bluuebunny/crossref_metadata_2025 huggingface dataset:
Field-emission properties of arrays and extended areas of laser-fabricated silicon microstructures
Authors: Zorba V , Stratakis E , Spanakis E , Papazoglou D. G. , Zergioti I , Tzanetakis P , Fotakis C
Published: October 2007

The current paper presents a review of the formation of spikes under pulsed laser irradiation of crystalline silicon. Large areas of spikes are fabricated, having uniform shapes and arrays of spots with a wide distribution of spike morphologies per spot. Cold electron emission studies show that, in all cases, the formation of these three-dimensional, quasiperiodical structures leads to significant emission at low applied voltages. Emission properties are improved for the spikes fabricated under the longest laser pulse, at the irradiation wavelength utilized. The observed currents are correlated to localized field enhancement originating from the geometry of the spikes. The extent to which geometry can account for the observed emission results is discussed and the plausible physical mechanisms responsible for the formation of these structures are commented on.
Parametric dependence of current-voltage characteristics for scanning tunnelling microscope tip-carbon nanotube contact
Authors: Shah K. A. , Islam S. S.
Published: October 2007

This study presents parametric dependence of current-voltage ( I-V) characteristics for scanning tunnelling microscope (STM) tip-carbon nanotube (CNT) contact in rectifying mode ( I ≠ 0 only with V<0), which is a special behaviour shown by the contact. In order to determine the parametric dependence for its experimentally observed I-V characteristics, a computer algorithm was developed. The I-V characteristics are dependent on temperature and tip-nanotube overlap area, which are varied within experimental range. The results revealed that the forward threshold voltage decreases with increase in temperature and tip-nanotube overlap area. The current increases sharply with increase in tip-nanotube overlap area, and is much pronounced at high temperatures. It is concluded that the I-V characteristics are more dependent on tip-nanotube overlap area than temperature. The results of the calculations are compared to experimental data obtained by Yamada [1].
Recent Development of Homogeneous Transition Metal Catalysts with Nanosize Ligands
Authors: Tsuji Yasushi , Fujihara Tetsuaki
Published: October 2007

Expanding catalytic environment to a nanosize is one of the most promising ways to improve performance of homogeneous catalysts. In this highlight review, recent development in homogeneous transition metal catalysts with well-defined nanosize ligands is overviewed. These systems realize efficient catalysts with remarkable enhancement of catalytic activity, suppression of metal aggregation, and unprecedented selectivity.
Catalytic Hydrogenation and Dehydrogenation over Solid-state Rhenium Sulfide Clusters with an Octahedral Metal Framework
Authors: Kamiguchi Satoshi , Nagashima Sayoko , Chihara Teiji
Published: October 2007

When solid-state rhenium sulfide clusters with an octahedral metal framework are treated in a hydrogen stream above 250 °C, a catalytic activity for dehydrogenation of cyclohexanone to yield 2-cyclohexen-1-one and phenol develops. Dehydrogenation of cyclohexanol to cyclohexanone and hydrogenation of phenylacetylene to styrene also proceed. This catalytic behavior is the same as that of the platinum group metals. The catalytic activities are attributable to the partial loss of the sulfur ligands.
Blue Phosphorescent Iridium(III) Complex. A Reaction Path on the Triplet Potential Energy Surface
Authors: Treboux Gabin , Mizukami Junji , Yabe Masayoshi , Nakamura Shinichiro
Published: October 2007

The potential energy surfaces associated with the triplet electronic state of the Ir(ppz)3 and Ir(ppy)3 cyclometalated complexes, respectively, are calculated using density functional theory [where ppz = 1-phenylpyrazolyl-N,C2′, ppy = 2-phenylpyridyl]. Both surfaces present a metal-to-ligand charge-transfer energy minimum and a ligand-field energy minimum, connected by a chemical path involving only the rotation of one pyrazolyl or pyridyl group. Unlike Ir(ppy)3, the lowest energy minimum of Ir(ppz)3 is the ligand-field state.
On-chip Capillary Electrophoresis Fractionation of DNA Construct for Cell-free Protein Expression
Authors: Nojima Takahiko , Kaneda Shohei , Fujii Teruo
Published: October 2007

An on-chip capillary electrophoresis-based DNA collection was applied to isolate desired DNA construct from a reaction mixture of DNA-assembly instead of traditional living cell-based screening. The isolated construct was amplified with polymerase chain reaction and subjected to a coupled cell-free transcription/translation system as a template, and the template-dependent protein expression was observed. It was demonstrated that total process of standard recombinant DNA technology was performed in a cell-free condition.
Fabrication of TiO2 Microrod with Desired Shapes from Rod-like Titanium Glycolate
Authors: Han Jianjun , Zhang Hua , Li Yuanzhi , Zhao Xiujian , Chen Hong , Wu Zhongkui , Kim Sun-Jae , Park Kyeong Soon
Published: October 2007

Rod-like titanium glycolate was prepared by poly-condensation of TiCl4, ethylene glycol, and water. Focusing electronic beam on one side of a titanium glycolate microrod led to bending of the micro-rod at the irradiation part. Calcination of the polymer results in formation of rod-like titania. By controlling irradiation time and changing focus position of electronic beam, we realized controllable processing of titania microrod with desired shapes, which may be find application in nano or microdevices.
A New Class of Acetophenone-based Cinchona Alkaloids as Phase-transfer Catalysts: Application to the Enantioselective Synthesis of α-Amino Acids
Authors: Lv Jian , Zhang Liping , Liu Lei , Wang Yongmei
Published: October 2007

A new class of acetophenone-based cinchona alkaloid-derived quaternary ammonium salts were prepared and evaluated as phase-transfer catalysts in the enantioselective alkylation of glycine imine ester. +R3N-CH2COAr and electron-withdrawing 4′-NO2 moieties may play an important role leading to high enantioselectivity (85–>99% ee).
Direct Sol–Gel Fabrication of Patterned Zirconia Thin Films Using Self-assembly in Phase-separated Mixed Langmuir–Blodgett Films
Authors: Shibata Hirobumi , Sato Masahiro , Sakai Hideki , Abe Masahiko , Matsumoto Mutsuyoshi
Published: October 2007

We demonstrate a new method through sol–gel processes for the preparation of patterned zirconia thin films by using directed self-assembly into patterns reflecting the phase-separated structures of mixed Langmuir–Blodgett films. Atomic force microscopy and Kelvin probe force microscopy images confirmed the formation of patterned zirconia thin films.
Electrochemical Control of the Bioluminescence by Bacterial Luciferase Using Platinum-mesh Electrode
Authors: Takehara Kô , Nakashima Shinya , Yamasaki Shinya , Matsuoka Shiro
Published: October 2007

Bioluminescence reaction by bacterial luciferase has been successfully controlled by a controlled-potential electrolysis using platinum-mesh electrode to regenerate the reduced form of flavin mononucleotide (FMNH2), which is one of the substrates of the reaction. It was found that the regeneration of FMNH2 is facilitated by the adsorbed hydrogen atoms formed on a platinum electrode surface in the presence of phosphate ions.
Learning - the only way to improve health-care outcomes
Authors: Waldman J Deane , Yourstone Steven A
Published: October 2007

Attempts to improve health care have generally failed. Systems analysis urges addressing processes, such as learning, rather than isolated parts of a system. We apply learning curve theory to health care and then explicate the process of learning. Specific recommendations involve how we learn (and unlearn), who should learn, and what should be learned.
A research model of health-care competition and customer satisfaction
Authors: Asoh Derek A , Rivers Patrick A
Published: October 2007

In all industries, competition among businesses has long been encouraged as a mechanism to increase value for customers. In other words, competition ensures the provision of better products and services to satisfy the needs of customers. Various perspectives of competition, the nature of service quality, health-care system costs and customer satisfaction in health care are examined. A model of the relationship among these variables is developed. The model depicts customer satisfaction as an outcome measure directly dependent on competition. Quality of care and health-care system costs, while also directly dependent on competition, are considered as determinants of customer satisfaction as well. The model is discussed in the light of propositions for empirical research.
Professional or administrative value patterns? Clinical pathways in medical problem-solving processes
Authors: Holmberg Leif
Published: October 2007

A health-care organization simultaneously belongs to two different institutional value patterns: a professional and an administrative value pattern. At the administrative level, medical problem-solving processes are generally perceived as the efficient application of familiar chains of activities to well-defined problems; and a low task uncertainty is therefore assumed at the work-floor level. This assumption is further reinforced through clinical pathways and other administrative guidelines. However, studies have shown that in clinical practice such administrative guidelines are often considered inadequate and difficult to implement mainly because physicians generally perceive task uncertainty to be high and that the guidelines do not cover the scope of encountered deviations. The current administrative level guidelines impose uniform structural features that meet the requirement for low task uncertainty. Within these structural constraints, physicians must organize medical problem-solving processes to meet any task uncertainty that may be encountered. Medical problem-solving processes with low task uncertainty need to be organized independently of processes with high task uncertainty. Each process must be evaluated according to different performance standards and needs to have autonomous administrative guideline models. Although clinical pathways seem appropriate when there is low task uncertainty, other kinds of guidelines are required when the task uncertainty is high.
Hospital volunteer's role and accident-prevention systems: a nationwide survey of Japanese hospitals
Authors: Aragaki Madoka , Saito Tami , Takahashi Miyako , Kai Ichiro
Published: October 2007

This study aimed to examine the scope of activities performed by hospital volunteers. A survey was conducted on 3055 hospitals, randomly selected throughout Japan. Attention was also paid to the accident-prevention systems instituted by those facilities. Almost one-third (36.5%) of all hospitals had some hospital volunteers. About 60% (59.9%) of hospitals conducted volunteer activities more than once a week. Recreation (50.1%) was the most common role of the volunteers. The other activities in decreasing order were: conversation partners (45.8%), music and entertainment (43.7%), wheelchair pushing (41.8%) and helping administration (36.3%). Both direct and indirect contact between volunteers and patients was prevalent. Less than half of the hospitals had accident-prevention systems, such as guidelines for volunteer activities (except for Volunteer Insurance). Hospitals that had a volunteer coordinator tended to have significantly more accident-prevention systems. It is, therefore, important to establish volunteer coordinators in order to prevent accidents during hospital volunteer activities.
Benchmarking in National Health Service Procurement in Scotland
Authors: Walker Scott , Masson Ron , Telford Ronnie , White David
Published: October 2007

The paper reports the results of a study on benchmarking activities undertaken by the procurement organization within the National Health Service (NHS) in Scotland, namely National Procurement (previously Scottish Healthcare Supplies Contracts Branch). NHS performance is of course politically important, and benchmarking is increasingly seen as a means to improve performance, so the study was carried out to determine if the current benchmarking approaches could be enhanced. A review of the benchmarking activities used by the private sector, local government and NHS organizations was carried out to establish a framework of the motivations, benefits, problems and costs associated with benchmarking. This framework was used to carry out the research through case studies and a questionnaire survey of NHS procurement organizations both in Scotland and other parts of the UK. Nine of the 16 Scottish Health Boards surveyed reported carrying out benchmarking during the last three years. The findings of the research were that there were similarities in approaches between local government and NHS Scotland Health, but differences between NHS Scotland and other UK NHS procurement organizations. Benefits were seen as significant and it was recommended that National Procurement should pursue the formation of a benchmarking group with members drawn from NHS Scotland and external benchmarking bodies to establish measures to be used in benchmarking across the whole of NHS Scotland.
Expectations and realities of student nurses' experiences of negative behaviour and bullying in clinical placement and the influences of socialization processes
Authors: Hoel H , Giga S I , Davidson M J
Published: October 2007

This paper explores nursing students' experiences and perceptions of negative behaviour and bullying in clinical placement measured against expectations at the start of their education. It explores their understanding and how they make sense of their circumstances and their experiences of negative behaviour, emphasizing socialization processes and factors which may prevent or reproduce negative behaviour and bullying. To this end, a focus group study was conducted, and this revealed that many students felt exploited, ignored or were made to feel unwelcome, although few reported personal experience of bullying. These frequent but less severe negative experiences appear to play a key role in institutionalizing an unwelcoming culture within which bullying could easily be triggered or take hold. Students' coping mechanisms may also contribute to reproducing such negative behaviour. The paper concludes that while the vulnerable position of student nurses might offer some protection against outright bullying, it is unable to shield them from unfriendly and negative behaviour, with implications for their learning and professional socialization. If student nurses respond to their experiences by suppressing their feelings and developing a hard front, such responses may themselves contribute to a reproduction of such behaviour with implications for personal wellbeing and retention rates.
Heavy physician workloads: impact on physician attitudes and outcomes
Authors: Williams Eric S , Rondeau Kent V , Xiao Qian , Francescutti Louis H
Published: October 2007

The intensity of physician workload has been increasing with the well-documented changes in the financing, organization and delivery of care. It is possible that these stressors have reached a point where they pose a serious policy issue for the entire healthcare system through their diminution of physician's ability to effectively interact with patients as they are burned out, stressed and dissatisfied. This policy question is framed in a conceptual model linking workloads with five key outcomes (patient care quality, individual performance, absenteeism, turnover and organizational performance) mediated by physician stress and satisfaction. This model showed a good fit to the data in a structural equation analysis. Ten of the 12 hypothesized pathways between variables were significant and supported the mediating role of stress and satisfaction. These results suggest that workloads, stress and satisfaction have significant and material impacts on patient care quality, individual performance, absenteeism, turnover and organizational performance. Implications of these results and directions for future research are discussed.
Behavioural interventions and abuse: secondary analysis of reinfection in minority women
Authors: Champion Jane Dimmitt , Shain Rochelle N , Korte Jeffrey E , Holden Alan E C , Piper Jeanna M , Perdue Sondra T , Guerra Fernando A
Published: October 2007

Sexually transmitted infection (STI), including AIDS disproportionately affects minority women with a history of physical or sexual abuse. The objective of this study was to evaluate the efficacy of gender- and culture-specific behavioural interventions and interactive STI counselling for high-risk minority women with a history of physical or sexual abuse over two years. African- and Mexican-American women with a non-viral STI were enrolled in a randomized trial. Follow-up screens and interviews occurred at six months and one and two years. The primary outcome was subsequent infection with chlamydia and/or gonorrhoea. Secondary analysis of primary outcomes was made by self-reported physical or sexual abuse. Logistic regression was utilized on an intention-to-treat basis. Baseline data from 853 women were included; the retention rate was 91%. Infection rates were higher in abused women in Year 1 (29% vs. 23.8%, P=0.12), Year 2 (23.4% vs.17.6%, P=0.03) and cumulatively (43.8% vs. 33.0%, P=0.003). Unadjusted association between abuse and reinfection was stronger for adolescents (<19 years) than adults in Year 1 (42.7% vs. 30.8%, P=0.03), Year 2 (32.7% vs. 22.0%, P=0.03) and cumulatively (59.4% vs. 43.3%, P=0.004). Corresponding rates for adults were Year 1 (17.8% vs. 17.0%, P=0.84), Year 2 (17.4% vs. 12.7%, P=0.23) and cumulatively (30.7% vs. 22.3%, P=0.08). Reinfection rates were further stratified by adolescence and substance use. Abused adolescents had consistently higher reinfection than non-abused adolescents and abused adults. In conclusion, risk-reduction interventions decreased infective episodes with chlamydia and/or gonorrhoea in the two-year study period for non-abused women. Abused women, particularly adolescents and substance users, had increased episodes in these study periods.
Genitourinary symptoms in urban China: a population-based study
Authors: Parish William L , Hao Yanni , Laumann Edward O , Schneider John
Published: October 2007

Analysis of the first population-based sexual health survey in China found a prevalence of self-reported genitourinary (GU) symptoms among 2999 urban respondents for men and women as follows: burning (12.5% and 15.7%), discharge (2.6% and 20.1%), ulcer (1.3% and 3.6%) and warts (1.2% and 2.0%). Risk factors among men were unprotected commercial sex, short-term and other secondary partners, and living elsewhere than a coastal area or a major city. Among women, risk factors were her main partner's having other concurrent partners or socializing often, and her absence of condom use with her main partner, prior forced sex, low education and living elsewhere than a coastal area or a major city. These findings were consistent with many GU symptoms being concentrated in paths that led from commercial sex workers or short-term partners to husband/steady partner to wife/steady partner. The results also reveal factors other than sexual behaviour as predictors for GU symptoms.
Verrucous carcinoma of the groin misdiagnosed as granuloma hypertrophicus
Authors: Puri Neerja , Talwar Ashutosh
Published: October 2007

Verrucous carcinoma is a rare well-differentiated squamous cell carcinoma. We report a case of a 63-year-old male with a tumour-like growth in the right groin for three years. The tumour was slowly progressive without any considerable signs and symptoms. The first biopsy of the patient showed chronic dermal inflammation. The second biopsy revealed cellular atypia, dyskeratotic cells and increased mitotic figures. Subsequently, surgical excision of the growth with bilateral lymphadenopathy was carried out.
Combining social network analysis and cluster analysis to identify sexual network types
Authors: De Rubeis E , Wylie J L , Cameron D W , Nair R C , Jolly A M
Published: October 2007

Increases in the rates of sexually transmitted infections (STIs) suggest that control programmes may not be effectively targeting diverse subpopulations. The objective of this investigation was to examine STI transmission within different groups, using both social network analysis and cluster analysis. Routine partner notification data were analysed from individuals diagnosed with, or exposed to an STI in Manitoba. Groups were identified and characterized. Three different clusters of groups were identified, comprised of demographically and clinically distinct individuals. A greater understanding of disease transmission patterns within these groups will aid in the development of targeted education and prevention programmes for all STIs.
Inadequate adherence to antiretroviral treatment and prevention in hospital and community sites in Burkina Faso and Mali: a study by the ATARAO group
Authors: Aboubacrine S Ag , Niamba P , Boileau C , Zunzunegui M V , Machouf N , Nguyen V K , Rashed S
Published: October 2007

Our objective was to determine the prevalence and identify the factors that influence antiretroviral therapy (ART) adherence among patients in Bamako and Ouagadougou. A cross-sectional study was conducted among 94 men and 176 women receiving ART. Data were collected through questionnaires and chart reviews. Logistic regressions were performed to isolate determinants of adherence.

Overall, 58% of the patients were adherent, but there were differences in the levels of adherence according to country and treatment site. Sociodemographic factors were not associated with adherence. However, social characteristics such as having children, in Ouagadougou, or being a housewife and not planning to have a child in the next year, in Bamako were associated with adherence. Time on ART was negatively associated with adherence in both countries with decline occurring later in Bamako.

Levels of adherence are inadequate particularly among more experienced patients. Further adherence research and monitoring using longitudinal designs are warranted to assess the extent to which adherence is declining with time on treatment.
Direct observation therapy-highly active antiretroviral therapy in a resource-limited setting: the use of community treatment support can be effective
Authors: Idoko J A , Agbaji O , Agaba P , Akolo C , Inuwa B , Hassan Zuweira , Akintunde L , Badung B , Muazu M , Danang M , Imade G , Sankale J Louis , Kanki Phyllis
Published: October 2007

This study examines the use of various direct observation therapy-HAART treatment support modalities in Jos, Nigeria. A 12-month observational study enrolling 175 antiretroviral naïve patients into four arms of direct observation therapy-HAART (highly active antiretroviral therapy); daily observed therapy (DOT), twice weekly observed therapy (TWOT), weekly observed therapy (WOT) and self-administered therapy (SAT), examined community treatment support using family and community members. Treatment outcomes were much better in the treatment-supported groups compared with the control self-therapy group. CD4 cell increases were 218/ μL (DOT), 267/ μL (TWOT), 205/ μL (WOT) versus 224/ μL (SAT), whereas plasma HIV-1 RNA reached undetectable levels (<400 copies/mL) in 91%, 88%, 84% versus 79% of patients in the DOT, TWOT, WOT versus SAT groups, respectively, at 48 weeks. We, therefore, strongly support the use of treatment support in our settings.
Health providers' competence in the management of reproductive tract infections in Vientiane, Lao People's Democratic Republic
Authors: Sihavong Amphoy , Lundborg Cecilia Stålsby , Syhakhang Lamphone , Vernby Åsa , Panyanouvong Amphayvanh , Marions Lena , Wahlström Rolf
Published: October 2007

This cross-sectional study aimed to assess health providers' reported knowledge and practice competence regarding management of reproductive tract infections (RTIs) including sexually transmitted infections (STIs) in Vientiane, Laos. All 272 health providers (medical doctors/assistants, midwives/nurses and drug sellers) working with RTI/STI patients in one urban and one rural district were invited to fill in a self-completed questionnaire including four written simulated case scenarios, and 93% participated in the study. Of 252 respondents, 34% scored below 50% regarding both the case scenarios and reported knowledge, and 87% gave inadequate advice regarding health education. Only 34% gave correct advice on contact tracing, 38% on counselling, 52% regarding compliance and 59% on condom promotion. Drug sellers scored lowest in all aspects of RTI/STI management. Urban respondents were more likely to report adequate knowledge. Continuous training in syndromic approach and supervision are recommended to improve the quality of RTI/STI management, particularly at private pharmacies and in rural areas.
Voice disorders in HIV-infected individuals: a preliminary study
Authors: Mathew M , Bhat J
Published: October 2007

HIV-1 infects brain cells, and this results in damage to the functioning of both the central and peripheral nervous systems. Progressive decline in communication behaviours can be seen from early stages of infection. Among the communication problems observed in those infected with HIV are speech, language, cognition and swallowing. This study was undertaken with the aim of creating a profile of the vocal impairments in individuals affected with HIV/AIDS, which would in turn support evidence-based practices in the assessment and management of such individuals. Eight participants were included in the study. Subjective analysis was carried out by a speech pathologist and objective analysis of acoustic parameters, by the use of Kay Elemetrics MDVP software. The results of the study reveal that all participants had affected parameters in the voice analysis, which ranged across subjects from one parameter to all parameters. Even in the absence of direct pathology to the voice production mechanism, almost all of the parameters of voice are affected in HIV-infected persons. As this is a preliminary study, it is too early to conclude that there is a correlation between vocal deviancies and medical conditions.
Septic illness and Kaposi's sarcoma
Authors: Daniel Jessica , Shaw Andrew
Published: October 2007

Kaposi's sarcoma (KS) usually presents with typical skin lesions. We report two cases that presented with illnesses suggesting major sepsis, but were found to have disseminated KS at postmortem with little in the way of cutaneous involvement.
Feasibility of a telemedicine framework for collaborative pacemaker follow-up
Authors: Kollmann Alexander , Hayn Dieter , García José , Trigo Jesús Daniel , Kastner Peter , Rotman Brigitte , Tscheliessnigg Karlheinz , Schreier Guenter
Published: October 2007

We propose a telemedicine framework for remote and manufacturer independent pacemaker (PM) follow-up. The main goal is to provide the caregiver at the point-of-care with an efficient screening method to identify possible malfunction of the pacing system in collaboration with the specialist at the PM clinic. The concept was evaluated in a clinical trial on 44 patients (mean age 76 years). A total of 62 electrocardiogram (ECG) recordings were transmitted using a mobile PM follow-up unit. Using the automatic classification algorithm, 32 PMs were classified as 'OK' and eight PMs were classified as 'not OK'. In four cases a prediction regarding the working status of the PM was not possible. The signal processing classification was confirmed by expert classification (manual review of the ECG). The results indicate that the proposed PM follow-up concept has the potential to work as an efficient screening method and may spare a significant number of patients the burden of having to travel to specialized PM clinics.
Telemedicine in diagnostic pleural cytology: a feasibility study between universities in Iran and the USA
Authors: Ayatollahi Hossein , Khoei Alireza , Mohammadian Nema , Sadeghian Mohammad Hadi , Azari Jafar Bordbar , Ghaemi Mohammad Reza , Khoob Mahdi Khabbaz
Published: October 2007

We evaluated the concordance rate and diagnostic accuracy of digital cytology slides reviewed by experienced pathologists at the University of Miami and the Ohio State University in comparison with review of conventional glass slides by the pathologist at the Mashhad University of Medical Sciences. In addition, we evaluated interobserver reproducibility in telecytology diagnosis in pleural effusion smears between Ohio State and Miami University. For this, we selected 50 pleural effusion smears with different diagnoses. For each case, digital images were sent via the Internet to the consulting pathologists at the two US universities. The accuracy of the telecytology diagnoses was 83% and 87% at the two US universities and the accuracy of glass slide review was 89%. The inter-observer reproducibility of telecytology diagnosis between these two universities was 0.71. The concordance rate, inter-observer reproducibility and diagnostic accuracy of telecytology diagnosis in pleural effusion smears between the three institutions were good. Telecytology diagnosis of pleural effusion smears is potentially useful in screening and diagnosis and may allow more efficient use of scarce cytopathologist resources and expertise.
Guidance for preparing evaluation reports in telemedicine and health informatics generally
Authors: Hailey David
Published: October 2007

The European Federation for Medical Informatics is developing a detailed guideline for preparing evaluation reports. By doing this, it is hoped that the quality of evaluation studies in health informatics will improve and thus the evidence base. While much of the necessary information for preparing good quality evaluation publications is available in other documents, the Statement on Reporting of Evaluation Studies in Health Informatics (STARE-HI) is valuable in bringing together many points into a single document. The current version is comprehensive and includes valuable information on a number of areas. A list of recommended items for inclusion in an evaluation report is given. There is perhaps a danger that some authors might be intimidated by the suggested detail to be provided. Nonetheless, the Federation is to be congratulated for putting together a comprehensive guideline which promises to be a useful contribution to improving the quality of evaluation studies in information technology, including telemedicine.
A national survey of telemedicine in the Republic of Ireland
Authors: Maher Laura , Craig Agnella , Menezes Gerard
Published: October 2007

We conducted a national survey of hospitals in the Republic of Ireland to assess their use of telemedicine. Information was sought from 187 hospitals and replies were received from 157, a response rate of 84%. Activity was identified in a total of 40 hospitals (25% of the respondents). The main disciplines using telemedicine were radiology, pathology, neurosurgery, oncology and paediatrics, and the main applications were teleradiology (25 hospitals), videoconferencing (16) and telepathology (5). Dublin, the capital city, was found to act as a centre for telemedicine activity for the whole country. A number of regional networks had developed in the east, but the pattern of development in the west was very different where there were mainly isolated links. One fully operational national network was found but this was only used for consultation in one discipline (neurosurgery). It appears that the development of telemedicine in the Republic of Ireland has been unplanned. A national telemedicine strategy might lead to an integrated national network in the future, which could help to provide more equitable access to health care.
Telemedicine in the blood transfusion laboratory – remote interpretation of pre-transfusion tests
Authors: Meža Marko , Breskvar Marko , Košir Andrej , Bricl Irena , Tasič Jurij , Rožman Primož
Published: October 2007

We have developed a telemedicine system for blood transfusion work, to supply the local hospital laboratory with an expert opinion from the central reference laboratory. The telemedicine system allows remote inspection and interpretation of pre-transfusion tests, which are performed by ID-cards (micro-tube gel technology). The system was installed at three blood transfusion laboratories in Slovenia, approximately 70 km apart. Validation of the telemedicine system was performed using 99 clinical cases selected randomly from routine work. Two groups of immunohaematology specialists participated. Group A ( n = 8) performed the read-out of the pre-transfusion tests on ID-cards by using the telemedicine system. Group B ( n = 2) then read the ID-cards independently using the standard visual method. All 98 final interpretations which were recorded using the telemedicine system were correct. We recorded 591 micro-tube read-outs of agglutination strength using the telemedicine system, of which 582 were correct. For comparison, we recorded 591 micro-tube read-outs using the standard visual method, of which 582 were correct. The validation proved that the telemedicine system was suitable for operational use.
DICOM transmission of simultaneous stereoscopic images of the optic nerve in patients with glaucoma
Authors: Khouri Albert S , Szirth Bernard C , Salti Haytham I , Fechtner Robert D
Published: October 2007

We evaluated the Digital Imaging and Communications in Medicine (DICOM) standard for the transmission of stereoscopic images of the optic nerve. Digital optic nerve images were obtained from patients with glaucoma. Fifteen simultaneous stereo images from consecutive patients were analysed independently twice, in random order, by two glaucoma specialists to establish baseline values of vertical and horizontal cup-to-disc (CDV and CDH) ratios and image quality (1 = worst, 5 = best). Images were transmitted to a distant location and returned to the sending site using DICOM standards in both directions. The received images were reassessed again by the two glaucoma specialists. The image file size slightly increased for all received images (mean 2545 kByte) in comparison with the transmitted images (mean 2460 kByte). The mean baseline values for CDV, CDH and quality score were 0.66, 0.59 and 3.9, respectively. The corresponding mean values for the received images were 0.66, 0.62 and 3.73, respectively. The differences between transmitted and received images were not significant. Clinical interpretation of digital stereoscopic images of glaucomatous optic nerves appears to be unaffected by DICOM capture and transmission.
A survey in Alberta and Quebec of the telehealth applications that physicians need
Authors: Gagnon Marie-Pierre , Duplantie Julie , Fortin Jean-Paul , Jennett Penny , Scott Richard
Published: October 2007

We studied the utility of various telehealth applications to support practice in rural and remote regions from the physicians' point of view. A postal survey was conducted among physicians from rural and remote regions of Alberta and Eastern Quebec. A total of 321 questionnaires were returned (13% response rate), comprising 180 from Quebec (16%) and 141 from Alberta (11%). Differences in the perceived utility of telehealth applications were explored using univariate and multivariate analyses. Telehealth applications were grouped into four categories: (1) asynchronous; (2) synchronous; (3) education; and (4) access to health information. The perceived utility of each application varied significantly between provinces. However, the two categories of telehealth applications perceived to be the most relevant were the same in both provinces: access to health information and applications for tele-education.
The validity of video clips in the diagnosis of gait disorder
Authors: Salih Salih A , Wootton Richard , Beller Elaine , Gray Len
Published: October 2007

We investigated the accuracy and validity of clinical gait assessment, performed by experienced geriatricians viewing video clips of 10 s duration. Nineteen patients with normal or characteristic abnormal gait patterns were studied. The treating physician's diagnosis served as the gold standard. Another live assessment was then performed by a geriatrician blinded to the medical record to establish inter-rater reliability of live assessments. Subsequently, each gait video clip was examined by two independent geriatricians without any background clinical documentation. Diagnostic accuracy was tested at two levels – whether the gait was abnormal, and the specific gait diagnosis. The agreement of the video clip examination with the gold standard to identify abnormal gait from normal gait ranged from substantial to excellent among assessors ( κ = 0.68–0.85), although low agreement with the gold standard was achieved in the detection of specific gait diagnosis (average agreement between both viewing geriatricians 50%). The technique appears to be a valid screening procedure for detecting gait abnormalities (average sensitivity 100%, specificity 70%).
Patient satisfaction with nurse-led telephone follow-up in women with lower urinary tract symptoms
Authors: Jeffery Stephen , Doumouchtsis Stergios K , Fynes Michelle
Published: October 2007

We assessed the clinical effectiveness and patient satisfaction with nurse-led telephone follow-up of women with lower urinary tract symptoms. Participants were offered telephone follow-up with a nurse instead of a conventional outpatient appointment. Suitability was decided by the doctor who saw the women at her last visit. The consultation was conducted using the same principles as a routine clinic visit. Patient satisfaction was evaluated by postal questionnaire and they were also sent a standard urinary continence questionnaire, the Kings Health Questionnaire (KHQ), to evaluate their current symptoms. In total, 116 women were included. The mean number of telephone consultations was 2 (range 1–12). The mean overall satisfaction score was 77 (maximum 100, where a higher score indicates greater satisfaction). Only 16 patients (17%) did not prefer telephone follow-up to a clinic visit. Women who had been discharged via the telephone follow-up clinic expressed similar mean satisfaction scores to those whose next visit was a clinic visit (80 and 82, respectively). The KHQ also indicated that the patients had been appropriately discharged or given a further follow-up appointment. Nurse-led telephone follow-up is associated with high satisfaction and has the advantages of consistent follow-up by the same clinician, convenience to the patient and cost-savings.
Real Options in Technology Licensing
Authors: Ziedonis Arvids A.
Published: October 2007

This paper examines the use of options contracts by firms acquiring rights to commercialize university technologies. By combining information about the sequence of licensing decisions with characteristics of the firms and technologies involved, I explore factors that shape decisions to purchase and exercise option contracts for these technologies. Decisions by firms that considered but did not purchase an option or a license are included in the sample. Consistent with the basic premise of real-options theory, I find that firms are more likely to purchase option contracts for more uncertain technologies. Also in line with theoretical predictions, I find that firms that are better able to evaluate an external technology are less likely to purchase options before licensing. The results also highlight more complex motives for exercising options in technology licensing. On the one hand, firms appear to benefit from their ability to learn about the technology during the option period. On the other hand, firms that are better able to “absorb” the technology during the contract period may have reduced incentives to subsequently license the invention.
Supply Chain Relationships and Contracts: The Impact of Repeated Interaction on Capacity Investment and Procurement
Authors: Taylor Terry A. , Plambeck Erica L.
Published: October 2007

Consider a firm developing an innovative product. Due to market pressures, production must begin soon after the product development effort is complete, which requires that an upstream supplier invests in capacity while the design of the product and production process are in flux. Because the product is ill-defined at this point in time, the firms are unable to write court-enforceable contracts that specify the terms of trade or the supplier's capacity investment. However, the firms can adopt an informal agreement (relational contract) regarding the terms of trade and capacity investment. The potential for future business provides incentive for the firms to adhere to the relational contract. We show that the optimal relational contract may be complex, requiring the buyer to order more than her demand to indirectly monitor the supplier's capacity investment. We propose a simpler relational contract and show that it performs very well for a broad range of parameters. Finally, we identify characteristics of the business environment that make relational contracting particularly valuable.
The Performance Consequences of Ambidexterity in Strategic Alliance Formations: Empirical Investigation and Computational Theorizing
Authors: Lin Zhiang (John) , Yang Haibin , Demirkan Irem
Published: October 2007

Although alliance studies have generally favored an ambidextrous approach between exploration and exploitation, they tend to overlook a firm's characteristics, its industry constraints, or the dynamic network in which the firm is embedded. This study examines the ambidexterity hypothesis and its boundary conditions with a unique research method. We not only analyze empirical data from five U.S. industries spanning eight years, but also expand theoretical insights to the network level by building a computer simulation model. Both our empirical and simulation results reveal the contingencies of the ambidexterity hypothesis in alliance formation. Our findings show that although an ambidextrous formation of alliances benefits large firms, a focused formation of either exploratory or exploitative alliances benefits small firms. In an uncertain environment an ambidextrous formation enhances firm performance but so does a focused formation in a stable environment. Finally, the simulation model demonstrates that a firm's centrality and structural hole positions in network relations can moderate the relationships between alliance formation choices and firm performance, and that the ambidexterity hypothesis may be limited to the earlier stage of the network. Our study provides critical evidence into the viability of adopting a dynamic network perspective in understanding the ambidexterity hypothesis and advancing strategic alliance research beyond static and dyadic levels.
Information and Inventory in Distribution Channels
Authors: Iyer Ganesh , Narasimhan Chakravarthi , Niraj Rakesh
Published: October 2007

We examine the trade-offs between demand information and inventory in a distribution channel. While better demand information has a positive direct effect for the manufacturer in improving the efficiency of holding inventory in a channel, it can also have the strategic effect of increasing retail prices and limiting the extraction of retail profits. Having inventory in the channel can help the manufacturer to manage retail pricing behavior while better extracting retail surplus. Thus, even if the information system is perfectly reliable, the manufacturer might not always want to institute an information-enabled channel over a channel with inventory.

We show this first in a channel with a single retailer, where the channel with perfect information is preferred over the channel with inventory only if the marginal cost of production is sufficiently high. We also analyze a channel with an imperfectly reliable information system and find that if the manufacturer were to choose the precision of the demand information system, it might not prefer perfect information, even if such information was costless to acquire. In a channel with competing retailers, the channel with perfect information is preferred when retail competition is sufficiently intense. Thus, the presence of inventory can play a role in managing competition among retailers and in helping the manufacturers to appropriate surplus especially when retailers are sufficiently differentiated.
Auctioning Supply Contracts
Authors: Chen Fangruo
Published: October 2007

This paper studies a procurement problem with one buyer and multiple potential suppliers who hold private information about their own production costs. Both the purchase quantity and the price need to be determined. An optimal procurement strategy for the buyer requires the buyer to first design a supply contract that specifies a payment for each possible purchase quantity and then invites the suppliers to bid for this contract. The auction can be conducted in many formats such as the English auction, the Dutch auction, the first-priced, sealed-bid auction, and the Vickrey auction. The winner is the supplier with the highest bid, and is given the decision right for the quantity produced and delivered. Applying this theory to a newsvendor model with supply-side competition, this paper establishes a connection between the above optimal procurement strategy and a common practice in the retail industry, namely, the use of slotting allowances and vendor-managed inventory. Also discussed in the newsvendor context are the role of well-known supply contracts such as returns contracts and revenue-sharing contracts in procurement auctions, the scenarios where the buyer and suppliers may possess asymmetric information about the demand distribution, and how the cost of supply-demand mismatch is affected by supply-side competition. Finally, this paper compares the optimal procurement strategy with a simpler but suboptimal strategy where the buyer first determines a purchase quantity and then seeks the lowest-cost supplier for the quantity in an auction.
Brand Value in Social Interaction
Authors: Kuksov Dmitri
Published: October 2007

This paper explores the consumer value of publicly associating oneself with a brand image. The economic value of such association to the consumer of a brand is coming from its affect on the information exchange between consumers engaged in a search for partnerships with each other. It turns out that the brand use can be valuable to consumers for communication even when they do not have the proper incentives to make simple conversations valuable or informative. In particular, when the correlation of the interests of agents in a partnership is low, conversations are not very informative, while brand use remains informative and valuable. Furthermore, the more widespread the brand use is, the less truthful (and informative) one can expect conversations to be. In addition, the consumer value of a brand image is shown to have an inverse-U shape in the difficulty of searching, as consumers look for conformity when a search is difficult, and conversations become more and more truthful when a search becomes very easy.
Optimal Risk Taking with Flexible Income
Authors: Cvitanić Jakša , Goukasian Levon , Zapatero Fernando
Published: October 2007

We study the portfolio selection problem of an investor who can optimally exert costly effort for more income. The possibility of generating more income, if necessary, increases the risk-taking appetite of the investor. We find the optimal allocation to the risky security as a proportion of financial wealth and as a proportion of the total wealth, defined as the combination of the financial wealth and the human capital of the investor. When the investor's objective is the maximization of the terminal wealth, we show that the optimal allocation to the risky security is a hump-shaped function of the investment horizon. However, when the investor maximizes utility from intertemporal consumption, the optimal allocation in the risky security is a constant proportion of the total wealth of the investor.