The soaking in aqueous ammonia process was also optimized by a statistical method.\n\nResults: Response surface methodology was employed. The determination coefficient (R-2) value was found to be 0.9607 and the coefficient of variance was 6.77. The optimal pretreatment conditions were a temperature of 42.75 degrees C, an aqueous ammonia concentration of 20.93%, and a reaction time of 48 h. The optimal enzyme concentration for saccharification was 30 filter paper units. The crystallinity index was approximately 60.23% and the Fourier BI 6727 in vitro transform infrared results showed the distinct peaks of glucan. Ethanol production using Saccharomyces

cerevisiae K35 was performed to verify whether the glucose saccharified from rice straw was fermentable.\n\nConclusions: The combined pretreatment using dilute sulfuric acid and aqueous ammonia on rice straw efficiently yielded fermentable sugar and achieved almost the same crystallinity index as that of alpha-cellulose.”
“BACKGROUND: Within a trauma network in the Netherlands, neurosurgical facilities are usually limited to Level I hospitals. Initial transport to a district hospital of patients who are later found to require neurosurgical intervention may cause delay. The purpose of this study was to assess the influence on outcome and time intervals

of secondary transfer in trauma patients requiring emergency CDK activity neurosurgical intervention.\n\nMETHODS: In a 3-year period, all patients who sustained a severe traumatic brain injury and underwent a neurosurgical intervention

within 6 hours after admission to a Level I trauma center were included. Patients were classified into two groups: direct presentation to the Level I trauma center (TC) group or requiring secondary transport after having been diagnosed for neurosurgical intervention in other hospitals (transfer group).\n\nRESULTS: Eighty patients were included for analyses. Twenty-four patients in the transfer group had a better Glasgow Coma Scale on-scene but a higher 30-day mortality compared with patients who were primarily presented to the Level I trauma center (33% vs. 27%; p = 0.553). In the PR-171 clinical trial transfer group, time to operation was 304 minutes compared with 151 minutes in the TC group (p < 0.001). Most delay occurred during the initial trauma evaluation and the interval between the first computed tomography and the transfer ambulance departure at the referring hospital.\n\nCONCLUSION: Patients requiring an emergency neurosurgical intervention appear to have a clinically relevant worse outcome after secondary transfer to a neurosurgical service. Therefore, patient care can probably be improved by better triage on-scene and standardized procedures in case of a secondary transfer. (J Trauma. 2012; 72: 487-490.