bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Evaluation of the ACEP Guideline for Mild Head Injuries in Taiwan
Authors: Hsiao KY , Li WC , Chang CH , Lin MHC , Yang JT , Wang PC , Chen KH 
Published: December 2017

Introduction Traumatic brain injury (TBI) is an important issue in the emergency department. In the United States, the American College of Emergency Physicians (ACEP) published clinical guideline to select patients with mild head injuries for head computed tomography (CT) scans in 2008. The aim of this study was to identify the possible benefits of compliance with these guidelines for mild head injury patients in Taiwan. Method This was a secondary analysis on our previous study published for association of hypertension and head injuries. In our previous study, we collected data about 1290 patients with head injuries who received brain CT scans in the emergency department from September 2012 to August 2013 for a study regarding the association between head injury and hypertension. In present study, we subjected this data to further analysis to try to validate the ACEP clinical policy for mild head injuries. Results Of these 1,290 patients, 154 were found to have brain haemorrhage on the initial brain CT scan, and 5 were in need of neurosurgical intervention. A total of 859 patients met the ACEP guideline criteria, and 117 of these had brain haemorrhages. The sensitivity and specificity of the ACEP guideline to predict brain haemorrhage were 75.97% (95% confidence interval [CI], 68.44% to 82.48%) and 34.68% (95% CI, 31.91% to 37.53%), respectively. In predicting neurosurgical intervention, the sensitivity and specificity of the guideline were 100% (95% CI, 47.82% to 100%) and 33.54% (95% CI, 30.96% to 36.2%), respectively. Conclusion Although adoption of the ACEP clinical policy may reduce the number of brain CT scans in mild head injury patients who may need neurosurgical interventions, it is not a good selection tool in Taiwan.
Outpatient Treatment of Pulmonary Embolism: sPESI Score and Highly Sensitive Troponin may Prove Helpful
Authors: Kartal M , Unal A , Goksu E , Yilmaz D , Gungor F 
Published: December 2017

IntroductionDespite advances in therapeutic and diagnostic options, acute pulmonary embolism (PE) is associated with high morbidity and mortality. Risk classification is important in deciding how and where to treat patients This study aimed to investigate simplified pulmonary embolism severity index (sPESI) scores and highly sensitive troponin levels to predict 30‐day clinical outcomes.MethodsPatients with the symptoms of dyspnoea, chest pain, and haemoptysis were included in the study. Multiple detector computed tomography (CT) examinations were performed. If the patients' glomerular filtration rate levels were less than 60 ml/min/1.73 m2, then the ventilation/perfusion (V/Q) scan was the preferred imaging modality. Venous blood samples were collected to test for highly sensitive troponin T levels (Elecsys troponin T high sensitive, Roche diagnostics). All patients were examined by two‐dimensional bedside echocardiography for detection of right ventricular dilatation. Patients' baseline characteristics (sex, ages, etc.) were recorded along with co‐morbidities, symptoms, haemodynamic conditions, all‐cause mortality rates during hospitalisation, the duration of hospital stay, radiographic test results, and laboratory findings, and electrocardiography were also obtained during emergency department admission. Primary outcome measure was defined as death in a month. Logistic regression model was created to reveal the associated parameters related to mortality within a month of the emergency department visit.ResultsOne hundred and seventy patients suspected of PE underwent either a CT angiogram or pulmonary V/Q scan. In total 70 patients were diagnosed with PE and included in the study. The logistic regression model was created in order to assess poor prognosis markers. In addition to the troponin levels and sPESI scores commonly used for pulmonary embolism prognosis, right ventricular dilatation, heart rate, systolic blood pressure and oxygen saturation using logistic regression models were created. Positive troponin level (odds ratio: 5.23 and 95% confidence interval [CI] 1.03 to 26.51) and negative sPESI score (odds ratio 2.14 and 95% CI 1.00 to 4.60) were found to be significant.ConclusionsSome scoring systems, including PESI and sPESI score, can be used for predicting mortality in patients with pulmonary embolism. If sPESI score is zero, and troponin levels are negative, the patient can be discharged safely.
Association between Systolic Blood Pressure after Thrombolysis and Early Neurological Improvement in Ischaemic Stroke Patients
Authors: Seok J , Lee JS , Jeong KY , Lee CM 
Published: December 2017

IntroductionThis study aimed to evaluate the relationship between systolic blood pressures (SBPs) within 12 hours after intravenous recombinant tissue plasminogen activator (rtPA) treatment and early neurological outcomes.MethodsThis was a retrospective observational study of acute ischaemic stroke (AIS) patients who received intravenous rtPA administration. SBPs at the time of rtPA bolus and thereafter every hour were collected. The mean, standard deviation, and coefficient of variation values of SBP during the periods of 0‐2 h, 2‐6 h, and 6‐12 h were calculated. The primary outcome was major neurologic improvement (MNI) at 24 hours after thrombolysis.ResultsSerial measures of SBPs revealed different 12‐hour courses between the patients with and without MNI. The difference of SBP tendency was statistically significant (p=0.013). In univariate analysis, patients with MNI showed lower levels of mean SBPs during the periods of 2‐6 h and 6‐12 h (p=0.030 and p=0.005, respectively), and higher frequency of very early neurologic improvement (VENI) at the end of rtPA infusion (p<0.001). In logistic regression analysis, VENI at 1 h, mean SBP value during 6‐12 h, and atrial fibrillation were independently related to MNI at 24 h.ConclusionsSBP level during the first 12 hours after intravenous rtPA treatment may be an important clinical factor that is associated with early neurological improvement of AIS patients.
A Case of Penetrating Neck Injury with Retained Foreign Body in the Cervical Vertebral Body and Vertebral Artery Dissection
Authors: Tong TMC , Wong OF , Kwan GWM , Chan KKC 
Published: December 2017

Vertebral artery injury is an uncommon but life‐threatening condition. We report a young lady with penetrating neck injury, after stabbed by her husband with a ceramic knife, resulting in right C5 nerve root injury and vertebral artery dissection. The tip of the knife was retained in the cervical vertebral body. Embolisation of the proximal vertebral artery was performed before the removal of the retained knife tip. The nerve root injury was successfully repaired and the patient had only minimal proximal weakness after the operation. The management of penetrating neck trauma with vertebral artery injury is discussed.
Age Stratification of 30-Day Postoperative Outcomes Following Excisional Laminectomy for Extradural Cervical and Thoracic Tumors
Authors: Phan Kevin , Cheung Zoe B. , Vig Khushdeep S. , Hussain Awais K. , Lima Mauricio C. , Kim Jun S. , Di Capua John , Cho Samuel K. 
Published: December 2017

Study Design: Retrospective cohort study. Objectives: To evaluate age as an independent predictive factor for perioperative morbidity and mortality in patients undergoing surgical decompression for metastatic cervical and thoracic spinal tumors using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2011 to 2014. Methods: We identified 1673 adult patients undergoing excisional laminectomy of cervical and thoracic extradural tumors. Patients were stratified into quartiles based on age, with Q1 including patients aged 18 to 49 years, Q2 including patients aged 50 to 60 years, Q3 including patients aged 61 to 69 years, and Q4 including patients ≥70 years. Univariate and multivariate regression analyses were performed to examine the association between age and 30-day perioperative morbidity and mortality. Results: Age was an independent risk factor for 30-day venous thromboembolism (VTE) and reoperation. Patients in Q3 for age had nearly a 4 times increased risk of VTE than patients in Q1 (odds ratio [OR] 3.97; 95% CI 1.91-8.25; P < .001). However, there was no significant difference in VTE between patients in Q4 and Q1 ( P = .069). Patients in Q2 (OR 1.99; 95% CI 1.06-3.74; P = .032) and Q4 (OR 2.18; 95% CI 1.06-4.52; P = .036) for age had a 2 times increased risk of reoperation compared with patients in Q1. Conclusions: Age was an independent predictive factor for perioperative VTE and reoperation, but there was no clear age-dependent relationship between increasing age and the risk of these perioperative complications.
Effects of a multi-strain probiotic supplement for 12 weeks in circulating endotoxin levels and cardiometabolic profiles of medication naïve T2DM patients: a randomized clinical trial
Authors: Sabico Shaun , Al-Mashharawi Ayah , Al-Daghri Nasser M. , Yakout Sobhy , Alnaami Abdullah M. , Alokail Majed S. , McTernan Philip G. 
Published: December 2017

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

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

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

Conclusion
Using a multi-strain probiotic supplement daily for 12/13 weeks significantly improved HOMA-IR and modestly reduced abdominal adiposity among medication naïve T2DM patients.
Trial Registration: ClinicalTrials.gov Identifier: NCT01765517, Registered January 10, 2013
Management and investigation of a Serratia marcescens outbreak in a neonatal unit in Switzerland – the role of hand hygiene and whole genome sequencing
Authors: Zingg Walter , Soulake Isabelle , Baud Damien , Huttner Benedikt , Pfister Riccardo , Renzi Gesuele , Pittet Didier , Schrenzel Jacques , Francois Patrice 
Published: December 2017

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

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

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

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

Background Characterization of the blood labyrinth barrier (BLB) is extremely important to determine whether the BLB can be manipulated pharmacologically. However, experiments to investigate the BLB are technically difficult to perform. In this report, we demonstrated a unique method of controlling the BLB, and established the pharmacokinetics of gentamicin in perilymph, cerebrospinal fluid (CSF) and blood with and without mannitol. Study design Controlled animal research project. Methods Permeability of the BLB and the blood brain barrier (BBB) to gentamicin with and without mannitol was studied by collecting 175 samples from 44 guinea pigs using concentrations relevant to human clinical situations. Samples were taken from two groups of 22 animals, with each animal undergoing sampling at a different time after administration of either 10 mg/ml gentamicin (4 mg/kg) (Gardena, CA) alone or gentamicin with 20% mannitol (250 mg/kg) (Mallinckrodt Inc., KY). The sample times varied from 0.5 to 17.5 h post-infusion. Samples were also taken from 4 animals as negative controls after administration of normal saline. Our goal was to simultaneously assess the pharmacokinetics of gentamicin in each of three different fluid samples in the same animal. Thus at the pre-determined post-infusion sampling time, each animal was sampled once for perilymph, CSF, and blood before being euthanized. Each animal contributed to a single time point on the subsequent pharmacokinetic curves with more than one animal per time point. Results Mannitol increased the rate of entry and egress of gentamicin through BLB significantly ( p = 0.0044) but the effects on the BBB did not reach statistical significance ( p = 0.581). Mannitol did not alter renal clearance of gentamicin from the blood ( p = 0.433). The concentration of gentamicin in perilymph and CSF was always significantly lower than in blood. Conclusions Mannitol administration transiently increases the permeability of the BLB. Potential clinical benefits may accrue from selected timing of administration of osmotic agents such as mannitol augmenting the rate of entry and egress of compounds such as gentamicin into and out of perilymph.
A New Photo-Control Method for Organic–Inorganic Interface Dipoles and Its Application to Photo-Controllable Molecular Devices
Authors: Suda Masayuki 
Published: December 2017

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

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

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

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

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

Advances in knowledge:
This is the first time to apply RS-fMRI, VBM and diffusion tensor tractography to study the structural and functional abnormalities in MS-SSCI, and to explore its correlation with EDSS score.
Crystallization and preliminary X-ray diffraction analysis of YejM from Salmonella typhimurium: an essential inner membrane protein involved in outer membrane directed cardiolipin transport
Authors: Gabale Uma , Qian Gene , Roach Elaina , Ressl Susanne 
Published: December 2017

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

The purpose of the study is to work out practical recommendations for the formation of bank liabilities, optimization of their structure and the use of credit resources in the commercial bank «Russian Standard».
Practical recommendations, given for optimizing the formation and the use of credit resources in the commercial bank "Russian Standard" can be used in different bank organizations
CARACTERÍSTICAS GENERALES DEL CICLO DE VIDA DE LOS MONOGENEOS Y SU INCORPORACIÓN A UN PROGRAMA DE INVESTIGACIÓN CIENTÍFICA EN PARASITOLOGÍA
Authors: Orensanz Martín , Denegri Guillermo 
Published: December 2017

El Programa de Investigación Científica elaborado por Denegri (1991, 1997, 2002, 2008) está basado en la metodología y filosofía de la ciencia de Imre Lakatos (1978). Su cinturón protector tiene dos hipótesis fundamentales. La hipótesis de los ciclos biológicos se funda en el trabajo de Boskov (1986) y resalta patrones en los ciclos de vida de los cestodes, trematodes, nematodes y acantocéfalos. La hipótesis del desarrollo de comunidades está basada en el trabajo de varios ecólogos y postula cuatro modelos para las comunidades de parásitos. Aquí ampliaremos el contenido de la hipótesis de los ciclos biológicos incorporándole los patrones generales del ciclo de vida de los monogeneos.
Indywidualizacja nauczania i uczenia się – otwarte formy pracy w gimnazjum oraz w kształceniu akademickim (action research)
Authors: Karpeta-Peć Beata 
Published: December 2017

The aim of this article is the theoretical and empirical analysis of the issue of individualization of learning and teaching foreign languages with reference to open forms of work at foreign language lessons and in academic study. The empirical part is the report on the author’s own educational studies of open forms of work, conducted at lower-secondary school and in the academic context (at the pilot-phase). The starting point for the analysis is methodological background of educational and language teaching research. The conclusions may serve as the inspiration for further research in this field.
Analiza wybranych podręczników do nauczania języka polskiego jako obcego w kontekście edukacji seniorów
Authors: Fiema Mariola , Janowska Iwona 
Published: December 2017

The main aim of the article is to direct attention towards the specific educational needs of elderly people who are learning a foreign language. One of the main points of this paper is to describe seniors and present biological, psychological, cultural and social factors that affect their SLA (Second Language Acquisition) process. Course books used for the process of learning Polish as a foreign language have also been analyzed on the basis of their usefulness for seniors. The analysis of the course books was conducted on the basis of specially prepared criteria for the evaluation of language teaching materials.