary cardiac hospital in Montreal, Quebec. Between November 2006 and March 2010, 3,795 patients were assessed for eligibility based on two risk factors for ED revisits (≥1 ED visit in the past year and ≥6 medications); 132 were randomized to the experimental group (EG) and 133 to the control group (CG). The intervention included one nurse-patient meeting before leaving the ED, with two additional telephone contacts over the next 2 weeks. The primary outcome was time to ED revisits within 30 days after discharge. Secondary outcomes included time to ED revisits over 90, 180, and 365 days and hospitalizations over 30, 90, 180, and 365 days.

Results

A planned interim analysis that stopped the study with half of the planned sample showed that the time to ED revisits was similar in both groups at 30 days (p=0.81; revisits: 18.2% in EG, 19.6% in CG), 90 days (p=0.44), 180 days (p=0.98), and 365 days (p=0.75). The only difference identified was a lower hospitalization proportion at 180 days in the EG group (13.6% v. 24.1%; p=0.038).

Conclusions

These findings are consistent with previous research showing that few ED-based interventions are successful in reducing ED returns. Factors other than those targeted by the intervention, including an improvement in usual care, may explain the findings.
Presenting characteristics of patients undergoing cardiac troponin measurements in the emergency department
Authors: Goodman Daniel A. , Kavsak Peter A. , Hill Stephen A. , Worster Andrew
Published: February 2015

Introduction

Not all patients with suspected acute coronary syndrome (ACS) receiving cardiac troponin (cTn) testing present to the emergency department (ED) with cardiac chest pain. Since elderly patients (age ≥70) have increased morbidity and mortality associated with ACS, complaints other than cardiac chest pain may justify cTn testing. Our primary objective was to characterize the population of ED patients who receive cTn testing. The secondary objective was to determine if elderly patients underwent cTn testing for different presenting complaints than their younger counterparts.

Methods

We created an electronic database including Canadian Emergency Department Information Systems (CEDIS) presenting complaints, age, sex, disposition, and Canadian Triage Acuity Scale (CTAS) score, for patients who received cTn testing in three Canadian EDs during 2011. We analyzed the data for patient characteristics and sorted by age (<70 and ≥70) for further analysis.

Results

In the 15,824 included patients, the average age was 66 (51%<70; 51% female). The most common presenting complaints were cardiac chest pain (n=3,267) and shortness of breath (n=2,266). The elderly underwent cTn testing for significantly (p<0.0001) different complaints than their younger counterparts. They more commonly presented with generalized weakness (n=898), whereas younger patients more frequently had abdominal pain (n=576).

Conclusions

Cardiac chest pain and shortness of breath are presenting complaints in one-third of patients undergoing ED cTn testing. The majority of patients undergoing cTn testing did not have typical ACS symptoms. Half of all cTn testing in the ED is on the elderly, who present with different complaints than their younger counterparts.
Prevalence of alternative diagnoses in patients with suspected uncomplicated renal colic undergoing computed tomography: a prospective study
Authors: Pernet Julie , Abergel Sandra , Parra Jerome , Ayed Amine , Bokobza Jerome , Renard-Penna Raphaelle , Tostivint Isabelle , Bitker Marc-Olivier , Riou Bruno , Freund Yonathan
Published: February 2015

Objectives

Unenhanced computed tomography (CT) has become a standard imaging technique for uncomplicated renal colic in many countries. The appropriate timing of CT imaging has not been established, and guidelines recommend that this imaging be performed between 1 and 7 days of presentation. The primary objective of this study was to determine the prevalence of alternative diagnosis identified with low-dose unenhanced CT in the emergency department (ED) in patients with suspected uncomplicated renal colic.

Methods

This prospective single-centre study was carried out in a large university hospital ED. Over a 6-month period, all patients with clinically diagnosed renal colic and a plan to be discharged underwent low-dose unenhanced CT in the ED. Pregnant women, women of childbearing age not willing to have a pregnancy test, and patients who had already undergone diagnostic imaging were excluded. The primary outcome was the number and nature of the alternative diagnosis. Univariate analyses were performed to assess factors associated with the primary outcome.

Results

A total of 178 patients were screened, and 155 underwent CT in the ED. The mean age was 42.2 years; 69% were male. The diagnosis of uncomplicated renal colic was confirmed in 118 participants (76%); 27 (17%) had an inconclusive CT scan. Overall, 10 patients (6%; 95% confidence interval [CI] 3–10) had an alternative diagnosis, 5 of whom were subsequently hospitalized.

Conclusion

Low-dose unenhanced CT in the ED detects alternative diagnoses in 6% (95% CI 3–10) of patients with suspected uncomplicated renal colic, half of whom are subsequently hospitalized. Our prospective findings, which were similar to those reported in retrospective studies, are a potential argument for a systematic approach to ED imaging in suspected renal colic. Future research involving intervention and control groups would be helpful.
Epidemiology and outcomes of bloodstream infections in patients discharged from the emergency department
Authors: Chan Justine , Wong Jenna , Saginur Raphael , Forster Alan J. , van Walraven Carl
Published: February 2015

Objective

To determine the outcomes of patients discharged from the emergency department (ED) with a bloodstream infection (BSI) and how these outcomes are influenced by antibiotic treatment.

Method

We identified every BSI in adult patients discharged from our ED to the community between July 1, 2002, and March 31, 2011. The medical records of all cases were reviewed to determine antibiotic treatment in the ED and at discharge. Microorganism sensitivities were used to determine whether antibiotics were appropriate. These data were linked to population-based administrative data to determine specific patient outcomes within the subsequent 2-week period: death, urgent hospitalization, or an unplanned return to the ED.

Results

A total of 480 adults with BSI were identified (1.49 cases per 1,000 adults discharged from the department). Compared to controls (321,048 patients), BSI patients had a significantly higher risk of urgent hospitalization (adjusted OR 2.1 [95% CI 1.6–2.8]) and unplanned return to the ED (adjusted OR 4.1 [95% CI 3.3–4.9]). Outcome risk was significantly lowered in BSI patients who received appropriate antibiotics in the ED and at discharge. In elderly patients, the risk of urgent hospitalization increased significantly as the time to appropriate antibiotics was delayed.

Conclusions

BSI patients discharged from the ED have a significantly increased risk of urgent hospitalization and unplanned return to the ED in the subsequent 2 weeks. These risks decrease significantly with the timely provision of appropriate antibiotics. Our results support the aggressive use of measures ensuring that such patients receive appropriate antibiotics as soon as possible.
Inflating the endotracheal tube cuff with saline to confirm correct depth using bedside ultrasonography
Authors: Tessaro Mark O. , Arroyo Alexander C. , Haines Lawrence E. , Dickman Eitan
Published: February 2015

Although bedside ultrasonography can accurately distinguish esophageal from tracheal intubation, it is not used to establish the correct depth of endotracheal tube insertion. As indirect sonographic markers of endotracheal tube insertion depth have proven unreliable, a method for visual verification of correct tube depth would be ideal. We describe the use of saline to inflate the endotracheal cuff to confirm correct endotracheal tube depth (at the level of the suprasternal notch) by bedside ultrasonography during resuscitation. This rapid technique holds promise during emergency intubation.
Function of Isolated Pancreatic Islets From Patients at Onset of Type 1 Diabetes: Insulin Secretion Can Be Restored After Some Days in a Nondiabetogenic Environment In Vitro
Authors: Krogvold Lars , Skog Oskar , Sundström Görel , Edwin Bjørn , Buanes Trond , Hanssen Kristian F. , Ludvigsson Johnny , Grabherr Manfred , Korsgren Olle , Dahl-Jørgensen Knut
Published: February 2015

The understanding of the etiology of type 1 diabetes (T1D) remains limited. One objective of the Diabetes Virus Detection (DiViD) study was to collect pancreatic tissue from living subjects shortly after the diagnosis of T1D. Here we report the insulin secretion ability by in vitro glucose perifusion and explore the expression of insulin pathway genes in isolated islets of Langerhans from these patients. Whole-genome RNA sequencing was performed on islets from six DiViD study patients and two organ donors who died at the onset of T1D, and the findings were compared with those from three nondiabetic organ donors. All human transcripts involved in the insulin pathway were present in the islets at the onset of T1D. Glucose-induced insulin secretion was present in some patients at the onset of T1D, and a perfectly normalized biphasic insulin release was obtained after some days in a nondiabetogenic environment in vitro. This indicates that the potential for endogenous insulin production is good, which could be taken advantage of if the disease process was reversed at diagnosis.
Correlates of Aortic Stiffness Progression in Patients With Type 2 Diabetes: Importance of Glycemic Control
Authors: Ferreira Marcel T. , Leite Nathalie C. , Cardoso Claudia R.L. , Salles Gil F.
Published: February 2015

OBJECTIVE

The correlates of serial changes in aortic stiffness in patients with diabetes have never been investigated. We aimed to examine the importance of glycemic control on progression/regression of carotid-femoral pulse wave velocity (cf-PWV) in type 2 diabetes.

RESEARCH DESIGN AND METHODS

In a prospective study, two cf-PWV measurements were performed with the Complior equipment in 417 patients with type 2 diabetes over a mean follow-up of 4.2 years. Clinical laboratory data were obtained at baseline and throughout follow-up. Multivariable linear/logistic regressions assessed the independent correlates of changes in cf-PWV.

RESULTS

Median cf-PWV increase was 0.11 m/s per year (1.1% per year). Overall, 212 patients (51%) increased/persisted with high cf-PWV, while 205 (49%) reduced/persisted with low cf-PWV. Multivariate linear regression demonstrated direct associations between cf-PWV changes and mean HbA1c during follow-up (partial correlation 0.14, P = 0.005). On logistic regression, a mean HbA1c ≥7.5% (58 mmol/mol) was associated with twofold higher odds of having increased/persistently high cf-PWV during follow-up. Furthermore, the rate of HbA1c reduction relative to baseline levels was inversely associated with cf-PWV changes (partial correlation −0.11, P = 0.011) and associated with reduced risk of having increased/persistently high aortic stiffness (odds ratio 0.82 [95% CI 0.69–0.96]; P = 0.017). Other independent correlates of progression in aortic stiffness were increases in systolic blood pressure and heart rate between the two cf-PWV measurements, older age, female sex, and presence of dyslipidemia and retinopathy.

CONCLUSIONS

Better glycemic control, together with reductions in blood pressure and heart rate, was the most important correlate to attenuate/prevent progression of aortic stiffness in patients with type 2 diabetes.
The Effect of Hull Biofouling on Parameters Characterising Ship Propulsion System Efficiency
Authors: Tarełko Wiesła
Published: February 2015

One of most important issues concerning technical objects is the increase of their operating performance. For a ship this performance mainly depends on the efficiency of its main pro-pulsion system and the resistance generated during its motion on water. The overall ship re-sistance, in turn, mainly depends on the hull friction resistance, closely related with the pres-ence of different types of roughness on the hull surface, including underwater part biofouling. The article analyses the effect of hull biofouling on selected parameters characterising the efficiency of the ship propulsion system with adjustable propeller. For this purpose a two-year research experiment was performed on a sailing vessel during its motor navigation phases. Based on the obtained results, three groups of characteristics were worked out for different combinations of engine rotational speed and adjustable propeller pitch settings. The obtained results have revealed that the phenomenon of underwater hull biofouling affects remarkably the parameters characterising propulsion system efficiency. In particular, the development of the biofouling layer leads to significant reduction of the speed of navigation.
Capabilities to Assess Health/Maintenance Status of Gas Turbine Blades with Non-Destructive Methods
Authors: Błachnio Józef
Published: February 2015

The paper has been intended to discuss non-destructive testing methods and to present capabilities of applying them to diagnose objectively changes in the microstructure of a turbine blade with computer software engaged to assist with the analyses. The following techniques are discussed: a visual method, based on the processing of images of the material surface in visible light, active thermography, based on the detection of infrared radiation, and the X-ray computed tomography. All these are new non-destructive methods of assessing technical condition of structural components of machines. They have been intensively developed at research centers worldwide, and in Poland. The computer-aided visual method of analyzing images enables diagnosis of the condition of turbine blades, without the necessity of dismantling of the turbine. On the other hand, the active thermography and the X-ray computed tomography, although more sensitive and more reliable, can both be used with the blades dismounted from the turbine. If applied in a complex way, the non-destructive methods presented in this paper, are expected to increase significantly probability of detecting changes in the blade's condition, which in turn would be advantageous to reliability and safety of gas turbine service.
A Hydrogenic Electrolyzer for Fuels
Authors: Żółtowski Bogdan , Żółtowski Mariusz
Published: February 2015

In this work - in view of still decreasing crude oil resources and increasing fuel prices - are presented issues concerning research on development of other, alternative fuel sources including those used in water, land and air transport means. One of them is hydrogen which, while burning, does not produce noxious carbon dioxide but only side effects such as heat and clean water.

It is almost true that along with sudden drop of availability and rising price of crude oil many countries face economical paralysis. Any of alternative sources is not capable of supplying even only a basic amount of such energy, not mentioning the whole amount of energy demanded by our civilization. Hydrogen as an independent fuel for internal combustion engines has yet to go a long way to commercialization. to be Co-burning systems (combustion of mixtures)of today used hydrocarbon fuels combined with hydrogen seem closer to this aim. As proved in many investigations the substitution of a part of hydrocarbon fuel by hydrogen enables to make use of beneficial features of both the fuels.

One of possible solutions of the problem may be application of an innovative hydrogenic fuel electrolyzer which is presented and evaluated in this paper.
Effect of Microstructure on Mechanical Properties and Corrosion Resistance of 2205 Duplex Stainless Steel
Authors: Łabanowski Jerzy , Świerczyńska Aleksandra , Topolska Santina
Published: February 2015

This paper presents results of the research on impact of microstructure of austenitic-ferritic steel of duplex type on its mechanical properties and susceptibility to stress corrosion cracking. As showed, improper processing technologies more and more often used in shipbuilding industry for plates and other half-finished products made of duplex steel may cause significant lowering their properties, which frequently makes their replacing necessary. Results of the tests on stress corrosion under tension with low strain rate (SSRT) conducted in an inert and corrosion (boiling magnesium chloride) environment, are presented. It was proved that even minor structural transformations taking place in 500°C ageing temperature lower corrosion resistance of the steel. Structural transformations occurring in 700°C temperature to a smaller extent influence susceptibility to stress corrosion of the steel, however they cause drastic drop in its plasticity.
The Possibilities of Using the Terrestrial Scanning Data for Classification of Rocks in Limestone Mine “Czatkowice”
Authors: Toś Cezary
Published: February 2015

This paper presents results of a research of potential utilisation of the intensity of laser beam reflection recorded by ground-based lasers, for an initial classification of rock formations within the Czatkowice Limestone Quarry. As part of the research, spectrometric analysis in visible (VIS), near-infrared (NIR) and Short-wavelength infrared (SWIR) bands was carried out for rock samples typical for the Czatkowice Quarry. Moreover, the rock samples were scanned using equipment working within different wavelengths. The reflected intensity of the laser beam recorded for each rock sample with several different scanners were analysed to assess their potential use for rock classification. The results of this analysis were then compared with spectral curves of each sample. The relationship between the intensity of the laser beam reflection and the spectral curves can be used for selection of most suitable scanner for rock classification.
Study of Vertical Movements of the European Crust Using Tide Gauge and Gnss Observations
Authors: Tretyak Kornyliy , Dosyn Solomiya
Published: February 2015

This research is devoted to the study of vertical movements of the European crust on the basis of two independent methods, namely tide gauge and GNSS observations results. The description and classification of factors affecting sea level change has been made. The precision with which the movement of the earth's crust according to the results of tide gauge observations can be explored has been calculated . A methodology to identify the duration of tide gauge observations required for studies of vertical movements of the earth 's crust has been presented. Approximation of tide gauge time series with the help of Fourier series has been implemented, the need for long-term observations in certain areas has been explained. The diagram of the velocities of the vertical movements of the European crust on the basis of the tide gauge data and GNSS observations has been built and the anomalous areas where the observations do not coincide have been identified.
The Time Course of Dexamethasone Delivery Using Iontophoresis Through Human Skin, Measured via Microdialysis
Authors: Rigby Justin H. , Draper David O. , Johnson A. Wayne , Myrer J. William , Eggett Dennis L. , Mack Gary W.
Published: February 2015

Study Design

Controlled laboratory study.

Objective

To determine the time course of dexamethasone sodium phosphate (Dex-P) during iontophoresis to underlying tissues using microdialysis.

Background

In human participants, real-time information of Dex-P transdermal delivery during iontophoresis is unknown.

Methods

Sixty-four healthy male participants (mean ± SD age, 24.2 ± 3.3 years; height, 181.8 ± 26.1 cm; mass, 82.4 ± 11.8 kg; subcutaneous fat thickness, 0.61 ± 0.19 cm) were randomly assigned into 1 of 6 groups: (1) 1-mA current, 1-mm probe depth; (2) 1-mA current, 4-mm probe depth; (3) 2-mA current, 1-mm probe depth; (4) 2-mA current, 4-mm probe depth; (5) in vivo retrodialysis; and (6) skin perfusion flowmetry. Microdialysis probes were used to assess the combined recovery (Dex-total) of Dex-P, dexamethasone, and its metabolite.

Results

There was no difference in Dex-total between current intensities (P = .99), but a greater amount of Dex-total was recovered superficially at 1 mm compared to the 4-mm depth (P<.0001). Peak concentration mean ± SD values for the 1- and 2-mA currents at 1 mm were 10.8 ± 8.1 and 7.7 ± 5.5 µg/mL, and at 4 mm were 2.0 ± 0.8 and 1.3 ± 0.9 µg/mL, respectively. Peak skin perfusion was 741.4% ± 408.7% and 711.6% ± 260.8% at baseline for 1- and 2-mA intensities, respectively. Skin perfusion returned to baseline levels earlier during 1-mA intensity at a 110 mA·min dose within the treatment, compared to 2 mA at 60 minutes posttreatment.

Conclusion

Transdermal delivery of Dex-P during iontophoresis was successfully measured in vivo through human skin. Measurable concentrations of Dex-total were found regardless of current intensity. Although current-induced vasodilation occurred, it did not significantly affect the tissue accumulation of Dex-total. J Orthop Sports Phys Ther 2015;45(3):190–197. doi:10.2519/jospt.2015.5308
Cluster of two cases of botulism due to Clostridium baratii type F in France, November 2014
Authors: Castor C , Mazuet C , Saint-Leger M , Vygen S , Coutureau J , Durand M , Popoff M R , Jourdan Da Silva N
Published: February 2015

The first two cases in France of botulism due to Clostridium baratii type F were identified in November 2014, in the same family. Both cases required prolonged respiratory assistance. One of the cases had extremely high toxin serum levels and remained paralysed for two weeks. Investigations strongly supported the hypothesis of a common exposure during a family meal with high level contamination of the source. However, all analyses of leftover food remained negative.
Surveillance of infant pertussis in Sweden 1998–2012; severity of disease in relation to the national vaccination programme
Authors: Carlsson R M , von Segebaden K , Bergström J , Kling A M , Nilsson L
Published: February 2015

Binary file ES_Abstracts_Final_ECDC.txt matches
The One Health approach for the management of an imported case of rabies in mainland Spain in 2013
Authors: Pérez de Diego A C , Vigo M , Monsalve J , Escudero A
Published: February 2015

After more than 30 years without any reported cases of rabies in terrestrial carnivores in mainland Spain, an imported case was detected in June 2013 in Toledo. Although the infected dog was moved across different locations and had contact with humans and dogs, the incident was controlled within a few days. An epidemiological investigation was performed and rabies-free status in terrestrial carnivores in mainland Spain was restored six months after the incident. Key to the successful management of this case were the previous vaccination of susceptible animals in the affected area before the case was detected, the collaboration of different authorities in decision making, and the application of control measures according to national and international regulations and to the One Health concept.
A World Event (On Circumnavigation, 1519-1522)
Authors: Giucci Guillermo
Published: February 2015

The idea of the world as a sphere was an old theoretical presupposition. Only with both the crossing of the Strait of Magellan and circumnavigation were the geographical areas unknown to the Europeans opened to global trade. Therefore, this world event would be inscribed in the annals of history as a marker of the beginning of modernity, the era of maritime colonization that forever altered the notion of radical isolation.
Rethinking Children's Independent Mobility
Authors: Murray Lesley
Published: February 2015

The concept of “children's independent mobility,” which originates in a study carried out between 1971 and 1990, underpins much of the research on children's mobilities. The study used particular criteria, based on parental determination of children's abilities and freedoms, to construct a notion of independence. This article contributes to previous work challenging the assumptions underlying this conceptualization of independence and suggests a rethinking of children's mobilities to more firmly incorporate children's agency and imagination. It does so first by critically reviewing existing scholarship and second by engaging with an example of a fictional story, Emil and the Detectives, which itself sets out to privilege both of these key aspects of children's mobilities.
Displaying Roads
Authors: Moraglio Massimo , Seely Bruce
Published: February 2015

We argue that road engineers—in the cases presented in the articles in this special section—were acting as cultural actors, playing a greater role than experts and especially policy makers. Even as they utilized technical information in cultural debates, road representation had huge symbolic value in driving the social and political discussions. However, once road experts used and accepted such political tools, they could not disconnect themselves from the political process, which determined success and failure in these projects.
Making Place for the Modern Road
Authors: Peleman David
Published: February 2015

This article describes how two temporary road exhibitions before World War II functioned as tools to frame the Belgian road project as a rich cultural venture. In the absence of a comprehensive policy and any diverse cultural engagement by the government, a particular relationship between culture, technology, and society crystallized in the museological arrangement of these exhibitions. The article argues that, while these exhibitions relate the road project to a broad cultural field, they simultaneously instill a rigid way of reasoning about the modern road.
Radical Mobilities on Display
Authors: Smith Wergeland Even
Published: February 2015

This article explores the 1965 Transport Analysis for Greater Oslo, a municipal planning document in which the routing of a large urban motorway through Oslo is richly illustrated in a series of drawings and prints. The images on display in the Transport Analysis were widely circulated in the mid- to late 1960s, thereby creating a mobile exhibition that reached a wide audience and connected with a number of other images. Through this circulation, the Transport Analysis became entangled in an intricate visual discourse that aestheticized urban motorways and linked up with radical currents in European postwar architecture. While the Transport Analysis has previously been interpreted quite narrowly, merely as the product of a pragmatic engineering mind-set, this article posits that one must move beyond the technocratic level to unravel its wider meanings.
The Exterritory Project
Authors: Stela Ruti , Amir Maayan
Published: February 2015

Exterritory Project is an ongoing art project dedicated to encouraging practical and theoretical exploration of ideas concerning extraterritoriality in an interdisciplinary context. Th is project was conceived when we decided to screen a video compilation of works by Middle Eastern artists onto the sails of boats sailing in the extraterritorial waters of the Mediterranean, as a response to the ongoing Israeli-Palestinian conflict. We wished to create an image of art exhibited in a neutral space, unsaturated by any one national precondition. The extraterritorial waters seemed to us a space that could temporally offer the suspension of border regimes. In 2011 the project was recognized by the United Nations Educational, Scientific and Cultural Organization (UNESCO) and was awarded the title of “Young Artist for Intercultural Dialogue between Arab and Western Worlds”.
New Mobile Methods
Authors: Newman Daniel
Published: February 2015

G39, an artist-run gallery, is located within a disused and dilapidated warehouse
on a run-down side street in Cardiff ’s city center. Th e artists who run
the gallery have sought to reclaim the structure as a productive hub and rebuild
the community by providing a creative stimulus. Th at approach is epitomized
in Barnraising and Bunkers. Th e show explores the various ways in
which we build the places in which we live, work, and play, and the manner in
which these locations are (re)appropriated by future generations. Th e artists
have been tasked with utilizing architectural and physical structures to highlight
that the built environment is a process, not a fixed state; growth happens
organically at the will of those who live in an area and not under the dictate
of architects and urban planners. Th is exhibition, then, draws on the interplay
between place and mobility; the sense of being somewhere and a part of
something but with the possibility that people, cultures, or even the buildings
themselves can move on.
“Everything Happens Fast”
Authors: Gott Michael
Published: February 2015

Il sorpasso, Italy, 1962; Mario Cecchi Gori (producer); Dino Risi (director),
Dino Risi, Ettore Scola, and Ruggero Maccari (screenplay); starring Vittorio
Gassman and Jean-Louis Trintignant. 2014 DVD release by the Criterion Collection
includes new English subtitle translation, interviews, essays, excerpts of
a documentary, and an introduction by filmmaker Alexander Payne.
Visualization of regional cerebrospinal fluid flow with a dye injection technique in focal arachnoid pathologies
Authors: Yamaguchi Satoshi , Hida Kazutoshi , Takeda Masaaki , Mitsuhara Takafumi , Morishige Mizuki , Yamada Naoto , Kurisu Kaoru
Published: February 2015

Surgical lysis of the thickened arachnoid membrane is the first choice of treatment in spinal arachnoid pathologies that cause flow disturbances or blockage of CSF. However, it is important to consider that while extensive lysis of the arachnoid may temporarily provide a wide pathway for CSF, an extensive lytic procedure may later cause secondary adhesion. Thus, it is ideal for the proper extent of the arachnoid lysis to be determined after careful analysis of regional CSF flow. The authors report their limited experience with intraoperative visualization of CSF flow in spinal arachnoid pathologies. Two patients with a dorsal arachnoid web (DAW) with cervical syringomyelia and 1 patient with focal adhesive arachnoiditis causing edema of the spinal cord were surgically treated at the authors' institution between 2007 and 2013. In all cases, the presence of a DAW or focal adhesive arachnoiditis was suspected from the findings on MRI, namely 1) an indentation on the upper thoracic spinal cord and 2) syringomyelia and/or edema of the spinal cord above the indentation. Exploratory surgery disclosed a transversely thickened arachnoid septum on the dorsal side of the indented cord. To prove blockage of the CSF by the septum and to decide on the extent of arachnoid lysis, regional CSF flow around the arachnoid septum was visualized by subarachnoid injection of gentian violet solution close to the web. Injected dye stagnated just close to the arachnoid septum in all cases, and these findings documented CSF blockage by the septum. In 2 cases, a 2-minute observation showed that the injected dye stayed close to the web without diffusion. The authors performed not only resection of the web itself but also lysis of the thickened arachnoid on both sides of the spinal cord to make a CSF pathway on the ventral side. In the third case, the dye stagnated close to the web at first but then diffused through the nerve root to the ventral CSF space. The lysis procedure was completed after exclusive removal of the dorsal web. Postoperative MR images confirmed reduction of the syrinx and/or improvement of the edema in all cases, suggesting that the extent of arachnoid lysis was optimal in each case. No adverse effect was observed after subarachnoid injection of gentian violet. The authors believe that their technique of visualizing regional CSF flow will be helpful to decide the optimal extent of lysis in some local arachnoid pathologies.
Decreased apparent diffusion coefficient in the pituitary and correlation with hypopituitarism in patients with traumatic brain injury
Authors: Zheng Ping , He Bin , Guo Yijun , Zeng Jingsong , Tong Wusong
Published: February 2015

OBJECT

The relationship between microstructural abnormality in patients with traumatic brain injury (TBI) and hormone-secreting status remains unknown. In this study, the authors aimed to identify the role of the apparent diffusion coefficient (ADC) using a diffusion-weighted imaging (DWI) technique and to evaluate the association of such changes with hypopituitarism in patients with TBI.

METHODS

Diffusion-weighted images were obtained in 164 consecutive patients with TBI within 2 weeks after injury to generate the pituitary ADC as a measure of microstructural change. Patients with TBI were further grouped into those with and those without hypopituitarism based on the secretion status of pituitary hormones at 6 months postinjury. Thirty healthy individuals were enrolled in the study and underwent MRI examinations for comparison. Mean ADC values were compared between this control group, the patients with TBI and hypopituitarism, and the patients with TBI without hypopituitarism; correlational studies were also performed. Neurological outcome was assessed with the Glasgow Outcome Scale (GOS) for all TBI patients 6 months postinjury.

RESULTS

In the TBI group, 84 patients had hypopituitarism and 80 had normal pituitary function. The pituitary ADC in TBI patients was significantly less than that in controls (1.83 ± 0.16 vs 4.13 ± 0.33, p < 0.01). Furthermore, the mean ADC was much lower in TBI patients with hypopituitarism than in those without pituitary dysfunction (1.32 ± 0.09 vs 2.28 ± 0.17, p < 0.05). There was also a significant difference in ADC values between patients with hyperprolactinemia and those with normal prolactin levels (p < 0.05). Additionally, the receiver operating characteristic curve analysis showed that the pituitary ADC could predict hypopituitarism with a sensitivity of 90.0% and a specificity of 90.1% at the level of 1.720 (ADC value). Finally, the ADC value was positively correlated with neurological outcome at 6 months following TBI (r = 0.602, p < 0.05).

CONCLUSIONS

Use of DWI demonstrated that the pituitary ADC is correlated with hormone-secreting status in TBI patients. The authors suggest that pituitary ADC may be a useful biomarker to predict pituitary function in patients with TBI.
Intracranial pressure monitoring in pediatric and adult patients with hydrocephalus and tentative shunt failure: a single-center experience over 10 years in 146 patients
Authors: Sæhle Terje , Eide Per Kristian
Published: February 2015

OBJECT

In patients with hydrocephalus and shunts, lasting symptoms such as headache and dizziness may be indicative of shunt failure, which may necessitate shunt revision. In cases of doubt, the authors monitor intracranial pressure (ICP) to determine the presence of over- or underdrainage of CSF to tailor management. In this study, the authors reviewed their experience of ICP monitoring in shunt failure. The aims of the study were to identify the complications and impact of ICP monitoring, as well as to determine the mean ICP and characteristics of the cardiac-induced ICP waves in pediatric versus adult over- and underdrainage.

METHODS

The study population included all pediatric and adult patients with hydrocephalus and shunts undergoing diagnostic ICP monitoring for tentative shunt failure during the 10-year period from 2002 to 2011. The patients were allocated into 3 groups depending on how they were managed following ICP monitoring: no drainage failure, overdrainage, or underdrainage. While patients with no drainage failure were managed conservatively without further actions, over- or underdrainage cases were managed with shunt revision or shunt valve adjustment. The ICP and ICP wave scores were determined from the continuous ICP waveforms.

RESULTS

The study population included 71 pediatric and 75 adult patients. There were no major complications related to ICP monitoring, but 1 patient was treated for a postoperative superficial wound infection and another experienced a minor bleed at the tip of the ICP sensor. Following ICP monitoring, shunt revision was performed in 74 (51%) of 146 patients, while valve adjustment was conducted in 17 (12%) and conservative measures without any actions in 55 (38%). Overdrainage was characterized by a higher percentage of episodes with negative mean ICP less than −5 to −10 mm Hg. The ICP wave scores, in particular the mean ICP wave amplitude (MWA), best differentiated underdrainage. Neither mean ICP nor MWA levels showed any significant association with age.

CONCLUSIONS

In this cohort of pediatric and adult patients with hydrocephalus and tentative shunt failure, the risk of ICP monitoring was very low, and helped the authors avoid shunt revision in 49% of the patients. Mean ICP best differentiated overdrainage, which was characterized by a higher percentage of episodes with negative mean ICP less than −5 to −10 mm Hg. Underdrainage was best characterized by elevated MWA values, indicative of impaired intracranial compliance.
Acute intracranial bleeding and recurrence after bur hole craniostomy for chronic subdural hematoma
Authors: Pang Chang Hwan , Lee Soo Eon , Kim Chang Hyeun , Kim Jeong Eun , Kang Hyun-Seung , Park Chul-Kee , Paek Sun Ha , Kim Chi Heon , Jahng Tae-Ahn , Kim Jin Wook , Kim Yong Hwy , Kim Dong Gyu , Chung Chun Kee , Jung Hee-Won , Yoo Heon
Published: February 2015

OBJECT

There is inconsistency among the perioperative management strategies currently used for chronic subdural hematoma (cSDH). Moreover, postoperative complications such as acute intracranial bleeding and cSDH recurrence affect clinical outcome of cSDH surgery. This study evaluated the risk factors associated with acute intracranial bleeding and cSDH recurrence and identified an effective perioperative strategy for cSDH patients.

METHODS

A retrospective study of patients who underwent bur hole craniostomy for cSDH between 2008 and 2012 was performed.

RESULTS

A consecutive series of 303 cSDH patients (234 males and 69 females; mean age 67.17 years) was analyzed. Postoperative acute intracranial bleeding developed in 14 patients (4.57%) within a mean of 3.07 days and recurrence was observed in 37 patients (12.21%) within a mean of 31.69 days (range 10–104 days) after initial bur hole craniostomy. The comorbidities of hematological disease and prior shunt surgery were clinical factors associated with acute bleeding. There was a significant risk of recurrence in patients with diabetes mellitus, but recurrence did not affect the final neurological outcome (p = 0.776). Surgical details, including the number of operative bur holes, saline irrigation of the hematoma cavity, use of a drain, and type of postoperative ambulation, were not significantly associated with outcome. However, a large amount of drainage was associated with postoperative acute bleeding.

CONCLUSIONS

Bur hole craniostomy is an effective surgical procedure for initial and recurrent cSDH. Patients with hematological disease or a history of prior shunt surgery are at risk for postoperative acute bleeding; therefore, these patients should be carefully monitored to avoid overdrainage. Surgeons should consider informing patients with diabetes mellitus that this comorbidity is associated with an increased likelihood of recurrence.