bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of an in-house emergency radiologist on report turnaround time
Authors: Lamb Leslie , Kashani Paria , Ryan John , Hebert Guy , Sheikh Adnan , Thornhill Rebecca , Fasih Najla 
Published: February 2015

AbstractBackgroundOne of the many challenges facing emergency departments (EDs) across North America is timely access to emergency radiology services. Academic institutions, which are typically also regional referral centres, frequently require cross-sectional studies to be performed 24 hours a day with expedited final reports to accelerate patient care and ED flow.ObjectiveThe purpose of this study was to determine if the presence of an in-house radiologist, in addition to a radiology resident dedicated to the ED, had a significant impact on report turnaround time.MethodsPreliminary and final report turnaround times, provided by the radiology resident and staff, respectively, for patients undergoing computed tomography or ultrasonography of their abdomen/pelvis in 2008 (before the implementation of emergency radiology in-house staff service) were compared to those performed during the same time frame in 2009 and 2010 (after staffing protocols were changed).ResultsA total of 1,624 reports were reviewed. Overall, there was no statistically significant decrease in the preliminary report turnaround times between 2008 and 2009 (p = 0.1102), 2009 and 2010 (p = 0.6232), or 2008 and 2010 (p = 0.0890), although times consistently decreased from a median of 2.40 hours to 2.08 hours to 2.05 hours (2008 to 2009 to 2010). There was a statistically significant decrease in final report turnaround times between 2008 and 2009 (p < 0.0001), 2009 and 2010 (p < 0.0011), and 2008 and 2010 (p < 0.0001). Median final report times decreased from 5.00 hours to 3.08 hours to 2.75 hours in 2008, 2009, and 2010, respectively. There was also a significant decrease in the time interval between preliminary and final reports between 2008 and 2009 (p < 0.0001) and 2008 and 2010 (p < 0.0001) but no significant change between 2009 and 2010 (p = 0.4144).ConclusionOur results indicate that the presence of a dedicated ED radiologist significantly reduces final report turnaround time and thus may positively impact the time to ED patient disposition. Patient care is improved when attending radiologists are immediately available to read complex films, both in terms of health care outcomes and regarding the need for repeat testing. Providing emergency physicians with accurate imaging findings as rapidly as possible facilitates effective and timely management and thus optimizes patient care.
Airway management of an open penetrating neck injury
Authors: Youssef Nayer , Raymer Karen E. 
Published: February 2015

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

AbstractObjectiveTo determine whether a nursing intervention delivered at emergency department (ED) discharge would reduce ED revisits.MethodA randomized study was conducted in the ED of a tertiary cardiac hospital in Montreal, Quebec. Between November 2006 and March 2010, 3,795 patients were assessed for eligibility based on two risk factors for ED revisits (≥1 ED visit in the past year and ≥6 medications); 132 were randomized to the experimental group (EG) and 133 to the control group (CG). The intervention included one nurse-patient meeting before leaving the ED, with two additional telephone contacts over the next 2 weeks. The primary outcome was time to ED revisits within 30 days after discharge. Secondary outcomes included time to ED revisits over 90, 180, and 365 days and hospitalizations over 30, 90, 180, and 365 days.ResultsA planned interim analysis that stopped the study with half of the planned sample showed that the time to ED revisits was similar in both groups at 30 days (p=0.81; revisits: 18.2% in EG, 19.6% in CG), 90 days (p=0.44), 180 days (p=0.98), and 365 days (p=0.75). The only difference identified was a lower hospitalization proportion at 180 days in the EG group (13.6% v. 24.1%; p=0.038).ConclusionsThese findings are consistent with previous research showing that few ED-based interventions are successful in reducing ED returns. Factors other than those targeted by the intervention, including an improvement in usual care, may explain the findings.
Presenting characteristics of patients undergoing cardiac troponin measurements in the emergency department
Authors: Goodman Daniel A. , Kavsak Peter A. , Hill Stephen A. , Worster Andrew 
Published: February 2015

AbstractIntroductionNot all patients with suspected acute coronary syndrome (ACS) receiving cardiac troponin (cTn) testing present to the emergency department (ED) with cardiac chest pain. Since elderly patients (age ≥70) have increased morbidity and mortality associated with ACS, complaints other than cardiac chest pain may justify cTn testing. Our primary objective was to characterize the population of ED patients who receive cTn testing. The secondary objective was to determine if elderly patients underwent cTn testing for different presenting complaints than their younger counterparts.MethodsWe created an electronic database including Canadian Emergency Department Information Systems (CEDIS) presenting complaints, age, sex, disposition, and Canadian Triage Acuity Scale (CTAS) score, for patients who received cTn testing in three Canadian EDs during 2011. We analyzed the data for patient characteristics and sorted by age (<70 and ≥70) for further analysis.ResultsIn the 15,824 included patients, the average age was 66 (51%<70; 51% female). The most common presenting complaints were cardiac chest pain (n=3,267) and shortness of breath (n=2,266). The elderly underwent cTn testing for significantly (p<0.0001) different complaints than their younger counterparts. They more commonly presented with generalized weakness (n=898), whereas younger patients more frequently had abdominal pain (n=576).ConclusionsCardiac chest pain and shortness of breath are presenting complaints in one-third of patients undergoing ED cTn testing. The majority of patients undergoing cTn testing did not have typical ACS symptoms. Half of all cTn testing in the ED is on the elderly, who present with different complaints than their younger counterparts.
Prevalence of alternative diagnoses in patients with suspected uncomplicated renal colic undergoing computed tomography: a prospective study
Authors: Pernet Julie , Abergel Sandra , Parra Jerome , Ayed Amine , Bokobza Jerome , Renard-Penna Raphaelle , Tostivint Isabelle , Bitker Marc-Olivier , Riou Bruno , Freund Yonathan 
Published: February 2015

AbstractObjectivesUnenhanced computed tomography (CT) has become a standard imaging technique for uncomplicated renal colic in many countries. The appropriate timing of CT imaging has not been established, and guidelines recommend that this imaging be performed between 1 and 7 days of presentation. The primary objective of this study was to determine the prevalence of alternative diagnosis identified with low-dose unenhanced CT in the emergency department (ED) in patients with suspected uncomplicated renal colic.MethodsThis prospective single-centre study was carried out in a large university hospital ED. Over a 6-month period, all patients with clinically diagnosed renal colic and a plan to be discharged underwent low-dose unenhanced CT in the ED. Pregnant women, women of childbearing age not willing to have a pregnancy test, and patients who had already undergone diagnostic imaging were excluded. The primary outcome was the number and nature of the alternative diagnosis. Univariate analyses were performed to assess factors associated with the primary outcome.ResultsA total of 178 patients were screened, and 155 underwent CT in the ED. The mean age was 42.2 years; 69% were male. The diagnosis of uncomplicated renal colic was confirmed in 118 participants (76%); 27 (17%) had an inconclusive CT scan. Overall, 10 patients (6%; 95% confidence interval [CI] 3–10) had an alternative diagnosis, 5 of whom were subsequently hospitalized.ConclusionLow-dose unenhanced CT in the ED detects alternative diagnoses in 6% (95% CI 3–10) of patients with suspected uncomplicated renal colic, half of whom are subsequently hospitalized. Our prospective findings, which were similar to those reported in retrospective studies, are a potential argument for a systematic approach to ED imaging in suspected renal colic. Future research involving intervention and control groups would be helpful.
Epidemiology and outcomes of bloodstream infections in patients discharged from the emergency department
Authors: Chan Justine , Wong Jenna , Saginur Raphael , Forster Alan J. , van Walraven Carl 
Published: February 2015

AbstractObjectiveTo determine the outcomes of patients discharged from the emergency department (ED) with a bloodstream infection (BSI) and how these outcomes are influenced by antibiotic treatment.MethodWe identified every BSI in adult patients discharged from our ED to the community between July 1, 2002, and March 31, 2011. The medical records of all cases were reviewed to determine antibiotic treatment in the ED and at discharge. Microorganism sensitivities were used to determine whether antibiotics were appropriate. These data were linked to population-based administrative data to determine specific patient outcomes within the subsequent 2-week period: death, urgent hospitalization, or an unplanned return to the ED.ResultsA total of 480 adults with BSI were identified (1.49 cases per 1,000 adults discharged from the department). Compared to controls (321,048 patients), BSI patients had a significantly higher risk of urgent hospitalization (adjusted OR 2.1 [95% CI 1.6–2.8]) and unplanned return to the ED (adjusted OR 4.1 [95% CI 3.3–4.9]). Outcome risk was significantly lowered in BSI patients who received appropriate antibiotics in the ED and at discharge. In elderly patients, the risk of urgent hospitalization increased significantly as the time to appropriate antibiotics was delayed.ConclusionsBSI patients discharged from the ED have a significantly increased risk of urgent hospitalization and unplanned return to the ED in the subsequent 2 weeks. These risks decrease significantly with the timely provision of appropriate antibiotics. Our results support the aggressive use of measures ensuring that such patients receive appropriate antibiotics as soon as possible.
Inflating the endotracheal tube cuff with saline to confirm correct depth using bedside ultrasonography
Authors: Tessaro Mark O. , Arroyo Alexander C. , Haines Lawrence E. , Dickman Eitan 
Published: February 2015

AbstractAlthough bedside ultrasonography can accurately distinguish esophageal from tracheal intubation, it is not used to establish the correct depth of endotracheal tube insertion. As indirect sonographic markers of endotracheal tube insertion depth have proven unreliable, a method for visual verification of correct tube depth would be ideal. We describe the use of saline to inflate the endotracheal cuff to confirm correct endotracheal tube depth (at the level of the suprasternal notch) by bedside ultrasonography during resuscitation. This rapid technique holds promise during emergency intubation.
Correlates of Aortic Stiffness Progression in Patients With Type 2 Diabetes: Importance of Glycemic Control
Authors: Ferreira Marcel T. , Leite Nathalie C. , Cardoso Claudia R.L. , Salles Gil F. 
Published: February 2015

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

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

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

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

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

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

Abstract
In this work - in view of still decreasing crude oil resources and increasing fuel prices - are presented issues concerning research on development of other, alternative fuel sources including those used in water, land and air transport means. One of them is hydrogen which, while burning, does not produce noxious carbon dioxide but only side effects such as heat and clean water.
It is almost true that along with sudden drop of availability and rising price of crude oil many countries face economical paralysis. Any of alternative sources is not capable of supplying even only a basic amount of such energy, not mentioning the whole amount of energy demanded by our civilization. Hydrogen as an independent fuel for internal combustion engines has yet to go a long way to commercialization. to be Co-burning systems (combustion of mixtures)of today used hydrocarbon fuels combined with hydrogen seem closer to this aim. As proved in many investigations the substitution of a part of hydrocarbon fuel by hydrogen enables to make use of beneficial features of both the fuels.
One of possible solutions of the problem may be application of an innovative hydrogenic fuel electrolyzer which is presented and evaluated in this paper.
Effect of Microstructure on Mechanical Properties and Corrosion Resistance of 2205 Duplex Stainless Steel
Authors: Łabanowski Jerzy , Świerczyńska Aleksandra , Topolska Santina 
Published: February 2015

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

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

Abstract
This research is devoted to the study of vertical movements of the European crust on the basis of two independent methods, namely tide gauge and GNSS observations results. The description and classification of factors affecting sea level change has been made. The precision with which the movement of the earth's crust according to the results of tide gauge observations can be explored has been calculated . A methodology to identify the duration of tide gauge observations required for studies of vertical movements of the earth 's crust has been presented. Approximation of tide gauge time series with the help of Fourier series has been implemented, the need for long-term observations in certain areas has been explained. The diagram of the velocities of the vertical movements of the European crust on the basis of the tide gauge data and GNSS observations has been built and the anomalous areas where the observations do not coincide have been identified.