bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and Validation of a Rapid Turbidimetric Assay to Determine the Potency of Cefuroxime Sodium in Powder for Dissolution for Injection
Authors: Vieira Daniela , Fiuza Thalita , Salgado Hérida
Published: July 2014

The cefuroxime sodium is a second generation cephalosporin indicated for infections caused by Gram-positive and Gram-negative microorganisms. Although this drug is highly studied and researched regarding the antimicrobial activity, pharmacokinetics and pharmacodynamics, there are few studies regarding the development of analytical methodology for this cephalosporin. Thus, research involving analytical methods is essential and highly relevant to optimize its analysis in the pharmaceutical industry and guarantee the quality of the product already sold. This study describes the development and validation of a microbiological assay applying the turbidimetric method for the determination of cefuroxime, using Micrococcus luteus ATCC 9341 as micro-organism test and 3x3 parallel line assay design, with nine tubes for each assay, as recommended by the Brazilian Pharmacopoeia. The developed and validated method showed excellent results of linearity, seletivity, precision and robustness, in the concentration range from 30.0 to 120.0 mg/mL, with 100.21% accuracy and content 99.97% to cefuroxime sodium in injectable pharmaceutical form.
Mixing Acid Salts and Layered Double Hydroxides in Nanoscale under Solid Condition
Authors: Nakayama Hirokazu , Hayashi Aki
Published: July 2014

The immobilization of potassium sorbate, potassium aspartate and sorbic acid in layered double hydroxide under solid condition was examined. By simply mixing two solids, immobilization of sorbate and aspartate in the interlayer space of nitrate-type layered double hydroxide, so called intercalation reaction, was achieved, and the uptakes, that is, the amount of immobilized salts and the interlayer distances of intercalation compounds were almost the same as those obtained in aqueous solution. However, no intercalation was achieved for sorbic acid. Although intercalation of sorbate and aspartate into chloride-type layered double hydroxide was possible, the uptakes for these intercalation compounds were lower than those obtained using nitrate-type layered double hydroxide. The intercalation under solid condition could be achieved to the same extent as for ion-exchange reaction in aqueous solution, and the reactivity was similar to that observed in aqueous solution. This method will enable the encapsulation of acidic drug in layered double hydroxide as nano level simply by mixing both solids.
Surface-Induced Ordering on Model Liquid Crystalline Dendrimers
Authors: Workineh Zerihun , Vanakaras Alexandros
Published: July 2014

The surface alignment of liquid crystalline dendrimers (LCDrs) is a key factor for many of their potential applications. Here, we present results from Monte Carlo simulations of LCDrs adsorbed on flat, impenetrable aligning substrates. A tractable coarse-grained force field for the inter-dendritic and the dendrimer-substrate interactions is introduced. We investigate the conformational and ordering properties of single, end-functionalized LCDrs under homeotropic, random (or degenerate) planar and unidirectional planar aligning substrates. Depending on the anchoring constrains to the mesogenic units of the LCDr and on temperature, a variety of stable ordered LCDr states, differing in their topology, are observed and analyzed. The influence of the dendritic generation and core functionality on the surface-induced ordering of the LCDrs are examined.
Using Small-Footprint Discrete and Full-Waveform Airborne LiDAR Metrics to Estimate Total Biomass and Biomass Components in Subtropical Forests
Authors: Cao Lin , Coops Nicholas , Hermosilla Txomin , Innes John , Dai Jinsong , She Guanghui
Published: July 2014

An accurate estimation of total biomass and its components is critical for understanding the carbon cycle in forest ecosystems. The objectives of this study were to explore the performances of forest canopy structure characterization from a single small-footprint Light Detection and Ranging (LiDAR) dataset using two different techniques focusing on (i) 3-D canopy structural information by discrete (XYZ) LiDAR metrics (DR-metrics), and (ii) the detailed geometric and radiometric information of the returned waveform by full-waveform LiDAR metrics (FW-metrics), and to evaluate the capacity of these metrics in predicting biomass and its components in subtropical forest ecosystems. This study was undertaken in a mixed subtropical forest in Yushan Mountain National Park, Jiangsu, China. LiDAR metrics derived from DR and FW LiDAR data were used alone, and in combination, in stepwise regression models to estimate total as well as above-ground, root, foliage, branch and trunk biomass. Overall, the results indicated that three sets of predictive models performed well across the different subtropical forest types (Adj-R2 = 0.42–0.93, excluding foliage biomass). Forest type-specific models (Adj-R2 = 0.18–0.93) were generally more accurate than the general model (Adj-R2 = 0.07–0.79) with the most accurate results obtained for coniferous stands (Adj-R2 = 0.50–0.93). In addition, LiDAR metrics related to vegetation heights were the strongest predictors of total biomass and its components. This research also illustrates the potential for the synergistic use of DR and FW LiDAR metrics to accurately assess biomass stocks in subtropical forests, which suggest significant potential in research and decision support in sustainable forest management, such as timber harvesting, biofuel characterization and fire hazard analyses.
A Capacitive Touch Screen Sensor for Detection of Urinary Tract Infections in Portable Biomedical Devices
Authors: Honrado Carlos , Dong Tao
Published: July 2014

Incidence of urinary tract infections (UTIs) is the second highest among all infections; thus, there is a high demand for bacteriuria detection. Escherichia coli are the main cause of UTIs, with microscopy methods and urine culture being the detection standard of these bacteria. However, the urine sampling and analysis required for these methods can be both time-consuming and complex. This work proposes a capacitive touch screen sensor (CTSS) concept as feasible alternative for a portable UTI detection device. Finite element method (FEM) simulations were conducted with a CTSS model. An exponential response of the model to increasing amounts of E. coli and liquid samples was observed. A measurable capacitance change due to E. coli presence and a tangible difference in the response given to urine and water samples were also detected. Preliminary experimental studies were also conducted on a commercial CTSS using liquid solutions with increasing amounts of dissolved ions. The CTSS was capable of distinguishing different volumes of liquids, also giving an exponential response. Furthermore, the CTSS gave higher responses to solutions with a superior amount of ions. Urine samples gave the top response among tested liquids. Thus, the CTSS showed the capability to differentiate solutions by their ionic content.
Enterobacter asburiae Strain L1: Complete Genome and Whole Genome Optical Mapping Analysis of a Quorum Sensing Bacterium
Authors: Lau Yin , Yin Wai-Fong , Chan Kok-Gan
Published: July 2014

Enterobacter asburiae L1 is a quorum sensing bacterium isolated from lettuce leaves. In this study, for the first time, the complete genome of E. asburiae L1 was sequenced using the single molecule real time sequencer (PacBio RSII) and the whole genome sequence was verified by using optical genome mapping (OpGen) technology. In our previous study, E. asburiae L1 has been reported to produce AHLs, suggesting the possibility of virulence factor regulation which is quorum sensing dependent. This evoked our interest to study the genome of this bacterium and here we present the complete genome of E. asburiae L1, which carries the virulence factor gene virK, the N-acyl homoserine lactone-based QS transcriptional regulator gene luxR and the N-acyl homoserine lactone synthase gene which we firstly named easI. The availability of the whole genome sequence of E. asburiae L1 will pave the way for the study of the QS-mediated gene expression in this bacterium. Hence, the importance and functions of these signaling molecules can be further studied in the hope of elucidating the mechanisms of QS-regulation in E. asburiae. To the best of our knowledge, this is the first documentation of both a complete genome sequence and the establishment of the molecular basis of QS properties of E. asburiae.
Environmental pH, O2 and Capsular Effects on the Geochemical Composition of Statoliths of Embryonic Squid Doryteuthis opalescens
Authors: Navarro Michael , Bockmon Emily , Frieder Christina , Gonzalez Jennifer , Levin Lisa
Published: July 2014

Spawning market squid lay embryo capsules on the seafloor of the continental shelf of the California Current System (CCS), where ocean acidification, deoxygenation and intensified upwelling lower the pH and [O2]. Squid statolith geochemistry has been shown to reflect the squid’s environment (e.g., seawater temperature and elemental concentration). We used real-world environmental levels of pH and [O2] observed on squid-embryo beds to test in the laboratory whether or not squid statolith geochemistry reflects environmental pH and [O2]. We asked whether pH and [O2] levels might affect the incorporation of element ratios (B:Ca, Mg:Ca, Sr:Ca, Ba:Ca, Pb:Ca, U:Ca) into squid embryonic statoliths as (1) individual elements and/or (2) multivariate elemental signatures, and consider future applications as proxies for pH and [O2] exposure. Embryo exposure to high and low pH and [O2] alone and together during development over four weeks only moderately affected elemental concentrations of the statoliths, and uranium was an important element driving these differences. Uranium:Ca was eight-times higher in statoliths exposed to low pHT (7.57–7.58) and low [O2] (79–82 µmol·kg−1) than those exposed to higher ambient pHT (7.92–7.94) and [O2] (241–243 µmol·kg−1). In a separate experiment, exposure to low pHT (7.55–7.56) or low [O2] (83–86 µmol·kg−1) yielded elevated U:Ca and Sr:Ca in the low [O2] treatment only. We found capsular effects on multiple elements in statoliths of all treatments. The multivariate elemental signatures of embryonic statoliths were distinct among capsules, but did not reflect environmental factors (pH and/or [O2]). We show that statoliths of squid embryos developing inside capsules have the potential to reflect environmental pH and [O2], but that these “signals” are generated in concert with the physiological effects of the capsules and embryos themselves.
Motivation, rébellion, climat de la classe et popularité perçue : étude sur 23 000 adolescents du collège
Authors: Lieury Alain , Lorant Sonia , Trosseille Bruno , Vourc’h Ronan , Fenouillet Fabien
Published: July 2014

Le but principal de cet article est d’explorer un nouveau concept de « rébellion » dans le cadre d’une variante de la théorie de l’autodétermination (SDT). La première étude est une enquête longitudinale sur un échantillon 23 886 élèves en 6 e et trois ans plus tard. La moitié des élèves sont en motivation extrinsèque. Chez les élèves de 3 e , 11 % sont en situation de rébellion (16 % chez les redoublants) et 8 % sont amotivés (13 % chez les redoublants). L’estime des professeurs (climat de la classe) est corrélée avec la rébellion. Dans la deuxième étude (élèves de 16 ans en filières professionnelles) une échelle de popularité perçue mesure trois facteurs, « leader », « respect » et « conseiller » : seule une corrélation faible entre les facteurs « leader » et « rébellion » émerge. Les élèves rebelles sont moins sensibles à la perception d’incompétence mais plus sensibles au climat de la classe, ce qui laisse aux éducateurs des pistes de remédiation.
Evaluation of Femtosecond Laser-Assisted and Manual Clear Corneal Incisions and Their Effect on Surgically Induced Astigmatism and Higher-Order Aberrations
Authors: Nagy Zoltán Z. , Dunai Árpád , Kránitz Kinga , Takács Ágnes Ildikó , Sándor Gábor László , Hécz Réka , Knorz Michael C.
Published: July 2014

PURPOSE:

To evaluate femtosecond laser-assisted and manual clear corneal incisions and their effect on surgically induced astigmatism (SIA) and corneal higher-order aberrations (HOAs).

METHODS:

In a prospective randomized study, conventional phacoemulsification with a 2.8-mm clear corneal incision using a disposable keratome was performed in 20 eyes of 20 patients (manual group), and femtosecond laser-assisted cataract surgery with a 2.8-mm biplanar clear corneal tunnel created by a femtosecond laser (LenSx; Alcon Laboratories, Inc., Aliso Viejo, CA) was performed in 20 eyes of 20 patients (femtosecond laser group). Corneal topography readings and corneal wavefront aberrations (diameter: 9.0 mm) were obtained using a Scheimpflug camera (Pentacam HR; Oculus Optikgerate, Wetzlar, Germany) preoperatively and 3 months postoperatively.

RESULTS:

There was no significant difference in SIA between the groups (femtosecond laser group: 0.47 ± 0.13 vs manual group: 0.41 ± 0.14;
P
= .218), but the axis deviation of the SIA axis from the previously planned axis was significantly smaller in the femtosecond laser group compared to the manual group (4.47°± 2.59° vs 7.38°± 4.72°, respectively;
P
= .048). Corneal HOAs increased significantly in both groups (femtosecond laser group: 0.13 ± 0.09 to 0.18 ± 0.12,
P
= .025; manual group: 0.13 ± 0.05 to 0.15 ± 0.05,
P
= .002), but preoperative and postoperative values did not differ significantly between them (
P
= .472 and .078, respectively). Lower-order and total corneal aberration values remained stable in both groups (
P
> .05).

CONCLUSIONS:

There was no difference in SIA and induced HOAs between manual and femtosecond laser-created clear corneal incisions.

[
J Refract Surg.
2014;30(8):522–525.]
Corneal Collagen Cross-linking (CXL) Combined With Refractive Procedures for the Treatment of Corneal Ectatic Disorders: CXL Plus
Authors: Kymionis George D. , Grentzelos Michael A. , Portaliou Dimitra M. , Kankariya Vardhaman P. , Randleman J. Bradley
Published: July 2014

PURPOSE:

To discuss current combined corneal collagen cross-linking (CXL) and refractive surgical techniques (herein termed “CXL plus”) for the treatment of corneal ectatic disorders to improve functional visual acuity in addition to corneal stability from CXL alone.

METHODS:

Literature review.

RESULTS:

Efficacious combined treatments with CXL include: photorefractive keratectomy, transepithelial phototherapeutic keratectomy, intrastromal corneal ring segments implantation, phakic intraocular lens implantation, and multiple combined procedures. Some uncertainty remains as to the optimal strategies for each patient. A decision tree is proposed to facilitate optimal patient management.

CONCLUSIONS:

With multiple adjuvant techniques, CXL plus is likely to benefit many patients with corneal ectatic disorders. The appropriate combined procedure will depend on multiple factors, such as refraction, corneal thickness, and degree of irregular astigmatism.

[
J Refract Surg.
2014;30(8):566–576.]
Paisajes duales en la Galicia tradicional: estructura, génesis y transformación
Authors: García Quintela Marco V.
Published: July 2014

Se estudian dos parroquias del interior de Galicia analizando información arqueológica, etnohistórica y etnográfica con una metodología estructural aplicada al examen de los paisajes. Los rasgos identificados en esas parroquias sugieren que se pueden definir como «paisajes duales» anclados o construidos sobre restos de la Edad del Hierro que, a su vez, nos invitan a preguntarnos sobre su génesis. Se señala la existencia de un dualismo dialéctico propio de un trasfondo cultural céltico, atestiguado en la protohistoria regional, y que se correspondería con esos «paisajes duales» identificados. Sin embargo, se desestima la pertinencia del concepto de «supervivencia», pues tanto el patrón de poblamiento como la religión cambian profundamente al principio de la Edad Media. Así, aunque la estructura dual identificada hunde sus raíces en la Edad del Hierro la situación observable responde a las vivencias de los campesinos cristianos que les dieron sentido durante los siglos posteriores.
La Concepción de María en el tiempo. Recuperación de fórmulas tempranas de representación de la Inmaculada Concepción en la retórica visual del virreinato de Nueva España
Authors: Doménech García Sergi
Published: July 2014

En este trabajo se aborda un aspecto genuino de la retórica visual concepcionista en el virreinato de Nueva España: el reciclaje de tipologías tempranas de representación de la Inmaculada Concepción que, con la consolidación de la imagen de la Inmaculada, derivada de la Tota Pulchra, habían caído en desuso en el arte peninsular. La inclinación de artistas y mecenas hacia estas tipologías revela un aspecto clave para entender la definición de la cultura hispánica en los siglos del barroco. En los espacios periféricos del Imperio, lugar de continua afirmación de la existencia de un único mundo hispánico, los resortes de control sobre la imagen religiosa permitieron la variabilidad en la ejecución del ideario católico. El artículo analiza la base de la recuperación de esta tradición visual y su correspondencia con la literatura de devoción y los sermones de la época.
La escritura sobre el pavimento callejero: Los mensajes de felicitación
Authors: Morant-Marco Ricard
Published: July 2014

El objetivo de este trabajo es estudiar el suelo como soporte comunicativo, especialmente en las ciudades. Para ello, se ha recogido y analizado una muestra de mil mensajes terrestres de carácter institucional, empresarial y personal, constituida por consignas, anuncios, protestas, declaraciones de amor, felicitaciones, etc. De entre todos estos textos escritos en el pavimento, nos hemos centrado primero, en los realizados por la ciudadanía en general y después, en los de felicitación por cumpleaños porque, además de ser muy numerosos, son un claro reflejo de ciertas transformaciones sociales.
Adulterio femenino, divorcio y honor en la escena decimonónica española. El debate social en la recepción de El nudo gordiano, de Eugenio Sellés (1842-1926)
Authors: Checa Olmos Francisco , Fernández Soto Concepción
Published: July 2014

El artículo muestra cómo en la España de la segunda mitad del siglo XIX el discurso de la estabilidad social y de la sumisión femenina —también llamado de la «domesticidad»— se asienta en el teatro a través de la representación de temas como el honor, el adulterio femenino, la honra y la muerte. Al mismo tiempo, el discurso teatral retroalimenta idénticos discursos ideológicos y morales —incluso psicológicos y legislativos— y sanciona los modelos de conducta que pretenden disolver el orden social burgués imperante. Como ejemplo metodológico se toma la obra El nudo gordiano, de Eugenio Sellés y Ángel, autor perteneciente a una generación de dramaturgos nacidos en torno a la década de 1840. El final propuesto por el autor, la muerte de la esposa adúltera, se situó en el centro de todas las reacciones inmediatas posibles, suscitadas entre espectadores, críticos y analistas, gacetilleros y especialistas, literatos y juristas, psicólogos o moralistas y personas de a pie. Por ello también se presenta la recepción crítica que la obra alcanzó, comprobando sus repercusiones sociales y literarias.
Memoria, imágenes y escrituras en la elaboración de un cuento oral
Authors: Sanfilippo Marina
Published: July 2014

En este trabajo, se analizará si el uso de la imagen como elemento clave de la memoria y de la construcción de narraciones tiene el mismo peso y presenta las mismas características en los narradores de tipo tradicional y en los nuevos narradores, a pesar de que el contexto cultural y los recursos manejados por los dos tipos de contadores de historias son muy distintos. Se prestará especial atención a los posibles cambios que implica el dominio de la escritura.
Formas de curanderismo en la Manchuela albacetense. Identidades y paradigmas
Authors: De las Heras Salord Jaime
Published: July 2014

La práctica del curanderismo reviste aspectos muy distintos, vinculados al medio en el que se produce y a las relaciones sociales que lo estructuran. En este artículo se parte de los modelos descritos por Irwing Press, Eduardo Menéndez, Roberto Campos, Gerardo Fernández Juárez o Francisco Ferrándiz para tratar de articularlos con los resultados obtenidos en un trabajo de campo realizado en la Manchuela albacetense, comarca situada al norte de la provincia de Albacete en España. Se proponen dos categorías de curanderos —endo y exocuranderos— basadas en diversos elementos, como la construcción social del sanador, la naturaleza de su performance y el pago de sus servicios, entre otros. Esta dicotomía se reproduce en otros escenarios terapéuticos, como la medicina científica o la sanación por medios espirituales.
Mobile epifaunal assemblages associated with Cystoseira beds: comparison between areas invaded and not invaded by Lophocladia lallemandii
Authors: Bedini Roberto , Bonechi Lisa , Piazzi Luigi
Published: July 2014

The study compared the structure of mobile epifaunal assemblages associated with Mediterranean Cystoseira beds between areas invaded and not invaded by Lophocladia lallemandii. A total of 150 taxa were identified: 42 Polychaeta, 78 Arthropoda, 26 Mollusca and 4 Echinodermata. Epifaunal assemblages differed between areas invaded and not invaded by Lophocladia lallemandii when the invasive species reached maximum values of cover and biomass, while differences between conditions were not significant in other periods of the year. The main differences were the greater abundance of amphipods, isopods and polychaetes in invaded areas and the greater abundance of molluscs and decapods in non-invaded areas, while richness and total abundance of organisms were not significantly different between conditions. The effects of Lophocladia lallemandii invasion on Cystoseira-associated assemblages seem to be limited to the period of vegetative growth of the alga and reversible during the period of its vegetative rest.
Culture viability of Sardina pilchardus (Fish, Teleost): Preliminary results of growth in captivity up to 18 months
Authors: Iglesias José , Fuentes Lidia
Published: July 2014

Larvae of Sardina pilchardus were obtained in captivity from fertilized eggs captured in the wild and grown in a 10000-L tank. Isochrysis galbana, Artemia franciscana nauplii and live zooplankton were used as prey during the first two weeks; afterwards, the animals were fed on Artemia metanauplii enriched with Isochrysis galbana. A dry feed (Gemma 0.4 and 0.8) from Skretting S.A. (Burgos, España) was supplied from the 3rd to the 18th month. The total length reached by sardines at one year of life was 162.02±9.49 mm, corresponding to a wet weight of 36.12±10.82 g. Total length of the last survivor individual at 18 months was 182.37 mm. An 18-month experiment of sardine culture is described for the first time, and the growth data reported can help to determine its potential as a candidate for marine aquaculture.
Dwellers in dens on sandy bottoms: Ecological and behavioural traits of Octopus vulgaris
Authors: Guerra Ángel , Hernández-Urcera Jorge , Garci Manuel E. , Sestelo Marta , Regueira Marcos , González Ángel F. , Cabanellas-Reboredo Miguel , Calvo-Manazza Matías , Morales-Nin Beatriz
Published: July 2014

Four visual censuses targeting Octopus vulgaris living in dens on sandy bottoms were carried out from June to October 2013 in the National Park of the Atlantic Galician Islands (NW Spain). Censuses were undertaken by scuba diving between 5 and 21 m depth in daytime. The total area swept was 13.75 ha. There were no significant differences between octopus presence in dens during open and closed fishing seasons. Depth had a significant negative relationship with occupancy. The average number of dens per 1000 m2 was 3.84±0.84 in June and 3.89 in October. The area per den was 260 m2. Den number estimations varied between 1586 and 2057. The largest number of dens (76.5%) was found between 5 and 10 m depth. Den distribution was clumped. No significant differences were found between octopus size classes (small, medium and large) and den diameter. Associate dens were observed. There were no significant differences in den diameter and shell types found around the middens. Many dens could be “permanent”. Drilling bivalve shell behaviour is discussed. The surveyed area had around 1100 individuals, mainly small specimens. No significant differences were found between octopus size and depth. Substrate, den type and food abundance and availability (especially razors Ensis arcuatus) seem to be the main factors influencing dens and octopus density and distribution. Den availability does not appear to be a limiting factor in this case. Temperature, den availability, predators and fishing pressure influencing density and distribution are discussed. Rodas inlet may be a preferential habitat for O. vulgaris individuals ranging from 200 to 2000 g, but especially small specimens ( ≤ 1000 g).
Do All Roads Lead to Rome?
Authors: Kubitschke Lutz , Meyer Ingo , Müller Sonja
Published: July 2014

The call for better joined-up service delivery, particularly to those suffering from chronic conditions, traces back as far as into the 1950s. However, a disjointed care provision split into multiple service silos prevails. In the present chapter, the authors present lessons from practice, particularly from two recent pilot projects, INDEPENDENT and SmartCare, to show what can be achieved through the use of ICT-supported, integrated care and to show how it can be achieved under given framework conditions. The guiding question is which roads will actually lead to Rome and which will not. By simply adding ICT to current care practices one will most likely not end up with better care. Rather, the authors argue that a multi-pronged innovation approach needs to be pursued, one that simultaneously pays attention to the stakeholders involved, to the particular working models of the different care actors, and to the technologies to be employed. Using such an approach is shown to considerably increase the likelihood of achieving positive impacts on different levels, even if risks and uncertainty cannot be completely avoided.
Technology for Integrated eCare
Authors: Rijnen Wil , Bierhoff Ilse , Gómez Rafael Llarena , Vellidou Eleftheria , Angelidis Pantelis
Published: July 2014

Today, healthcare and social care services are often delivered independently. This can lead to inefficiencies, duplication of resources, and potentially to reduced levels of care quality. Older people are particularly affected by this situation, since they often need both types of services, such as support with daily living activities and chronic disease management. At the same time, the potential of Information and Communication Technology (ICT) to support integrated service delivery remains largely unexploited. Against this background, many are the technologies that might offer a suitable canvas for integrated care, particularly to more vulnerable social groups. The main goal of this chapter is to provide insight into the most promising technologies for facilitation of integrated care, such as Ambient Intelligence, Internet of Things, Robotics, Service Platforms, etc., and to discuss the potential of combined technologies to yield efficient and well-accepted solutions.
Telemedically Augmented Palliative Care
Authors: Nemecek Romina , Huber Patrick , Schur Sophie , Masel Eva , Porkert Stefanie , Hofer Barbara , Watzke Herbert , Zielinski Christoph , Binder Michael
Published: July 2014

Patients with advanced cancer have a substantial symptom burden, which deteriorates their quality of life. Palliative care improves well-being of patients and their family caregivers. Within the scope of a controlled pilot study, a user-friendly telepresence system is developed, which enables patients and family caregivers to send a direct request to a palliative care team. Additionally, a specially tailored database is developed, which contains up to date patient information. Twenty patients with advanced non-small cell lung cancer are consecutively assigned in a control and an intervention group. The intervention group receives the telemedically augmented care, whereas the control group receives standard care. The primary goal of this chapter is to determine the usability and feasibility; the secondary goal is the assessment of the intervention's impact on quality of life and the number of unscheduled hospital admissions. To sum up, telemedically supported ambulatory palliative care may synergistically help to improve safety and quality of life.
Integrated eCare in Dementia
Authors: Delaney Sarah
Published: July 2014

This chapter describes the evaluation of the INDEPENDENT project as it was implemented in Ireland. The project in Ireland consisted of the collaboration of the Alzheimer Society of Ireland, a not-for-profit organization providing services for people with dementia and their family carers, and Tunstall Emergency Response (TER), a commercial telecare provider organization. A joint client database was developed that provided information on alerts and events generated by the telecare system to ASI staff. An evaluation was undertaken with family carers, staff, and key stakeholders in ASI and TER. The telecare packages were given a high satisfaction rating by family carers. The Web portal was seen as beneficial by staff, in that it provided close-to-real time access to information on telecare alerts and events that could enhance care planning. However, staff regarded the portal as difficult to navigate and use. Key informants in ASI and TER both viewed the Web portal as enhancing the reputation of their organization.
Exploring public bus service quality in South Africa: A structural equation modelling approach
Authors: Vilakazi Ayanda M. , Govender Krishna K.
Published: July 2014

This study, which is a deviation from the usual practice of using SERVQUAL or an adaptedversion thereof, uses McKnight, Pagano and Paaswell’s (1986) service quality dimensions,namely reliability; extent of service; comfort; safety; and affordability (RECSA) and structuralequation modelling to determine commuters’ perception of public bus service quality in amajor city in South Africa. The RECSA model was adapted and fitted to the data collectedfrom a convenience sample of bus commuters in Johannesburg, using structural equationmodelling. It was ascertained that reliability, service, comfort and safety influenced thepublic bus commuters’ perception of the overall service quality. The implications of theaforementioned findings for providers of public bus services are explained.
Computerized Provider Order Entry Reduces Length of Stay in a Community Hospital
Authors: Peters K. , Shaha S.H. , Schreiber R.
Published: July 2014

Objective: Does computerized provider order entry (CPOE) improve clinical, cost, and efficiency outcomes as quantified in shortened hospital length of stay (LOS)? Most prior studies were done in university settings with home-grown electronic records, and are now 20 years old. This study asked whether CPOE exerts a downward force on LOS in the current era of HITECH incentives, using a vendor product in a community hospital.

Methods: The methodology retrospectively evaluated correlation between CPOE and LOS on a per-patient, per-visit basis over 22 consecutive quarters, organized by discipline. All orders from all areas were eligible, except verbals, and medication orders in the emergency department which were not available via CPOE. These results were compared with quarterly case mix indices organized by discipline. Correlational and regression analyses were cross-checked to ensure validity of R-square coefficients, and data were smoothed for ease of display. Standard models were used to calculate the inflection point.

Results: Gains in CPOE adoption occurred iteratively house-wide, and in each discipline. LOS decreased in a sigmoid shaped curve. The inflection point shows that once CPOE adoption approaches 60%, further lowering of LOS accelerates. Overall there was a 20.2% reduction in LOS correlated with adoption of CPOE. Case mix index increased during the study period showing that reductions in LOS occurred despite increased patient complexity and resource utilization.

Conclusions: There was a 20.2% reduction in LOS correlated with rising adoption of CPOE. CPOE contributes to improved clinical, cost, and efficiency outcomes as quantified in reduced LOS, over and above other processes introduced to lower LOS. CPOE enabled a reduction in LOS despite an increase in the case mix index during the time frame of this study.

Citation: Schreiber R, Peters K, Shaha SH. Computerized provider order entry reduces length of stay in a community hospital. Appl Clin Inf 2014; 5: 685–698

http://dx.doi.org/10.4338/ACI-2014-04-RA-0029
Nursing Home Closures, Changes in Ownership, and Competition
Authors: Castle Nicholas G.
Published: July 2014

This research examines the relationship of competition among nursing homes and the likelihood of their closure or change in ownership. The study uses nationally representative data from the 1992–1998 Online Survey, Certification, and Reporting system, and is supplemented with several other primary and secondary data sources. It is hypothesized that facilities located in more competitive environments will be more likely to close. Multinomial logistic regression analyses are employed to examine this hypothesis in a model containing organizational and aggregate resident characteristics, and market factors. The Herfindahl index is used as a measure of competition. The descriptive analysis shows that 621 nursing homes closed and 6,471 changed ownership from 1992 to 1998. The incidence rate of closures was .7% of facilities per year. The multivariate analysis shows that facilities located in more competitive environments were significantly more likely to close.
The Impact of Elder Care on Women's Labor Supply
Authors: Johnson Richard W. , Lo Sasso Anthony T.
Published: July 2014

Adult daughters traditionally have served as primary caregivers for frail unmarried adults, but the levels of care they have provided in the past may interfere with their growing work responsibilities. This paper examines the impact of time transfers to elderly parents on labor supply at midlife. Using a sample of women ages 55 to 67 in the Health and Retirement Study, we estimate panel data models of annual hours of paid work controlling for the endogeneity of time assistance to parents. The results indicate that time help to parents strongly reduces female labor supply at midlife.
Health Insurance Coverage for Vulnerable Populations: Contrasting Asian Americans and Latinos in the United States
Authors: Alegría Margarita , Cao Zhun , McGuire Thomas G. , Ojeda Victoria D. , Sribney Bill , Woo Meghan , Takeuchi David
Published: July 2014

This paper examines the role that population vulnerabilities play in insurance coverage for a representative sample of Latinos and Asians in the United States. Using data from the National Latino and Asian American Study (NLAAS), these analyses compare coverage differences among and within ethnic subgroups, across states and regions, among types of occupations, and among those with or without English language proficiency. Extensive differences exist in coverage between Latinos and Asians, with Latinos more likely to be uninsured. Potential explanations include the type of occupations available to Latinos and Asians, reforms in immigration laws, length of time in the United States, and regional differences in safety-net coverage. Policy implications are discussed.
Economic Profiling of Physician Specialists: Use of Outlier Treatment and Episode Attribution Rules
Authors: Thomas J. William , Ward Kathleen
Published: July 2014

This paper examines the influence of episode attribution methodology and cost outlier methodology on the accuracy of physicians' economic profiles. Four years of claims data from a mixed model HMO were processed using the leading episode grouper software. Episode grouped results then were applied to construct input distributions for a simulation model. For each of four specialties (cardiology, family practice, general surgery, and neurology), we employed sets of 18 simulations to investigate the effects of three alternative episode attribution methodologies and six alternative cost outlier methodologies on sensitivity, specificity, and positive predictive error in classifying cost-efficient and cost-inefficient physicians. For identification of cost-efficient physicians, the most accurate profiling results were obtained when Winsorizing outliers at 2% and 98% of episode-type cost distributions, and attributing responsibility for episode costs to physicians who accounted for at least 30% of associated professional and prescribing fees. No consistent combination of outlier methodology and episode attribution rule was found to be superior for identifying cost-inefficient physicians.
Influence of aerosol chemical composition on N2O5 uptake: airborne regional measurements in North-Western Europe
Authors: Morgan W. T. , Ouyang B. , Allan J. D. , Aruffo E. , Di Carlo P. , Kennedy O. J. , Lowe D. , Flynn M. J. , Rosenberg P. D. , Williams P. I. , Jones R. , McFiggans G. B. , Coe H.
Published: July 2014

Abstract. Aerosol chemical composition was found to influence nighttime atmospheric chemistry during a series of airborne measurements in North-Western Europe in summer conditions, which has implications for regional air quality and climate. The uptake of dinitrogen pentoxide, γ (N2O5), to particle surfaces was found to be modulated by the amount of water content and ammonium nitrate present in the aerosol. The conditions prevalent in this study suggest that the net uptake rate of N2O5 to atmospheric aerosols was relatively efficient compared to previous studies, with γ (N2O5) values in the range 0.01–0.03. This is likely a consequence of the elevated relative humidity in the region, which promotes greater aerosol water content. Increased nitrate concentrations relative to particulate water were found to suppress N2O5 uptake. The results presented here contrast with previous ambient studies of N2O5 uptake, which have generally taken place in low-nitrate environments in the USA. Comparison of the N2O5 uptake derived from the measurements with a parameterised scheme that is based on the ratio of particulate water to nitrate yielded reasonably good agreement in terms of the magnitude and variation in uptake, provided the effect of chloride was neglected. An additional suppression of the parameterised uptake is likely required to fully capture the variation in N2O5 uptake, which could be achieved via the known suppression by organic aerosol. However, existing parameterisations representing the suppression by organic aerosol were unable to fully represent the variation in N2O5 uptake. These results provide important ambient measurement constraint on our ability to predict N2O5 uptake in regional and global aerosol models. N2O5 uptake is a potentially important source of nitrate aerosol and a sink of the nitrate radical, which is the main nocturnal oxidant in the atmosphere. The results further highlight the importance of ammonium nitrate in North-Western Europe as a key component of atmospheric composition in the region.
High-precision quasi-continuous atmospheric greenhouse gas measurements at Trainou tower (Orléans forest, France)
Authors: Schmidt M. , Lopez M. , Yver Kwok C. , Messager C. , Ramonet M. , Wastine B. , Vuillemin C. , Truong F. , Gal B. , Parmentier E. , Cloué O. , Ciais P.
Published: July 2014

Abstract. Results from the Trainou tall tower measurement station installed in 2006 are presented for atmospheric measurements of CO2, CH4, N2O, SF6, CO, H2 mole fractions and radon-222 activity. Air is sampled from four sampling heights (180, 100, 50 and 5 m) of the Trainou 200 m television tower in the Orléans forest in France (47°57'53" N, 2°06'45" E, 131 m a.s.l.). The station is equipped with a custom-built CO2 analyser (CARIBOU), which is based on a commercial non-dispersive, infrared (NDIR) analyser (Licor 6252), and a coupled gas chromatography (GC) system equipped with an electron capture detector (ECD) and a flame ionization detector (FID) (HP6890N, Agilent) and a reduction gas detector (PP1, Peak Performer). Air intakes, pumping and air drying system are shared between the CARIBOU and the GC systems. The ultimately achieved short-term repeatability (1 sigma, over several days) for the GC system is 0.05 ppm for CO2, 1.4 ppb for CH4, 0.25 ppb for N2O, 0.08 ppb for SF6, 0.88 ppb for CO and 3.8 for H2. The repeatability of the CARIBOU CO2 analyser is 0.06 ppm. In addition to the in situ measurements, weekly flask sampling is performed, and flask air samples are analysed at the Laboratoire des Sciences du Climat et de l'Environnement (LSCE) central laboratory for the same species as well for stable isotopes of CO2. The comparison between in situ measurements and the flask sampling showed averaged differences of 0.08 ± 1.40 ppm for CO2, 0.7 ± 7.3 ppb for CH4, 0.6 ± 0.6 ppb for N2O, 0.01 ± 0.10 ppt for SF6, 1.5± 5.3 ppb for CO and 4.8± 6.9 ppb for H2 for the years 2008–2012. At Trainou station, the mean annual increase rates from 2007 to 2011 at the 180 m sampling height were 2.2 ppm yr−1 for CO2, 4 ppb yr−1 for CH4, 0.78 ppb yr−1 for N2O and 0.29 ppt yr−1 for SF6. For all species, the 180 m sampling level showed the smallest diurnal variation. Mean diurnal gradients between the 50 m and the 180 m sampling level reached up to 30 ppm CO2, 15 ppm CH4 or 0.5 ppb N2O during nighttime whereas the mean gradients are smaller than 0.5 ppm for CO2 and 1.5 ppb for CH4 during afternoon.
Improving a plot-scale methane emission model and its performance at a northeastern Siberian tundra site
Authors: Mi Y. , van Huissteden J. , Parmentier F. J. W. , Gallagher A. , Budishchev A. , Berridge C. T. , Dolman A. J.
Published: July 2014

Abstract. In order to better address the feedbacks between climate and wetland methane (CH4) emissions, we tested several mechanistic improvements to the wetland CH4 emission model Peatland-VU with a longer Arctic data set than any other model: (1) inclusion of an improved hydrological module, (2) incorporation of a gross primary productivity (GPP) module, and (3) a more realistic soil-freezing scheme. A long time series of field measurements (2003–2010) from a tundra site in northeastern Siberia is used to validate the model, and the generalized likelihood uncertainty estimation (GLUE) methodology is used to test the sensitivity of model parameters. Peatland-VU is able to capture both the annual magnitude and seasonal variations of the CH4 flux, water table position, and soil thermal properties. However, detailed daily variations are difficult to evaluate due to data limitation. Improvements due to the inclusion of a GPP module are less than anticipated, although this component is likely to become more important at larger spatial scales because the module can accommodate the variations in vegetation traits better than at plot scale. Sensitivity experiments suggest that the methane production rate factor, the methane plant oxidation parameter, the reference temperature for temperature-dependent decomposition, and the methane plant transport rate factor are the most important parameters affecting the data fit, regardless of vegetation type. Both wet and dry vegetation cover are sensitive to the minimum water table level; the former is also sensitive to the runoff threshold and open water correction factor, and the latter to the subsurface water evaporation and evapotranspiration correction factors. These results shed light on model parameterization and future improvement of CH4 modelling. However, high spatial variability of CH4 emissions within similar vegetation/soil units and data quality prove to impose severe limits on model testing and improvement.
A simplified permafrost-carbon model for long-term climate studies with the CLIMBER-2 coupled earth system model
Authors: Crichton K. A. , Roche D. M. , Krinner G. , Chappellaz J.
Published: July 2014

Abstract. We present the development and validation of a simplified permafrost-carbon mechanism for use with the land surface scheme operating in the CLIMBER-2 earth system model. The simplified model estimates the permafrost fraction of each grid cell according to the balance between modelled cold (below 0 °C) and warm (above 0 °C) days in a year. Areas diagnosed as permafrost are assigned a reduction in soil decay, thus creating a slow accumulating soil carbon pool. In warming climates, permafrost extent reduces and soil decay increases, resulting in soil carbon release to the atmosphere. Four accumulation/decay rate settings are retained for experiments within the CLIMBER-2(P) model, which are tuned to agree with estimates of total land carbon stocks today and at the last glacial maximum. The distribution of this permafrost-carbon pool is in broad agreement with measurement data for soil carbon concentration per climate condition. The level of complexity of the permafrost-carbon model is comparable to other components in the CLIMBER-2 earth system model.
Floods and climate: emerging perspectives for flood risk assessment and management
Authors: Merz B. , Aerts J. , Arnbjerg-Nielsen K. , Baldi M. , Becker A. , Bichet A. , Blöschl G. , Bouwer L. M. , Brauer A. , Cioffi F. , Delgado J. M. , Gocht M. , Guzzetti F. , Harrigan S. , Hirschboeck K. , Kilsby C. , Kron W. , Kwon H.-H. , Lall U. , Merz R. , Nissen K. , Salvatti P. , Swierczynski T. , Ulbrich U. , Viglione A. , Ward P. J. , Weiler M. , Wilhelm B. , Nied M.
Published: July 2014

Abstract. Flood estimation and flood management have traditionally been the domain of hydrologists, water resources engineers and statisticians, and disciplinary approaches abound. Dominant views have been shaped; one example is the catchment perspective: floods are formed and influenced by the interaction of local, catchment-specific characteristics, such as meteorology, topography and geology. These traditional views have been beneficial, but they have a narrow framing. In this paper we contrast traditional views with broader perspectives that are emerging from an improved understanding of the climatic context of floods. We come to the following conclusions: (1) extending the traditional system boundaries (local catchment, recent decades, hydrological/hydraulic processes) opens up exciting possibilities for better understanding and improved tools for flood risk assessment and management. (2) Statistical approaches in flood estimation need to be complemented by the search for the causal mechanisms and dominant processes in the atmosphere, catchment and river system that leave their fingerprints on flood characteristics. (3) Natural climate variability leads to time-varying flood characteristics, and this variation may be partially quantifiable and predictable, with the perspective of dynamic, climate-informed flood risk management. (4) Efforts are needed to fully account for factors that contribute to changes in all three risk components (hazard, exposure, vulnerability) and to better understand the interactions between society and floods. (5) Given the global scale and societal importance, we call for the organization of an international multidisciplinary collaboration and data-sharing initiative to further understand the links between climate and flooding and to advance flood research.