bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atypical presentation of streptococcus salivarius meningitis
Authors: Ali Shahnila , Hussain Taarif 
Published: August 2017

Patient with past medical history significant for multiple co morbidities including hypertension, diabetes mellitus, paroxysmal atrial fibrillation (on Coumadin but sub-therapeutic INR on presentation), chronic systolic congestive cardiac failure/cardiomyopathy, aortic valve stenosis, mitral valve regurgitation presented with slurred speech. Due to concern for stroke, patient received initial CT scan head which was negative and admitted for further work up including MRI. Patient was also observed to be having shortness of breath and mild hypoxia in ED. Patient also had leukocytosis on complete blood count. Initial arterial blood gases results were within normal limits. CXR showed right lower lobe infiltrates suggestive of pneumonia. Infectious work up including blood cultures were also ordered. On clinical examination, no neck rigidity or any focal weakness. No facial droop either. No neurological abnormality other than slurred speech. In addition, patient was initiated on empirical coverage for possible pneumonia with consideration of aspiration event considering a sequela of stroke. Next morning, patient was able to speak clearly and stated that he did have headache few days before presentation. LP was ordered and patient found to have meningitis. Blood cultures grew Streptococcus salivarius. Patient received ceftriaxone and discharged without any complications in stable condition.
Presentation of aggressive high-grade B cell lymphoma as venous thromboembolism
Authors: Ali Shahnila , Hussain Taarif 
Published: August 2017

Patient with no known past medical history who came to United States few years back and no established PCP noticed right groin swelling and discomfort for 3 days. In addition to right groin swelling and discomfort, she also noticed fatigue especially at work. Due to progressive symptomatology, she seeked help at urgent care. On physical examination performed by urgent care doctor, patient found to have inguinal lymphadenopathy, which led to general surgery referral and subsequent lymph node biopsy a day afterwards. Curious surgeon followed pathology report, which turned out to be Burkitt’s lymphoma. Subsequently, surgeon referred for survey which included CT scans abdomen and pelvis with contrast. Radiologist reading imaging called patent to go to ED STAT as she found massive B/L pulmonary embolism in main pulmonary arteries incidently. Other findings included lymphadenopathy in the right inguinal, right pelvic and peri aortic locations. Mildly enlarged left pelvic lymph node. No lymphadenopathy in the chest. Patient was initiated immediately on heparin infusion on presentation to ED. Oncology consulted and ordered additional studies including ECHO. Patient received bone marrow biopsy and lumbar puncture as well. She was initiated on standard chemotherapy R-EPOCH regimen. Patient also received allopurinol entecavir and bactrim Subsequently, bone marrow biopsy results showed high grade B cell Lymphoma. Staging bone marrow negative. LP showed normal protein, borderline elevation of glucose, flow cytometry and cytology negative for involvement. C-myc translocation, phenotype of Burkitt’s but with lower Ki67. Sites of disease included massive right inguinal adenopathy, peri aortic and left pelvic adenopathy.Patient was followed during the hospital course and had excellent recovery. Symptomatically, she no longer felt fatigued and leg swelling / groin mass significantly improved at time of discharge. She was discharged in stable condition with outpatient follow up with oncology.Aggressive High Grade B cell Lymphoma may present with venous thromboembolism and due to aggressive nature of lymphoma, venous thromboembolism can pose/present with significant clot burden before being diagnosedLymphoma should be considered as a causative disease in a patient even adult with venous thromboembolismAggressive evaluation and prompt treatment is needed for good results and recovery
Value of routine milking of cystic duct during laparoscopic cholecystectomy
Authors: Elbalshy Mohammed , Gaber Ahmed , Ammar Mohamed S. , Soltan Hatem 
Published: August 2017

Background: Cystic duct stones (CDS) although they are occasionally encountered during laparoscopic cholecystectomy (LC) and are not detected easily by preoperative investigations however it is worthy to detect them intra-operatively as they will decrease the incidence of postcholecystectomy pain and they will alarm us to the more serious common bile duct (CBD) stones. So, we aimed at this study to evaluate the role of cystic duct milking in detection of cystic duct stones and its significance.Methods: This study was performed on 150 cases with calcular cholecystitis at Menofia University hospital in the period from August 2015 to May 2017. All patients had undergone LC, cystic duct milking. On table cholangiogram was done for cases that showed CDS.Results: CDS were detected in 28 cases, preoperative investigations failed to detect any of them however retrospectively 19 cases (67.8%) of them revealed to have mild transient liver functions derangement associated with acute right hypochondrial pain. Wide cystic duct (more than 4 mm) was recorded in 3 cases (10.7%) out of 28 cases that showed CDS. The incidence of association of cystic duct stones and CBD stones was found in 10 cases (35.7%).Conclusions: CDS are occasionally encountered during LC. They can be removed easily by just milking of cystic duct before clipping. The benefit is to decrease the incidence of post-cholecystectomy pain as well as it alerts us towards the more serious CBD stones. So on-table cholangiogram at that time becomes mandatory to avoid missed stone.
The relationship between primary tumour thicknesses in cancers of the oral cavity to subsequent lymph node metastasis
Authors: Fawzy Ahmed , Al zaqri Waleed Ali , Sabry Mohamed , Sabry Ahmed , Fol Hosam El , Kased Ahmed El 
Published: August 2017

Background: Elective dissection of cervical lymph nodes in oral cavity cancers gives very precious data on its pathological state, judge for adjuvant therapy requirement plus its therapeutic effect but it has its morbidities that cannot be condoned. Tumor thickness (TT) in oral cavity cancers show an increasing value to be one of the most important and reliable factors that have a great relationship to regional node involvement.Methods: Forty-three patients with T1, T2 oral cavity squamous cell carcinoma with clinically and radiologically negative cervical L.Ns underwent elective neck dissection and the relation between the tumor thickness and the nodal metastasis was monitored. Tumor thickness was estimated preoperatively by using the intra-oral ultrasound and confirmed by histopathology postoperatively.Results: Only 12 out of 43 neck dissections (27.9%) showed positive L.Ns metastasis of primary tumor. The excised number of L.Ns ranged from 15 to 31 with mean±SD (21.58±3.59) L.Ns. The (TT) ranged from 1.4 mm to 7.8 mm. Our statistical results showed that there is a cutoff point which was 4 mm where (TT) > 4 mm showed significant results with histologically found positive cervical node metastasis compared to (TT) ≤4 mm specimens.Conclusions: Relationship of tumor thickness to lymph node metastasis was found to be significant as shown by this study. Our results clearly demonstrate that conservative elective neck dissection is indicated in patients with stage I/II oral cavity carcinoma whose tumors are > 4 mm in thickness as they mostly have latent metastasis.
Validación de señales vibro-acústicas para el diagnóstico de fallas en rodamientos en un generador síncrono
Authors: Medrano Hurtado Zulma Yadira , Pérez Tello Carlos 
Published: August 2017

En este trabajo se describe el procedimiento y las herramientas utilizados en la medición y diagnóstico de señales de vibración capturadas a través de transductores de aceleración (acelerómetros piezoeléctricos) y acústicos (micrófonos omnidireccionales). Además, se desarrolló un arreglo experimental empleando la metodología Taguchi para validar la información registrada de las señales de vibración para rodamientos sin falla y con falla artificial, respectivamente. La falla artificial consistió en una grieta producida en la jaula de un rodamiento SKF-6303-2RSH. Este método es no invasivo, ya que utiliza micrófonos para analizar la vibración, lo que representa no tener que montar ningún tipo de transductor en la máquina, además de ser sensible a fallas en la jaula.
The automotive sector in emerging economies
Authors: Rocha Marco Antonio Martins da 
Published: August 2017

From the decades that followed the II World War, the automotive sector has been rebuilt as one of the pillars of global capitalism. With an elevated level of concentration and working in global scale, the automotive sector has been a major vector of technological diffusion and it demonstrates a notable capacity to absorb technology from other industries. This paper discusses some conclusions of the book published by the Friedrich Ebert Foundation, named The automotive sector in emerging economies: industrial policies, market dynamics and trade unions – trends & perspectives in Brazil, China, Mexico and Russia.
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México y la Agenda 2030 de Desarrollo Sostenible. Acciones, contribuciones y propuestas
Authors: Tinoco Riaño Maria Camila 
Published: August 2017

En este libro, Juan Pablo Prado Lallende se propone analizar el papel que desempeñó México, como país latinoamericano emergente, en el cumplimento de los Objetivos del Milenio (ODM), así como identificar su contribución en el establecimiento y cumplimiento de la Agenda de Desarrollo Post-2015. Esta nueva agenda se compone por 17 Objetivos de Desarrollo Sostenible (ODS) que apuntan a la transformación de la calidad de vida, a partir de lo conseguido por los Objetivos de Desarrollo del Milenio (ODM). Con los ODS, las naciones aspiran a metas más amplias y concretas para erradicar la pobreza, alcanzar la igualdad, mejorar la educación y la salud, entre otros temas importantes para la consecución del desarrollo humano sostenible a nivel global.
Lorentz Group Action on Ellips Space
Authors: Khalif Muhammad Ardhi 
Published: August 2017

The ellips space E has been constructed as cartesian product R+ × R+ × [ π 2 , π 2 ]. Its elements, (a, b, θ), is called as an ellipse with eccentricity is = p1 − b2/a2 if b a and is = p1 − a2/b2 if a b. The points (a, b, π/2) is equal to (b, a, 0). The action of subgrup SOoz(3, 1) of Lorentz group SOo(3, 1), containing Lorentz transformations on x−y plane and rotations about z axes, on E is defined as Lorentz transformation or rotation transformation of points in an ellipse. The action is effective since there are no rigid points in E. The action is also not free and transitive. These properties means that Lorentz transformations change any ellips into another ellips. Although mathematically we can move from an ellipse to another one with the bigger eccentrity but it is imposible physically. This is occured because we donot include the speed parameter into the definition of an ellipse in E.
Green Concrete Made From Iron Slag Waste
Authors: Mulyatun Mulyatun 
Published: August 2017

Synthesis of green concrete has been carried out by using iron slag waste of PT Inti Jaya Steel Jrakah, Semarang. Geopolimer (green concrete) is an aluminosilicate inorganic polymer with chain Si-O-Al that can be synthesized from material rich in silica and alumina with sodium hydroxide as an activator. Iron slag chemical content analysis indicated that this material is a part of pozzolan material with each individual components weight as follow: SiO2: 4.55%, Al2O3: 2.54%, CaO: 11.43%, Fe2O3: 77.10%, MnO2: 1.43 and other minerals: 4.07%. The mole ratio of SiO2/Al2O3 of iron slag waste of PT Inti Jaya Steel Jrakah, Semarang is quite high at 3.05. Although the ratio is high, it is still can be synthesized using an activator solution of NaOH and increasing the drying time to 3 days and 24 hours of curing time at 60°C temperature to help the process of water molecule condensation in the geopolymerisation process. Characterized concrete (green concrete) that has been formed shows that the maximum compressive power can be achieved at composition ratio of Iron slag/ Na-silicate /NaOH /H2O of 55/10/4/8, with compressive power of 11.254 MPa. © 2015 JNSMR UIN Walisongo. All rights reserved.
Comprehensive evaluation of multiple methods for assessing water resources variability of a lake–river system under the changing environment
Authors: Ye Xuchun , Xu Chong-Yu , Li Xianghu , Zhang Qi 
Published: August 2017

Abstract
The inherent regularities of hydrological processes will not be stationary under the changing environment, making the evaluation of hydrological characteristics and trend forecasting face great uncertainty. Based on the observed streamflow series in the Poyang Lake catchment during the period 1960–2013, this study investigated the evolution characteristics and future trend of water resources. The extracted trend component by wavelet decomposition and the reliability of trend forecasting by rescaled range analysis (R/S analysis) were verified and assessed by a non-parametric statistical test. Results indicate a change point at 1995 when the trend of annual streamflows across the catchment changed. Periodic components indicated that the lake basin seems to enter into an increasing process under inter-decadal scale, while decreasing under inter-annual scale in the near future. R/S analysis revealed that annual streamflow series of most stations in Poyang Lake show ‘weaker’ or ‘very weak’ persistence. For the whole study period, Hurst exponents of most stations are less than 0.5 (0.224–0.339), therefore, opposite from the increasing trend of historical series, decreasing trend is forecasted for the basin. However, due to the effect of intensified human activities in the Fuhe sub-basin, the reliability of R/S analysis on trend forecasting is disturbed at Lijiadu station.
Exploring the utility of drought indicators to assess climate risks to agricultural productivity in a humid climate
Authors: Haro-Monteagudo David , Daccache Andre , Knox Jerry 
Published: August 2017

AbstractDrought indices have been extensively used by the hydrological research community for understanding drought risks to water resources systems. In a humid climate, such as in England, most agricultural production is rainfed and dependent on summer rainfall, but knowledge of drought risks in terms of their occurrence and potential agronomic impacts on crop productivity remains limited. This paper evaluated the utility of integrating data from three well-established drought indices, including the standardised precipitation index (SPI), the standardised precipitation evapotranspiration index (SPEI) and the Palmer drought severity index (PDSI), with simulated yield outputs from a biophysical crop model for potato, a drought-sensitive and high-value crop. The relationships between drought onset and yield response were statistically evaluated. The SPEI-3 drought indicator was found to be most suited to monitoring water availability and hence drought conditions for both rainfed and irrigated production. ‘Heat maps’ were produced to illustrate the strength of the correlation between the modelled SUBSTOR-Potato yields and SPEI for different aggregation periods and monthly lags. Finally, the outputs were used to assess alternative ways in which decision-making could be improved regarding adaptation strategies to reduce agricultural system vulnerability to future drought events.
A self-organizing map approach to characterize hydrogeology of the fractured Serra-Geral transboundary aquifer
Authors: Iwashita Fabio , Friedel Michael J. , Ferreira Francisco J. F. 
Published: August 2017

Abstract
The aim of this work is to understand the exchange of water between the Serra Geral aquifer system (SGAS) and Guarani aquifer system (GAS). The objectives are two-fold. First, introduce the capability of the modified self-organizing maps (MSOM) as an unbiased nonlinear approach to estimate missing values of hydrochemistry and hydraulic transmissivity associated with the SGAS, a transboundary groundwater system spanning parts of four South American countries. Second, identify areas with potential connectivity of the SGAS with the GAS based on analysis of the spatial variability of key elements and comparison with current conceptual models of hydraulic connectivity. The MSOM is employed to calculate correlations (trends) between 27 variables from 1,132 wells. Hydraulic transmissivity is calculated from specific capacity values from well-pump tests in 157 locations. Hydrochemical facies estimates appear unbiased and consistent with current conceptual-connectivity models indicating that vertical fluxes from GAS are influenced by geological structure. The MSOM provides additional spatial estimates revealing new areas with likely connections between the two aquifer systems.
Study of Genetic Association With DCDC2 and Developmental Dyslexia in Hong Kong Chinese Children
Authors: Waye Mary M.Y. , Poo Lim K. , Ho Connie S-H 
Published: August 2017

Background:
Doublecortin domain-containing 2 (DCDC2) is a doublecortin domain-containing gene family member and the doublecortin domain has been demonstrated to bind to tubulin and enhance microtubule polymerization. It has been associated with developmental dyslexia and this protein family member is thought to function in neuronal migration where it may affect the signaling of primary cilia.

Objectives:
The objective of the study is to find out if there is any association of genetic variants of DCDC2 with developmental dyslexia in Chinese children from Hong Kong.

Methods:
The dyslexic children were diagnosed as developmental dyslexia (DD) using the Hong Kong Test of Specific Learning Difficulties in Reading and Writing (HKT-SpLD) by the Department of Health, Hong Kong. Saliva specimens were collected and their genotypes of DCDC2 were studied by DNA sequencing or TaqMan Real Time PCR Assays.

Results:
The most significant marker is rs6940827 which is associated with DD with nominal p-value (0.011). However, this marker did not remain significant after multiple testing corrections and the adjusted p-value from permutation test was 0.1329. Using sliding window haplotype analysis, several haplotypes were found to be nominally associated with DD. The smallest nominal p values was 0.0036 (rs2996452-rs1318700, C-A). However, none of the p values could withstand the multiple testing corrections.

Conclusion:
Despite early findings that DCDC2 is a strong candidate for developmental dyslexia and that some of the genetic variants have been linked to brain structure and functions, our findings showed that DCDC2 is not strongly associated with dyslexia.
Prolonged Cough in Pediatric Population First Line Care, Belgian Guidelines
Authors: Leconte Sophie , Valentin Stéphanie , Dromelet Estelle , De Jonghe Michel 
Published: August 2017

Background:The clinical approach to a prolonged cough,i.e. a cough lasting more than three weeks, is challenging for general practitioners as well for primary care pediatricians. What the recommended clinical approach in primary care is, how cough duration or cough characteristics impact the diagnosis, and what the efficiency and safety of antibiotics or symptomatic treatments are remain in question for primary care physicians.Objective:The last Belgian guidelines were published in 2006 and needed to be reviewed. Those background questions were used to conduct our guideline updating procedure.Methods:We systematically performed a pyramidal literature search between the periods 2006-2014 in order to write evidence based guidelines. The data of the literature was summarized, discussed by the authors, experts and the Belgian primary care guidelines committee. Recommendations were formulated and scored following the GRADE classification.Results:The consultation history as well as the physical examination should be directed towards searching for warning signs (GRADE 1B) and towards the common etiologies depending on cough duration (GRADE 2C). If the cough lasts for more than eight weeks, chest radiography and spirometry should be considered (GRADE 2C). An antibiotic is recommended for a prolonged wet cough (over eight weeks) if prolonged bacterial bronchitis is suspected (GRADE 1B). In the absence of clinical signs of a specific etiology of a cough, no drug can be recommended (GRADE 1B). For all cases, it is initially suggested to avoid irritants (GRADE 1C) as well as to take into account the concerns of parents and inform them about the natural development of a cough.Conclusions:More research is needed to provide evidence on the clinical pathway on prolonged cough for primary care. Cough duration of more than eight weeks and prolonged wet cough are the most useful cough characteristics. Regarding a specific cough treatment, no medication has proved any effect greater than placebo. Attention to environmental triggers and patient-centered care remain the keystones of interventions
Sleep Disordered Breathing May Signal Laryngomalacia
Authors: Clark Christine M. , DiSalvo Dale S. , Prozesky Jansie , Carr Michele M. 
Published: August 2017

Background:
Pediatric anesthesiologists are often confronted with children with sleep-disordered breathing (SDB) presenting for tonsillectomy and/or anesthesia. The typical patient has symptoms of obstructive sleep apnea (OSA) with enlarged tonsils; however, a subset of patients may have underlying laryngomalacia (LM) without tonsillar hypertrophy. Both OSA and LM significantly increase the risk of intra- and postoperative airway obstruction and sensitivity to narcotics. The prevalence of LM may be underestimated, because direct laryngoscopy (DL) is not routinely performed in the diagnostic evaluation of patients with SDB who lack tonsillar hypertrophy.

Aim:
To identify the prevalence and DL findings in pediatric patients with SDB without tonsillar hypertrophy.

Methods:
Retrospective chart review of 108 patients with SDB who underwent general anesthesia for adenotonsillectomy (TA) or adenoidectomy with concomitant DL. The following data were collected: demographic information, medical comorbidities, polysomnography results, anesthetic techniques, and postoperative complications.

Results:
94.5% of children had DL findings consistent with LM, including a retropositioned epiglottis and short aryepiglottic folds. Postglottic edema was observed in 42.2%, and these patients were significantly more likely to have a diagnosis of gastroesophageal reflux (P=0.023). 57.8% had vocal cord edema. 75.3% of children who received routine postoperative follow-up care experienced complete symptom resolution. Postoperative complications following discharge from hospital occurred in 12.4% of patients, and 15.7% underwent supraglottoplasty for continued SDB symptoms after TA or adenoidectomy.

Conclusion:
A substantial proportion of patients with SDB who lacked tonsillar hypertrophy had findings consistent with LM, suggesting that the larynx may be the primary site of upper airway obstruction in these patients. This has significant implications in terms of perioperative management. The majority of patients with SDB had symptomatic improvement following TA or adenoidectomy; however, a subset required further surgical intervention with supraglottoplasty.