bluuebunny/crossref_metadata_2025_split huggingface dataset:
Different responses of photosystem II and antioxidants to drought stress in two contrasting populations of Sour jujube from the Loess Plateau, China
Authors: Wang Yong , An Yuyan , Yu Jing , Zhou Ziyun , He Shaoxuan , Ru Mei , Cui Beimi , Zhang Yu , Han Ruilian , Liang Zongsuo 
Published: August 2016

AbstractSour jujube (Zizyphus jujuba Mill. var. spinosus (Bge.) Hu) has gained considerable attention for its adaptation to drought prone environments. To characterize the physiological and biochemical basis of this drought adaptation, the effects of drought stress on Sour jujube seedlings were investigated in a greenhouse. Two contrasting populations were employed in our study, which were from the wet (YL) and dry (SB) climatic regions in the Loess Plateau of China. Results showed that SB exhibited lower water consumption and growth inhibition, but higher water use efficiency than YL under drought stress, indicating that growth of the wet‐climate population is more sensitive to drought stress. SB exhibited higher non‐photochemical quenching (NPQ) during progressive soil drying, higher photochemical quenching (qP) during the sustained water supply stage, and higher ΔF/ and qP during a re‐watering period than YL. These results further indicate that the dry‐climate population possesses better PSII efficiency under adverse conditions. YL showed larger increases in the production rate of superoxide anions, hydrogen peroxide, and hydroxyl radicals than SB during the progressive soil drying stage, indicating that SB suffered from less oxidative damage than YL. Antioxidant enzymes including catalase, ascorbate peroxidase, peroxidase and glutathione reductase, and antioxidants including carotenoids, flavonoids and proline; when these interact, they contribute greatly to the antioxidant capacity of the dry‐climate population. Taken together, the better photosynthetic potential and antioxidant capacity contribute to the better performance of Sour jujube from the dry‐climate, providing useful information for understanding the drought tolerance mechanisms of Sour jujube.
Effects of Lipid Structure Changed by Interesterification on Melting Property and Lipemia
Authors: Wang Tong , Wang Xiaosan , Wang Xingguo 
Published: August 2016

AbstractInteresterification or the randomization reaction changes fatty acid positional distribution and solid fat content of fats, which may consequently affect fat absorption and metabolism. It is well established that saturated fatty acids in the sn‐2 position of triacylglycerols (TAG) have better digestibility and lower postprandial chylomicron clearance compared to those in the sn‐1,3 positions in animal experiments. TAG structure is also shown to affect fasting lipid level and atherosclerosis in animals, but fat interesterification it has been shown to not affect fasting lipid level in human adults. However, its effect on postprandial responses is controversial. In this review, the complex results of studies of interesterification and lipemia were briefly discussed. More importantly, the confounding of two factors that are both changed by interesterification, TAG structure and solid fat content as the main limitation on understanding how interesterification affects lipemia is emphasized. Separation of the two factors is possible using paired fats as demonstrated. This paper also discusses some intriguing effects of fats having saturated fatty acids in the sn‐2 position and the need for future research.
Topological Structures and Membrane Nanostructures of
Erythrocytes after Splenectomy in Hereditary Spherocytosis
Patients via Atomic Force Microscopy
Authors: LI Ying , Lu Liyuan , LI Juan 
Published: August 2016

Abstract
Hereditary spherocytosis is an inherited red blood cell membrane disorder resulting from mutations of genes encoding erythrocyte membrane and cytoskeletal proteins. Few equipments can observe the structural characteristics of hereditary spherocytosis directly expect for atomic force microscopy In our study, we proved atomic force microscopy is a powerful and sensitive instrument to describe the characteristics of hereditary spherocytosis. Erythrocytes from hereditary spherocytosis patients were small spheroidal, lacking a well-organized lattice on the cell membrane, with smaller cell surface particles and had reduced valley to peak distance and average cell membrane roughness vs. those from healthy individuals. These observations indicated defects in the certain cell membrane structural proteins such as α- and β-spectrin, ankyrin, etc. Until now, splenectomy is still the most effective treatment for symptoms relief for hereditary spherocytosis. In this study, we further solved the mysteries of membrane nanostructure changes of erythrocytes before and after splenectomy in hereditary spherocytosis by atomic force microscopy. After splenectomy, the cells were larger, but still spheroidal-shaped. The membrane ultrastructure was disorganized and characterized by a reduced surface particle size and lower than normal Ra values. These observations indicated that although splenectomy can effectively relieve the symptoms of hereditary spherocytosis, it has little effect on correction of cytoskeletal membrane defects of hereditary spherocytosis. We concluded that atomic force microscopy is a powerful tool to investigate the pathophysiological mechanisms of hereditary spherocytosis and to monitor treatment efficacy in clinical practices. To the best of our knowledge, this is the first report to study hereditary spherocytosis with atomic force microscopy and offers important mechanistic insight into the underlying role of splenectomy.
Magnetic Resonance Imaging of the Subcoracoid Region and Its Relationship with Subscapularis Lesions in the Chinese Population
Authors: Hay-Man Wan Keith , Wai-hung Lie Chester , Nin-yuan Pan , Yuen-yi Cheuk , Hung-lit Chow , Lam Chan Wai , Cheung Wong Wing 
Published: August 2016

Introduction Coracoid impingement is considered a known yet frequently overlooked cause of anterior shoulder pain. Subcoracoid stenosis has been shown to be related to subscapularis tear. Studies have shown that patients with coracoid impingement have a shorter coracohumeral distance (CHD) and a larger coracoid overlap (CO) but these are based on data from Western populations. The aim of our study was to provide a local database on the MRI measurement of these parameters in our Chinese population and raise the awareness of this disease entity. Methods All the shoulder MRI films taken in our hospital in 2011 were retrospectively reviewed and classified into two cohorts. The control group consisted of patients who had no subscapularis lesion. The subscapularis lesion group consisted of patients with complete tear, partial tear or abnormal signal over the subscapularis tendon. The CHD and CO were measured. Results We reviewed 133 sets of shoulder MRI obtained in our hospital during 2011. Thirteen patients were noted to have subscapularis lesion. The CHD in the subscapularis lesion group was 6.24 ± 2.18 mm. The CHD in the control group was 9.95 ± 3.9 mm. Women had shorter CHD (8.18 ± 2.57 mm) than men (11.0 ± 4.54 mm). We failed to notice any statistically significant difference with regards to CO, coracoid process and lesser tuberosity morphology between the two groups of patients. Conclusion MRI assessment of CHD can be useful in identifying patients at risk of having subscapularis lesion and coracoids impingement.
Emergency Medical Assistance Team Response following Taiwan Chi-Chi Earthquake
Authors: Hsu Edbert B. , Ma Matthew , Lin Fang Yue , VanRooyen Michael J. , Burkle Frederick M. 
Published: August 2016

AbstractIntroduction:On 21 September, 1999, an earthquake measuring 7.3 on the Richter scale, struck central Taiwan near the town of Chi-Chi. The event resulted in 2,405 deaths and 11,306 injuries. Ad hoc emergency medical assistance teams (EMATs) from Taiwan assumed the responsibility for initiating early assessments and providing medical care.Objective:To determine whether the EMATs served a key role in assisting critically injured patients through the assessment of number and level of hospitals responding, training background, timeliness of response, and acuity of patient encounters.Methods:Local and national health bureaus were contacted to identify hospitals that responded to the disaster. A comprehensive questionnaire was piloted and then, sent to those major medical centers that dispatched EMATs within the first 72 hours following the quake. In-depth interviews also were conducted with team leaders.Results:A total number of 104 hospitals/clinics responded to the disaster, including nine major medical centers and 12 regional hospitals. Each of the major medical centers/regional hospitals that dispatched EMATs during the first 72 hours following the quake were surveyed. Also, 20 individual team leaders were interviewed. Seventy-nine percent of the EMATs from the hospitals responded spontaneously to the scene, while only 21% were dispatched directly by national or local health authorities. Combining the phases of the disaster response, it is estimated that only 7% of EMATs were providing on-site care within the first 12 hours following the earthquake, 17% within <18 hours, and 20% within <24 hours. Thus, 80% of these EMATs required >24 hours to respond to the site. Based on a ED I-IV triage system (Level-I, highest acuity; Level-IV, lowest acuity), the vast majority of patient encounters consisted of Level-III and Level-IV patients. Fewer than 16% of teams encountered >10 Level-I patients, and <28% of teams evaluated >10 Level-II patients.Conclusions:1. The response from EMATs was impressive, but largely uncoordinated in the absence of a pre-existing dispatching mechanism.2. Most of the EMATs required >24 hours to reach the disaster sites, and generally, did not arrive in time to affect the outcome of victims with preventable deaths. Therefore, there is an urgent need to strengthen local prehospital care.3. A central governmental body that ensures better horizontal and vertical integration, and a comprehensive emergency management system is required in order to improve future disaster response and mitigation efforts.
Interface between Hospital and Fire Authorities — A Concept for Management of Incidents in Hospitals
Authors: Gretenkort Peter , Harke Henning , Blazejak Jan , Pache Bernd , Leledakis Georgios 
Published: August 2016

AbstractIntroduction:Although every hospital needs a security plan for the support of immobile patients who do not possess autonomous escape capabilities, little information exists to assist in the development of practical patient evacuation methods.Hypothesis:1) In hospitals during disasters, incident leadership of the fire authorities can be supported effectively by hospital executives experienced in the management of mass casualties; and 2) As an alternative for canvas carry sheets, rescue drag sheets can be employed for emergency, elevator-independent, patient evacuation.Methods:A hospital evacuation exercise was planned and performed to obtain experiences in incident command and to permit calculation of elevator-independent patient transport times. Performance of incident leadership was observed by means of pre-defined checklists. The effectiveness and efficiency of carrying teams with five persons each were compared to those with a rescue drag sheet employed by a single person.Results:Incident command for hospitals during a disaster is enhanced considerably by pre-defined and trained executives who are placed at the immediate disposal of the fire authorities. For elevator-independent patient transport, the rescue drag sheet was superior to conventional carrying measures because of a reduced number of transport personnel required to move each patient. With this method, patient transport times averaged 54 m/min. flat and 18 seconds for one floor descent.Conclusion:Experiences from a hospital during an evacuation exercise provided decision criteria for changes in the disaster preparedness plan. Hospital incident leadership was assigned to executives-in-charge in close co-operation with the fire authorities. All beds were equipped with a rescue drag sheet. Both concepts may help to cope with an emergency evacuation of a hospital.
Description of Ambulance Diversions in the Edmonton Region
Authors: Sookram Sunil , Riddle Kent , Chang Eddie , Sosnowski Terry 
Published: August 2016

AbstractBackground:Diversion of ambulances by hospital emergency departments has become a day-to-day occurrence in many jurisdictions within Canada. Yet, despite the increasing prevalence of this phenomenon, its impact on transported patients, on the EMS system, and on the health care system overall has not, to date, been well quantified. Despite the increasing sophistication and capabilities of North American EMS systems, it is difficult to argue with the principle that unstable or potentially unstable patients are best served by expeditious transport for definitive care to acute care facilities. T o this end, this study represents an effort to assess the systemic and patient care impacts of ambulance diversions.Methods:Patient-care and corresponding ambulance trip records for all patients transported by this EMS system for a five week period were abstracted to identify those patients in which an ambulance was diverted from its initial destination. Adverse events include hypotensive episodes, airway compromise, changes in level of consciousness, and the onset of violent behavior. Response and transport times also were abstracted, comparisons utilized student's t-test and 95% Confidence Intervals. Results: Ambulance diversions increased EMS response times and prehospital transport times. Adverse medical events occurred during 4.3% of diverted ambulance runs. Patients, when faced with the prospect of transport to other than their hospital of choice, not infrequently cancelled EMS transport and sought other means of transport. Subsequent interfacility transport was required for 4.3% of the diverted patients.Conclusions:Diversion of ambulances impacts the EMS system by increasing response and transport times; the region, by generating subsequent interfacility transports; and patients, as adverse medical events can occur during the diverted transport.
Resuscitation for Patients with Out-of-Hospital Cardiac Arrest: Singapore
Authors: Lim Ghee Hian , Seow Eillyne 
Published: August 2016

AbstractAim:To evaluate characteristics and outcome of out-of-hospital cardiac arrest (OHCA) patients presenting to the Emergency Department (ED), and to examine factors that could be used to determine to prolong or abort resuscitation for these patients.Method:All OHCA patients presenting to the ED were studied over a three-month period from November 2001 through January 2002. Patient with traumatic cardiac arrest were excluded. Data were collected from the ambulance case records, ED resuscitation charts, and the ED Very High Frequency (VHF) radio case-log sheet. Information collected included the patient's demographic characteristics, timings (time from call to ambulance arrival on scene, time from arrival at scene to departure from scene, time from scene to arrival in the ED) recorded in the pre-hospital setting, the outcome of the resuscitation, and the final outcome for patients who survived ED resuscitation.Results:Ninety-three non-traumatic patients with an OHCA were studied during the three-month period. Of the 93 patients, 15 (16.1%) survived ED resuscitation, and one survived to hospital discharge. There were no statistically significant differences for age, race, or gender with regards to the outcome of the resuscitation. The initial cardiac rhythms were asystole (65), pulseless electrical activity (21), and ventricular fibrillation (7). Fourteen (15%) received bystander cardiopulmonary resuscitation (CPR). All seven patients with return of spontaneous circulation (ROSC) on arrival in the ED survived ED resuscitation. The ambulance took an average of 11.80 ±3.36 minutes for the survivors and 11.8 ±4.22 minutes for the non-survivors from the time of call to get to these patients. The average of the scene times was 12.5 ±4.61 minutes for the survivors and 12.0 ±4.02 minutes for the non-survivors. Transport time from the scene to the ED took an average of 39.1 ±8.32 minutes for the survivors and 37.2 ±9.00 minutes for the non-survivors.Conclusion:The survival rate for patients with OHCA after ED resuscitation is similar to the results from other studies. There is a need to increase the awareness and delivery of basic life support by public education. Automatic External Defibrillators (AED) should be available widely to ensure that the chance of early defibrillation is increased. Prolonged resuscitation efforts appear to be futile for OHCA patients if the time from cardiac arrest until arrival in the ED is ≥30 minutes coupled with no ROSC, and if continuous asystole has been documented for >10 minutes.
Instrument Development and Evaluation of Domestic Preparedness Training for First Responders
Authors: Beaton Randal D. , Johnson L. Clark 
Published: August 2016

AbstractIntroduction:In the wake of domestic terrorists attacks on 11 September 2001 and subsequent bioterrorist events employing anthrax, there no longer can be any debate about the potential for attacks employing Nuclear, Biological, or Chemical (NBC)/Weapons of Mass Destruction (WMD). As one way of acknowledging this long-standing threat and, in a concerted effort to mitigate the effects of possible future domestic NBC/WMD terrorist attacks, the US Department of Defense (DOD) and other US governmental agencies already had mounted an effort to provide Domestic Preparedness Training for First Responders in urban centers throughout the USA.Methods:A paper and pencil questionnaire specifically designed to evaluate the effectiveness of Domestic Preparedness Training for Emergency First Responders has been developed. An earlier version of this instrument was piloted with a convenience sample of firefighters and paramedics (n = 78) in a northwest state. Based on replies to the pilot questionnaire, a pool of 27 items based on the objectives and content of the NBC/WMD Domestic Preparedness Awareness and Operations courses (plus additional background and appraised competency items) were selected for inclusion in a Domestic Preparedness Questionnaire (DPQ).Results:This paper first describes the essential psychometric properties of the DPQ based on replies from baseline and follow-up samples (n = 206 and n = 246 respectively) of urban firefighters and paramedics employed by a metropolitan city in a northwest state. The DPQ was employed to evaluate the outcomes of Domestic Preparedness training provided to a sample of urban fire-service personnel. The DPQ documented significant improvements in a group of “DP trained”-urban firefighters (n = 80) both in their awareness and operations content knowledge as well as in their perceived competencies to respond to acts of biological, chemical, or nuclear terrorism “in their own community” at four months post-training. A comparison group of “Not DP-trained” firefighters (n = 78) showed no statistically significant changes on these DPQ indices, suggesting that the documented improvements in the “DP-trained” firefighters on the DPQ were not due to “test reactivity” or to “historical” factors.Conclusion:The findings suggest that the DPQ has adequate inter-item and test-retest reliability, possesses concurrent validity, and appears to be a sensitive measure of the Domestic Preparedness Training provided for urban firefighter and paramedic First Responders.
First-aid Training and Bystander Actions at Traffic Crashes — A Population Study
Authors: Larsson Eva M. , Mártensson Niklas L. , Alexanderson Kristina A.E. 
Published: August 2016

AbstractIntroduction:Traffic crashes constitute a major, worldwide public-health problem that cause disabilities, life-long suffering, and huge economic losses. When a person is injured in a traffic crash, actions taken by bystanders often are of crucial importance. To perform first-aid actions in a correct manner, bystanders, often lay persons, need both the courage and the knowledge to do so. For preventive purposes, society spends large resources to inform and educate the public in order to enhance people's ability to take correct actions. However, there only is little information on the rate in a population of persons who have had first-aid training, have been bystanders at a traffic crash, on the actions taken by such persons, and on effects of first-aid training on patient care.Objective:The aim of this study was to acquire knowledge about: (1) the prevalence of first-aid training; (2) the incidence of being a bystander and of the first aid provided at traffic crashes and other emergencies; and (3) the impact of first-aid training on the risks people take in road traffic.Methods:A questionnaire was administered to 2,800 randomly selected persons aged 18–74 years.Results:The response rate was 67.5%. During the previous five years, 39% of the population had received first-aid training, with a higher rate among younger individuals and those with a higher education. After training, 30% of the respondents had used their skills, and 41% took fewer risks in traffic, particularly those who were older or had a lower level of education. Fourteen percent of those with training (significantly more men) had been bystanders at a traffic crash. At 20% of the crashes, a bystander had administered first aid, and one-third of those who provided such assistance had had use of their training. Conclusion: Intensified first-aid training of the general public could lead to citizens who are more cautious in traffic and to bystanders who provide more immediate and adequate first aid at traffic crashes and other emergencies.
Effectiveness of a Glasgow Coma Scale Instructional Video for EMS Providers
Authors: Lane Peter L. , Báez Amado Alejandro , Brabson Thomas , Burmeister David D. , Kelly John J. 
Published: August 2016

AbstractIntroduction:The Glasgow Coma Scale (GCS) is the standard measure used to quantify the level of consciousness of patients who have sustained head injuries. Rapid and accurate GCS scoring is essential.Objective:To evaluate the effectiveness of a GCS teaching video shown to prehospital emergency medical services (EMS) providers.Methods:Participants and setting—United States, Mid-Atlantic region EMS providers. Intervention—Each participant scored all of the three components of the GCS for each of four scenarios provided before and after viewing a video-tape recording containing four scenarios. Design—Before-and-after single (Phase I) and parallel Cohort (Phase II). Analysis— Proportions of correct scores were compared using chi-square, and relative risk was calculated to measure the strength of the association.Results:75 participants were included in Phase I. In Phase II, 46 participants participated in a parallel cohort design: 20 used GCS reference cards and 26 did not use the cards. Before observing the instructional video, only 14.7% score all of the scenarios correctly, where as after viewing the video, 64.0% scored the scenarios results were observed after viewing the video for those who used the GCS cards (p = 0.001; RR = 2.0; 95% CI = 1.29 to 3.10) than for those not using the cards (p <0.0001; RR = 10.0; 95% CI = 2.60 to 38.50).Conclusions:Post-video viewing scores were better than those observed before the video presentation. Ongoing evaluations include analysis of longterm skill retention and scoring accuracy in the clinical environment.