bluuebunny/crossref_metadata_2025_split huggingface dataset:
Studi Penggunaan Antibiotika pada Neonatus Di NICU RSAL Dr. Ramelan Surabaya
Authors: Fitriani Victoria Yulita 
Published: May 2017

ABSTRACT

Neonatal sepsis and nosocomial infection are the most common diagnosis of neonatal infections. Selections of antibiotics in neonatal infection should be based on type of bacteria, antibiotics dose and safety in neonates. The aim of this study was to explored type of antibiotics used in Neonatal Intensive Care Unit. Researchers conducted a prospective study of antibiotics used at Dr. Ramelan Navy Hospital neonatal intensive care unit Surabaya. From November 26th 2007 to January 26th 2008, 94 patients (5 preterm neonates and 89 term neonates) were included in this study. Demographic data, antibiotics used, relevant medical histories, laboratory data was recorded prospectively at the wards. Charts for all cases were reviewed. Early antibiotic use was defined as therapy within 72 hours of life. The most frequently used empiric antibiotic regimens were ampicillin sulbactam with gentamicin (60.2%), ampicillin sulbactam (30.1%), ceftriaxone (6.5%), ampicillin sulbactam with amikacin (1.1%), ampicillin sulbactam with ceftriaxone (1.1%), gentamicin with ceftriaxone (1.1%). Late antibiotic events also occurred in neonates. Fourty eight point four percent of late antibiotics events were used of ceftriaxone. Antibiotics are prescribed appropriately but earlier discontinuation or switches, which may be complicated either by the inability to confirm causative organism or patientâ€™s condition that showed no improvement, should be practiced.

Key words: Neonatus, antibiotic

ABSTRAK

Diagnosa infeksi pada neonatus umumnya berupa sepsis neonatorum dan infeksi nosokomial. Pemilihan antibiotika pada kondisi tersebut perlu didasarkan kepada jenis bakteri yang umumnya terlibat, dosis antibiotika dan tingkat keamanan pada neonatus. Penelitian ini bertujuan untuk mengeksplorasi jenis antibiotika yang digunakan pada pasien neonatus. Penelitian ini merupakan penelitian prospektif dengan melakukan pengamatan secara langsung selama 3 bulan di NICU RSAL Dr. Ramelan Surabaya. Peneliti mengobservasi pasien secara langsung dan mengambil data pemakaian antibiotika melalui rekam medik. Semua pasien neonatus yang menjalani rawat inap di NICU periode (Oktober â€“ Desember 2007) disertakan sebagai sampel penelitian. Hasil penelitian di dapat antibiotika untuk penanganan tahap awal yang sering digunakan adalah kombinasi ampisilin sulbaktam dengan gentamisin (60.2%), ampisilin sulbaktam (30.1%), ceftriaxonee (6.5%), kombinasi ampisilin sulbaktam dengan amikasin (1.1%), kombinasi ampisilin sulbaktam dengan ceftriaxonee (1.1%), kombinasi gentamisin dengan cetriaxone (1.1%). Antibiotika untuk penanganan tahap akhir adalah ceftriaxonee (48.4%), kombinasi ceftriaxone dengan amikasin (25.6%), amikasin (9.3%), ampisilin sulbaktam (4.7%), kombinasi ceftriaxone dengan gentamisin (4.7%), kombinasi ampisilin sulbaktam dengan gentamisin (4.7%), kombinasi ampisilin dengan amikasin (4.7%), kombinasi ampisilin sulbaktam dengan amikasin (4.7%), kombinasi ceftriaxone dengan amikasin (4.7%).

Kata Kunci: neonatus, antibiotika
Oligodendroglioma resection: a Surveillance, Epidemiology, and End Results (SEER) analysis
Authors: Alattar Ali A. , Brandel Michael G. , Hirshman Brian R. , Dong Xuezhi , Carroll Kate T. , Ali Mir Amaan , Carter Bob S. , Chen Clark C. 
Published: May 2017

OBJECTIVEThe available evidence suggests that the clinical benefits of extended resection are limited for chemosensitive tumors, such as primary CNS lymphoma. Oligodendroglioma is generally believed to be more sensitive to chemotherapy than astrocytoma of comparable grades. In this study the authors compare the survival benefit of gross-total resection (GTR) in patients with oligodendroglioma relative to patients with astrocytoma.METHODSUsing the Surveillance, Epidemiology, and End Results (SEER) Program (1999–2010) database, the authors identified 2378 patients with WHO Grade II oligodendroglioma (O2 group) and 1028 patients with WHO Grade III oligodendroglioma (O3 group). Resection was defined as GTR, subtotal resection, biopsy only, or no resection. Kaplan-Meier and multivariate Cox regression survival analyses were used to assess survival with respect to extent of resection.RESULTSCox multivariate analysis revealed that the hazard of dying from O2 and O3 was comparable between patients who underwent biopsy only and GTR (O2: hazard ratio [HR] 1.06, 95% confidence interval [CI] 0.73–1.53; O3: HR 1.18, 95% CI 0.80–1.72). A comprehensive search of the published literature identified 8 articles without compelling evidence that GTR is associated with improved overall survival in patients with oligodendroglioma.CONCLUSIONSThis SEER-based analysis and review of the literature suggest that GTR is not associated with improved survival in patients with oligodendroglioma. This finding contrasts with the documented association between GTR and overall survival in anaplastic astrocytoma and glioblastoma. The authors suggest that this difference may reflect the sensitivity of oligodendroglioma to chemotherapy as compared with astrocytomas.
Stereotactic radiosurgery alone or combined with embolization for brain arteriovenous malformations: a systematic review and meta-analysis
Authors: Russell Dylan , Peck Travis , Ding Dale , Chen Ching-Jen , Taylor Davis G. , Starke Robert M. , Lee Cheng-Chia , Sheehan Jason P. 
Published: May 2017

OBJECTIVEEmbolization of brain arteriovenous malformations (AVMs) prior to stereotactic radiosurgery (SRS) has been reported to negatively affect obliteration rates. The goal of this systematic review and meta-analysis was to compare the outcomes of AVMs treated with embolization plus SRS (E+SRS group) and those of AVMs treated with SRS alone (SRS group).METHODSA literature review was performed using PubMed to identify studies with 10 or more AVM patients and obliteration data for both E+SRS and SRS groups. A meta-analysis was performed to compare obliteration rates between the E+SRS and SRS groups.RESULTSTwelve articles comprising 1716 patients were eligible for analysis. Among the patients with radiological follow-up data, complete obliteration was achieved in 48.4% of patients (330/681) in the E+SRS group compared with 62.7% of patients (613/978) in the SRS group. A meta-analysis of the pooled data revealed that the obliteration rate was significantly lower in the E+SRS group (OR 0.51, 95% CI 0.41–0.64, p < 0.00001). Symptomatic adverse radiation effects were observed in 6.6% (27/412 patients) and 11.1% (48/433 patients) of the E+SRS and SRS groups, respectively. The annual post-SRS hemorrhage rate was 2.0%–6.5% and 0%–2.0% for the E+SRS and SRS groups, respectively. The rates of permanent morbidity were 0%–6.7% and 0%–13.5% for the E+SRS and SRS groups, respectively.CONCLUSIONSArteriovenous malformation treatment with combined embolization and SRS is associated with lower obliteration rates than those with SRS treatment alone. However, this comparison does not fully account for differences in the initial AVM characteristics in the E+SRS group as compared with those in the SRS group. Further studies are warranted to address these limitations.
Correlation between reduction in microvascular transit time after superficial temporal artery–middle cerebral artery bypass surgery for moyamoya disease and the development of postoperative hyperperfusion syndrome
Authors: Yang Tao , Higashino Yoshifumi , Kataoka Hiroharu , Hamano Eika , Maruyama Daisuke , Iihara Koji , Takahashi Jun C. 
Published: May 2017

OBJECTIVEHyperperfusion syndrome (HPS) is a notable complication that causes various neurological symptoms after superficial temporal artery (STA)–middle cerebral artery (MCA) bypass surgery for moyamoya disease (MMD). The authors used intraoperative indocyanine green (ICG) videoangiography to measure the change in microvascular transit time (MVTT) after bypass surgery. An analysis was then conducted to identify the correlation between change in MVTT and presence of postoperative HPS.METHODSThis study included 105 hemispheres of 81 patients with MMD who underwent STA-MCA single bypass surgery between January 2010 and January 2015. Intraoperative ICG videoangiography was performed before and after bypass surgery. The MVTT was calculated from the ICG time intensity curve recorded in the pial arterioles and venules. Multivariate logistic regression analysis was conducted to test the effect of multiple variables, including the change in MVTT after bypass surgery, on postoperative HPS.RESULTSPostoperative HPS developed in 28 (26.7%) of the 105 hemispheres operated on. MVTT was reduced significantly after bypass surgery (prebypass 5.34 ± 2.00 sec vs postbypass 4.12 ± 1.60 sec; p < 0.001). The difference between prebypass and postbypass MVTT values, defined as ΔMVTT, was significantly greater in the HPS group than in the non-HPS group (2.55 ± 2.66 sec vs 0.75 ± 1.78 sec; p < 0.001). Receiver operating characteristic curve analysis revealed that the optimal cutoff point of ΔMVTT was 2.6 seconds (sensitivity 46.4% and specificity 85.7% as a predictor of postoperative HPS). A ΔMVTT > 2.6 seconds was an independent predictor of HPS in multivariate analysis (hazard ratio 4.88, 95% CI 1.76–13.57; p = 0.002).CONCLUSIONSMVTT in patients with MMD was reduced significantly after bypass surgery. Patients with a ΔMVTT > 2.6 seconds tended to develop postoperative HPS. Because ΔMVTT can be easily measured during surgery, it is a useful diagnostic tool for identifying patients at high risk for HPS after STA-MCA bypass surgery for MMD.
Assessment of malpractice claims due to spinal epidural abscess
Authors: DePasse J. Mason , Ruttiman Roy , Eltorai Adam E. M. , Palumbo Mark A. , Daniels Alan H. 
Published: May 2017

OBJECTIVESpinal epidural abscesses (SEAs) can be difficult to diagnose and may result in neurological compromise or even death. Delays in diagnosis or treatment may worsen the prognosis. While SEA presents a high risk for litigation, little is known about the medicolegal ramifications of this condition. An enhanced understanding of potential legal implications is important for practicing spine surgeons, emergency medicine physicians, and internists.METHODSThe VerdictSearch database, a large legal-claims database, was queried for “epidural abscess”–related legal cases. Demographic and clinical data were examined for all claims; any irrelevant cases or cases with incomplete information were excluded. The effects of age of the plaintiff, sex of the plaintiff, presence of a known infection, resulting paraplegia or quadriplegia, delay in diagnosis, and delay in treatment on the proportion of plaintiff rulings and size of payments were assessed.RESULTSIn total, 56 cases met the inclusion criteria. Of the 56 cases, 17 (30.4%) were settled, 22 (39.3%) resulted in a defendant ruling, and 17 (30.4%) resulted in a plaintiff ruling. The mean award for plaintiff rulings was $5,277,468 ± $6,348,462 (range $185,000–$19,792,000), which was significantly larger than the mean award for cases that were settled out of court, $1,914,265 ± $1,313,322 (range $100,000–$4,500,000) (p < 0.05). The mean age of the plaintiffs was 47.0 ± 14.4 years; 23 (41.1%) of the plaintiffs were female and 33 (58.9%) were male. The proportion of plaintiff verdicts and size of monetary awards were not affected by age or sex (p > 0.49). The presence of a previously known infection was also not associated with the proportion of plaintiff verdicts or indemnity payments (p > 0.29). In contrast, juries were more likely to rule in favor of plaintiffs who became paraplegic or quadriplegic (p = 0.03) compared with plaintiffs who suffered pain or isolated weakness. Monetary awards for paraplegic or quadriplegic patients were also significantly higher (p = 0.003). Plaintiffs were more likely to win if there was a delay in diagnosis (p = 0.04) or delay in treatment (p = 0.006), although there was no difference in monetary awards (p > 0.57). Internists were the most commonly sued physician (named in 13 suits [23.2%]), followed by emergency medicine physicians (named in 8 [14.3%]), and orthopedic surgeons (named in 3 [5.4%]).CONCLUSIONSThis investigation is the largest examination of legal claims due to spinal epidural abscess to date. The proportion of plaintiff verdicts was significantly higher in cases in which the patient became paraplegic or quadriplegic and in cases in which there was delay in diagnosis or treatment. Additionally, paralysis is linked to large sums awarded to the plaintiff. Nonsurgeon physicians, who are often responsible for initial diagnosis, were more likely to be sued than were surgeons.
A Search for Laser Emission with Megawatt Thresholds from 5600 FGKM Stars
Authors: Tellis Nathaniel K. , Marcy Geoffrey W. 
Published: May 2017

Abstract
We searched high-resolution spectra of 5600 nearby stars for emission lines that are both inconsistent with a natural origin and unresolved spatially, as would be expected from extraterrestrial optical lasers. The spectra were obtained with the Keck 10 m telescope, including light coming from within 0.5 arcsec of the star, corresponding typically to within a few to tens of astronomical units of the star, and covering nearly the entire visible wavelength range from 3640 to 7890 Å. We establish detection thresholds by injecting synthetic laser emission lines into our spectra and blindly analyzing them for detections. We compute flux density detection thresholds for all wavelengths and spectral types sampled. Our detection thresholds for the power of the lasers themselves range from 3 kW to 13 MW, independent of distance to the star but dependent on the competing “glare” of the spectral energy distribution of the star and on the wavelength of the laser light, launched from a benchmark, diffraction-limited 10 m class telescope. We found no such laser emission coming from the planetary region around any of the 5600 stars. Because they contain roughly 2000 lukewarm, Earth-size planets, we rule out models of the Milky Way in which over 0.1% of warm, Earth-size planets harbor technological civilizations that, intentionally or not, are beaming optical lasers toward us. A next-generation spectroscopic laser search will be done by the Breakthrough Listen initiative, targeting more stars, especially stellar types overlooked here including spectral types O, B, A, early F, late M, and brown dwarfs, and astrophysical exotica.
The Great Solar Active Region NOAA 12192: Helicity Transport, Filament Formation, and Impact on the Polar Field
Authors: McMaken Tyler C. , Petrie Gordon J. D. 
Published: May 2017

Abstract
The solar active region (AR), NOAA 12192, appeared in 2014 October as the largest AR in 24 years. Here we examine the counterintuitive nature of two diffusion-driven processes in the region: the role of helicity buildup in the formation of a major filament, and the relationship between the effects of supergranular diffusion and meridional flow on the AR and on the polar field. Quantitatively, calculations of current helicity and magnetic twist from Helioseismic and Magnetic Imager (HMI) vector magnetograms indicate that, though AR 12192 emerged with negative helicity, positive helicity from subsequent flux emergence, consistent with the hemispheric sign-preference of helicity, increased over time within large-scale, weak-field regions such as those near the polarity inversion line (PIL). Morphologically, Atmospheric Imaging Assembly observations of filament barbs, sigmoidal patterns, and bases of Fe xii stalks initially exhibited signatures of negative helicity, and the long filament that subsequently formed had a strong positive helicity consistent with the helicity buildup along the PIL. We find from full-disk HMI magnetograms that AR 12192's leading positive flux was initially closer to the equator but, owing either to the region’s magnetic surroundings or to its asymmetric flux density distribution, was transported poleward more quickly on average than its trailing negative flux, contrary to the canonical pattern of bipole flux transport. This behavior caused the AR to have a smaller effect on the polar fields than expected and enabled the formation of the very long neutral line where the filament formed.
The Influence of Atomic Diffusion on Stellar Ages and Chemical Tagging
Authors: Dotter Aaron , Conroy Charlie , Cargile Phillip , Asplund Martin 
Published: May 2017

Abstract
In the era of large stellar spectroscopic surveys, there is an emphasis on deriving not only stellar abundances but also the ages for millions of stars. In the context of Galactic archeology, stellar ages provide a direct probe of the formation history of the Galaxy. We use the stellar evolution code MESA to compute models with atomic diffusion—with and without radiative acceleration—and extra mixing in the surface layers. The extra mixing consists of both density-dependent turbulent mixing and envelope overshoot mixing. Based on these models we argue that it is important to distinguish between initial, bulk abundances (parameters) and current, surface abundances (variables) in the analysis of individual stellar ages. In stars that maintain radiative regions on evolutionary timescales, atomic diffusion modifies the surface abundances. We show that when initial, bulk metallicity is equated with current, surface metallicity in isochrone age analysis, the resulting stellar ages can be systematically overestimated by up to 20%. The change of surface abundances with evolutionary phase also complicates chemical tagging, which is the concept that dispersed star clusters can be identified through unique, high-dimensional chemical signatures. Stars from the same cluster, but in different evolutionary phases, will show different surface abundances. We speculate that calibration of stellar models may allow us to estimate not only stellar ages but also initial abundances for individual stars. In the meantime, analyzing the chemical properties of stars in similar evolutionary phases is essential to minimize the effects of atomic diffusion in the context of chemical tagging.
New Insight on the Origin of the Double Red Clump in the Milky Way Bulge
Authors: Joo Seok-Joo , Lee Young-Wook , Chung Chul 
Published: May 2017

Abstract
The double red clump (RC) observed in the Milky Way bulge is widely interpreted as evidence for an X-shaped structure. We have recently suggested, however, an alternative interpretation based on the multiple population phenomenon, where the bright RC is from helium-enhanced second-generation stars (G2), while the faint RC is representing first-generation stars (G1) with normal helium abundance. Here, our RC models are constructed in a large parameter space to see the effects of metallicity, age, and helium abundance on the double RC feature. Our models show that the luminosity of RC stars is mainly affected by helium abundance, while the RC color is primarily affected by metallicity. The effect of age is relatively small, unless it is older than 12 Gyr or much younger than 6 Gyr. The observed double RC feature can therefore be reproduced in a relatively large parameter space, once ΔY between G2 and G1 is assumed to be greater than ∼0.10. We further show that the longitude dependence of the double RC feature at

, which was pointed out by Gonzalez et al. as a potential problem of our model, is well explained in our scenario by a classical bulge embedded in a tilted bar.
Falling Outer Rotation Curves of Star-forming Galaxies at 0.6 ≲ z ≲ 2.6 Probed with KMOS3D and SINS/zC-SINF
Authors: Lang Philipp , Förster Schreiber Natascha M. , Genzel Reinhard , Wuyts Stijn , Wisnioski Emily , Beifiori Alessandra , Belli Sirio , Bender Ralf , Brammer Gabe , Burkert Andreas , Chan Jeffrey , Davies Ric , Fossati Matteo , Galametz Audrey , Kulkarni Sandesh K. , Lutz Dieter , Mendel J. Trevor , Momcheva Ivelina G. , Naab Thorsten , Nelson Erica J. , Saglia Roberto P. , Seitz Stella , Tacchella Sandro , Tacconi Linda J. , Tadaki Ken-ichi , Übler Hannah , van Dokkum Pieter G. , Wilman David J. 
Published: May 2017

Abstract
We exploit the deep, resolved, Hα kinematic data from the KMOS3D and SINS/zC-SINF surveys to examine the largely unexplored outer-disk kinematics of star-forming galaxies (SFGs), out to the peak of cosmic star formation. Our sample contains 101 SFGs, representative of the more massive (

) main sequence population at 0.6 ≤ z ≤ 2.6. Through a novel stacking approach, we are able to constrain a representative rotation curve extending out to ∼4 effective radii. This average rotation curve exhibits a significant drop in rotation velocity beyond the turnover, with a slope of

in units of normalized coordinates V/V
max and R/R
turn. This result confirms that the fall-off seen in some individual galaxies is a common feature of our sample of high-z disks. The outer fall-off strikingly deviates from the flat or mildly rising rotation curves of local spiral galaxies that have similar masses. Through a comparison with models that include baryons and dark matter, we demonstrate that the falling stacked rotation curve is consistent with a high mass fraction of baryons, relative to the total dark matter halo (m
d ≳ 0.05), in combination with a sizeable level of pressure support in the outer disk. These findings agree with recent studies demonstrating that high-z star-forming disks are strongly baryon-dominated within the disk scale, and furthermore suggest that pressure gradients caused by large, turbulent gas motions are present even in their outer disks. These results are largely independent of our model assumptions, such as the presence of stellar bulges, the effect of adiabatic contraction, and variations in halo concentration.
Simulations of Fractal Star Cluster Formation. I. New Insights for Measuring Mass Segregation of Star Clusters with Substructure
Authors: Yu Jincheng , Puzia Thomas H. , Lin Congping , Zhang Yiwei 
Published: May 2017

Abstract
We compare the existent methods, including the minimum spanning tree based method and the local stellar density based method, in measuring mass segregation of star clusters. We find that the minimum spanning tree method reflects more the compactness, which represents the global spatial distribution of massive stars, while the local stellar density method reflects more the crowdedness, which provides the local gravitational potential information. It is suggested to measure the local and the global mass segregation simultaneously. We also develop a hybrid method that takes both aspects into account. This hybrid method balances the local and the global mass segregation in the sense that the predominant one is either caused by dynamical evolution or purely accidental, especially when such information is unknown a priori. In addition, we test our prescriptions with numerical models and show the impact of binaries in estimating the mass segregation value. As an application, we use these methods on the Orion Nebula Cluster (ONC) observations and the Taurus cluster. We find that the ONC is significantly mass segregated down to the 20th most massive stars. In contrast, the massive stars of the Taurus cluster are sparsely distributed in many different subclusters, showing a low degree of compactness. The massive stars of Taurus are also found to be distributed in the high-density region of the subclusters, showing significant mass segregation at subcluster scales. Meanwhile, we also apply these methods to discuss the possible mechanisms of the dynamical evolution of the simulated substructured star clusters.